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Li Y, Stewart CA, Finer Y. Advanced Antimicrobial and Anti-Infective Strategies to Manage Peri-Implant Infection: A Narrative Review. Dent J (Basel) 2024; 12:125. [PMID: 38786523 PMCID: PMC11120417 DOI: 10.3390/dj12050125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/21/2024] [Accepted: 04/25/2024] [Indexed: 05/25/2024] Open
Abstract
Despite reductions in bacterial infection and enhanced success rate, the widespread use of systemic antibiotic prophylaxis in implant dentistry is controversial. This use has contributed to the growing problem of antimicrobial resistance, along with creating significant health and economic burdens. The basic mechanisms that cause implant infection can be targeted by new prevention and treatment methods which can also lead to the reduction of systemic antibiotic exposure and its associated adverse effects. This review aims to summarize advanced biomaterial strategies applied to implant components based on anti-pathogenic mechanisms and immune balance mechanisms. It emphasizes that modifying the dental implant surface and regulating the early immune response are promising strategies, which may further prevent or slow the development of peri-implant infection, and subsequent failure.
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Affiliation(s)
- Yihan Li
- Faculty of Dentistry, University of Toronto, 124 Edward St., Toronto, ON M5G 1G6, Canada; (Y.L.); (C.A.S.)
| | - Cameron A. Stewart
- Faculty of Dentistry, University of Toronto, 124 Edward St., Toronto, ON M5G 1G6, Canada; (Y.L.); (C.A.S.)
- Institute of Biomedical Engineering, University of Toronto, 164 College St., Toronto, ON M5S 3E2, Canada
| | - Yoav Finer
- Faculty of Dentistry, University of Toronto, 124 Edward St., Toronto, ON M5G 1G6, Canada; (Y.L.); (C.A.S.)
- Institute of Biomedical Engineering, University of Toronto, 164 College St., Toronto, ON M5S 3E2, Canada
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2
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Zheng Y, Yang Y, Liu X, Liu P, Li X, Zhang M, Zhou E, Zhao Z, Wang X, Zhang Y, Zheng B, Yan Y, Liu Y, Xu D, Cao L. Accelerated corrosion of 316L stainless steel in a simulated oral environment via extracellular electron transfer and acid metabolites of subgingival microbiota. Bioact Mater 2024; 35:56-66. [PMID: 38283387 PMCID: PMC10810744 DOI: 10.1016/j.bioactmat.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/26/2023] [Accepted: 01/08/2024] [Indexed: 01/30/2024] Open
Abstract
316L stainless steel (SS) is widely applied as microimplant anchorage (MIA) due to its excellent mechanical properties. However, the risk that the oral microorganisms can corrode 316L SS is fully neglected. Microbiologically influenced corrosion (MIC) of 316L SS is essential to the health and safety of all patients because the accelerated corrosion caused by the oral microbiota can trigger the release of Cr and Ni ions. This study investigated the corrosion behavior and mechanism of subgingival microbiota on 316L SS by 16S rRNA and metagenome sequencing, electrochemical measurements, and surface characterization techniques. Multispecies biofilms were formed by the oral subgingival microbiota in the simulated oral anaerobic environment on 316L SS surfaces, significantly accelerating the corrosion in the form of pitting. The microbiota samples collected from the subjects differed in biofilm compositions, corrosion behaviors, and mechanisms. The oral subgingival microbiota contributed to the accelerated corrosion of 316L SS via acidic metabolites and extracellular electron transfer. Our findings provide a new insight into the underlying mechanisms of oral microbial corrosion and guide the design of oral microbial corrosion-resistant materials.
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Affiliation(s)
- Ying Zheng
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Yi Yang
- Shenyang National Laboratory for Materials Science, Northeastern University, Shenyang, China
- State Key Laboratory of Rolling and Automation, Northeastern University, Shenyang, China
| | - Xianbo Liu
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Pan Liu
- Shenyang National Laboratory for Materials Science, Northeastern University, Shenyang, China
- State Key Laboratory of Rolling and Automation, Northeastern University, Shenyang, China
| | - Xiangyu Li
- Shenyang National Laboratory for Materials Science, Northeastern University, Shenyang, China
- State Key Laboratory of Rolling and Automation, Northeastern University, Shenyang, China
| | - Mingxing Zhang
- Shenyang National Laboratory for Materials Science, Northeastern University, Shenyang, China
- State Key Laboratory of Rolling and Automation, Northeastern University, Shenyang, China
| | - Enze Zhou
- Shenyang National Laboratory for Materials Science, Northeastern University, Shenyang, China
- State Key Laboratory of Rolling and Automation, Northeastern University, Shenyang, China
| | - Zhenjin Zhao
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Xue Wang
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Yuanyuan Zhang
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Bowen Zheng
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Yuwen Yan
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Yi Liu
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Dake Xu
- Shenyang National Laboratory for Materials Science, Northeastern University, Shenyang, China
- State Key Laboratory of Rolling and Automation, Northeastern University, Shenyang, China
- Electrobiomaterials Institute, Key Laboratory for Anisotropy and Texture of Materials (Ministry of Education), Northeastern University, Shenyang, China
| | - Liu Cao
- College of Basic Medical Sciences, Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, China
- Institute of Health Sciences, China Medical University, Shenyang, China
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3
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Sanhueza C, Pavéz M, Hermosilla J, Rocha S, Valdivia-Gandur I, Manzanares MC, Beltrán V, Acevedo F. Poly-3-hydroxybutyrate-silver nanoparticles membranes as advanced antibiofilm strategies for combatting peri-implantitis. Int J Biol Macromol 2024; 269:131974. [PMID: 38692546 DOI: 10.1016/j.ijbiomac.2024.131974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 04/26/2024] [Accepted: 04/28/2024] [Indexed: 05/03/2024]
Abstract
Dental implant success is threatened by peri-implantitis, an inflammation leading to implant failure. Conventional treatments struggle with the intricate microbial and host factors involved. Antibacterial membranes, acting as barriers and delivering antimicrobials, may offer a promising solution. Thus, this study highlights the potential of developing antibacterial membranes of poly-3-hydroxybutyrate and silver nanoparticles (Ag Nps) to address peri-implantitis challenges, discussing design and efficacy against potential pathogens. Electrospun membranes composed of PHB microfibers and Ag Nps were synthesized in a blend of DMF/chloroform at three different concentrations. Various studies were conducted on the characterization and antimicrobial activity of the membranes. The synthesized Ag Nps ranged from 4 to 8 nm in size. Furthermore, Young's modulus decreased, reducing from 13.308 MPa in PHB membranes without Ag Nps to 0.983 MPa in PHB membranes containing higher concentrations of Ag Nps. This demonstrates that adding Ag Nps results in a less stiff membrane. An increase in elongation at break was noted with the rise in Ag Nps concentration, from 23.597 % in PHB membranes to 60.136 % in PHB membranes loaded with Ag Nps. The antibiotic and antibiofilm activity of the membranes were evaluated against Pseudomonas aeruginosa, Staphylococcus aureus, Streptococcus mutans, and Candida albicans. The results indicated that all PHB membranes containing Ag Nps exhibited potent antibacterial activity by inhibiting the growth of biofilms and planktonic bacteria. However, inhibition of C. albicans occurred only with the PHB-Ag Nps C membrane. These findings emphasize the versatility and potential of Ag Nps-incorporated membranes as a multifunctional approach for preventing and addressing microbial infections associated with peri-implantitis. The combination of antibacterial and antibiofilm properties in these membranes holds promise for improving the management and treatment of peri-implantitis-related complications.
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Affiliation(s)
- Claudia Sanhueza
- Center of Excellence in Translational Medicine - Scientific and Technology Bioresource Nucleus (CEMT- BIOREN), Faculty of Medicine, Universidad de La Frontera, Temuco, Chile; Scientific and Technological Bioresource Nucleus (BIOREN), Universidad de La Frontera, Temuco, Chile
| | - Mónica Pavéz
- Center of Excellence in Translational Medicine - Scientific and Technology Bioresource Nucleus (CEMT- BIOREN), Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Jeyson Hermosilla
- Center of Excellence in Translational Medicine - Scientific and Technology Bioresource Nucleus (CEMT- BIOREN), Faculty of Medicine, Universidad de La Frontera, Temuco, Chile; Doctoral Program in Sciences of Natural Resources, Universidad de La Frontera, Casilla 54-D, Temuco, Chile; Scientific and Technological Bioresource Nucleus (BIOREN), Universidad de La Frontera, Temuco, Chile
| | - Sebastián Rocha
- Escuela de Ingeniería, Facultad de Ciencias, Ingeniería y Tecnología, Universidad Mayor, Temuco, Chile
| | - Iván Valdivia-Gandur
- Biomedical Department, Universidad de Antofagasta, Av. Angamos 601, Antofagasta, Chile
| | - María-Cristina Manzanares
- Human Anatomy and Embryology Unit, Experimental Pathology and Therapeutics Department, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Víctor Beltrán
- Center of Excellence in Translational Medicine - Scientific and Technology Bioresource Nucleus (CEMT- BIOREN), Faculty of Medicine, Universidad de La Frontera, Temuco, Chile; Clinical Investigation and Dental Innovation Center (CIDIC), Dental School, Universidad de La Frontera, Temuco, Chile; Scientific and Technological Bioresource Nucleus (BIOREN), Universidad de La Frontera, Temuco, Chile.
| | - Francisca Acevedo
- Center of Excellence in Translational Medicine - Scientific and Technology Bioresource Nucleus (CEMT- BIOREN), Faculty of Medicine, Universidad de La Frontera, Temuco, Chile; Scientific and Technological Bioresource Nucleus (BIOREN), Universidad de La Frontera, Temuco, Chile; Department of Basic Sciences, Faculty of Medicine, Universidad de La Frontera, Casilla 54-D, Temuco, Chile.
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Zhou Z, Li A, Sun K, Guo D, Li T, Lu J, Tonin BSH, Ye Z, Watts DC, Wang T, Fu J. Synthesis of a novel monomer "DDTU-IDI" for the development of low-shrinkage dental resin composites. Dent Mater 2024; 40:608-618. [PMID: 38369405 DOI: 10.1016/j.dental.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/10/2024] [Accepted: 02/12/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVE The current dental resin composites often suffer from polymerization shrinkage, which can lead to microleakage and potentially result in recurring tooth decay. This study presents the synthesis of a novel monomer, (3,9-diethyl-1,5,7,11-tetraoxaspiro[5,5]undecane-3,9-diyl)bis(methylene) bis((2-(3-(prop-1-en-2-yl)phenyl)propan-2-yl)carbamate) (DDTU-IDI), and evaluates its effect in the formulation of low-shrinkage dental resin composites. METHODS DDTU-IDI was synthesized through a two-step reaction route, with the initial synthesis of the required raw material monomer 3,9-diethyl-3,9-dihydroxymethyl-1,5,7,11-tetraoxaspiro-[5,5] undecane (DDTU). The structures were confirmed using Fourier-transform infrared (FT-IR) spectroscopy and hydrogen nuclear magnetic resonance (1HNMR) spectroscopy. Subsequently, DDTU-IDI was incorporated into Bis-GMA-based composites at varying weight percentages (5, 10, 15, and 20 wt%). The polymerization reaction, degree of conversion, polymerization shrinkage, mechanical properties, physicochemical properties and biocompatibility of the low-shrinkage composites were thoroughly evaluated. Furthermore, the mechanical properties were assessed after a thermal cycling test with 10,000 cycles to determine the stability. RESULTS The addition of DDTU-IDI at 10, 15, and 20 wt% significantly reduced the polymerization volumetric shrinkage of the experimental resin composites, without compromising the degree of conversion, mechanical and physicochemical properties. Remarkably, at a monomer content of 20 wt%, the polymerization shrinkage was reduced to 1.83 ± 0.53%. Composites containing 10, 15, and 20 wt% DDTU-IDI exhibited lower water sorption and higher contact angle. Following thermal cycling, the composites exhibited no significant decrease in mechanical properties, except for the flexural properties. SIGNIFICANCE DDTU-IDI has favorable potential as a component which could produce volume expansion and increase rigidity in the development of low-shrinkage dental resin composites. The development of low-shrinkage composites containing DDTU-IDI appears to be a promising strategy for reducing polymerization shrinkage, thereby potentially enhancing the longevity of dental restorations.
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Affiliation(s)
- Zixuan Zhou
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University, Qingdao 266003, China; School of Stomatology, Qingdao University, Qingdao 266003, China
| | - Aihua Li
- College of Materials Science and Engineering, Qingdao University, Qingdao 266003, China
| | - Ke Sun
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University, Qingdao 266003, China; School of Stomatology, Qingdao University, Qingdao 266003, China
| | - Di Guo
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University, Qingdao 266003, China; School of Stomatology, Qingdao University, Qingdao 266003, China
| | - Tingting Li
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University, Qingdao 266003, China; School of Stomatology, Qingdao University, Qingdao 266003, China
| | - Jun Lu
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Bruna S H Tonin
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto 14040904, SP, Brazil
| | - Zhou Ye
- Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, 999077, Hong Kong S.A.R, China
| | - David C Watts
- University of Manchester, School of Medical Sciences, Oxford Road, M13 9PL Manchester, UK
| | - Ting Wang
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
| | - Jing Fu
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University, Qingdao 266003, China; School of Stomatology, Qingdao University, Qingdao 266003, China.
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5
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Bresser RA, Carvalho MA, Naves LZ, Melma H, Cune MS, Gresnigt MMM. Biomechanical behavior of molars restored with direct and indirect restorations in combination with deep margin elevation. J Mech Behav Biomed Mater 2024; 152:106459. [PMID: 38394767 DOI: 10.1016/j.jmbbm.2024.106459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/30/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024]
Abstract
STATEMENT OF PROBLEM The existing knowledge is insufficient for comprehending the fatigue survival and fracture resistance of molars that have deep approximal direct and indirect restorations, whether with or without deep margin elevation (DME). PURPOSE The aim of this laboratory and in silico study is to investigate the fatigue survival, fracture strength, failure pattern and tooth deformation of molars restored with DME in combination with a direct or indirect restoration. MATERIAL AND METHODS This study utilized 45 extracted sound human molars, divided into three groups (n = 15). Standardized 100% inter-cuspal inlay preparations were performed, extending 2 mm below the CEJ and immediate dentin sealing (IDS) was applied. Group 1 (Co_1) was restored with direct composite; Group 2 (Hyb_2) with a 2 mm DME of direct composite and a glass-ceramic lithium disilicate restoration; Group 3 (Cer_3) a glass-ceramic lithium disilicate restoration. All specimens were exposed to a fatigue process involving thermal-cyclic loading (50N for 1.2 × 106 cycles at 1.7 Hz, between 5 and 55 °C), if teeth survived, they were fractured using a load-to-failure test and failure types were analyzed. Finite element analysis (FEA) was conducted to assess tooth deformation and tensile stress in the restorations. Statistical evaluation of fracture strength was conducted using the Kruskal-Wallis test. Fisher's exact test was utilized to analyze the fracture types and repairability. A statistical significance level of α < 0.05 was set for all analyses. RESULTS All specimens successfully withstood the fatigue testing procedure, and no statistically significant differences in fracture strength were observed among the three groups (P > 0.05). The Fisher's exact test indicated a significant association between the restorative material and fracture type (F2 = 18.315, df = 2, P = 0.004), but also for repairability (F2 = 13.725, df = 2, P = 0.001). Crown-root fractures were significantly more common in the Cer_3 group compared to the Co_1 group (P = 0.001) and the Co_1 group had significantly more repairable fractures (F2 = 13.197, df = 2, P = 0.001). FEA revealed comparable outcomes of deformation among models and higher maximum tensile stress on models with higher frequency of catastrophic failures. CONCLUSIONS All tested restoration materials exhibited comparable fatigue survival and fracture strength in this laboratory and in silico study. However, it is important to recognize the potential for more severe and irreparable fractures when opting for deeply luted glass-ceramic inlay restorations in clinical practice. In such cases, it would be prudent to consider the alternative option being a direct composite approach, because of its more forgiving fracture types and repairability. CLINICAL IMPLICATIONS Molars with deep approximal direct and indirect restorations, whether with or without DME, are comparable in their fatigue survival and fracture resistance to withstand intra-oral forces. Deep direct restorations exhibit more repairable fractures compared to deeply luted glass-ceramics.
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Affiliation(s)
- Rijkje A Bresser
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, the Netherlands.
| | - Marco A Carvalho
- Dental School, Evangelical University of Goias, Anapolis, Brazil
| | - Lucas Z Naves
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, the Netherlands
| | - H Melma
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, the Netherlands
| | - Marco S Cune
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, the Netherlands; St. Antonius Hospital Nieuwegein, Department of Oral Maxillofacial Surgery, Prosthodontics and Special Dental Care, Nieuwegein, the Netherlands
| | - Marco M M Gresnigt
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, the Netherlands; Martini Hospital, Department of Special Dental Care, Groningen, the Netherlands
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Alarcón-Sánchez MA, Castro-Alarcón N, Sandoval-Guevara D, Vázquez-Villamar M, Fernández-Acosta K, Méndez-Gómez MY, Parra-Rojas I, Romero-Castro NS. Analysis of subgingival microbiota and IL-1β, TNF-α and CX3CL1 levels in gingival crevicular fluid of fixed dental prostheses. Dent Mater J 2024; 43:235-246. [PMID: 38417861 DOI: 10.4012/dmj.2023-136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
Prosthetic biomaterials can affect the composition of the subgingival microbiota and consequently the production of proinflammatory cytokines, causing damage to the periodontium. A total of 40 patients were divided into two groups: 20 with monolithic zirconia (MZ) prostheses and 20 with porcelain fused to metal (PFM) with nickel-chromium (Ni-Cr) alloy prostheses. Subgingival plaque and gingival crevicular fluid samples were taken. The Checkerboard technique for DNA-DNA hybridization and the enzyme-linked immunosorbent assay technique were performed. Teeth with MZ presented a lower percentage of bleeding on probing and tooth mobility compared to teeth with PFM with Ni-Cr alloy. Prosthodontic teeth harbored higher total levels of the 18 bacterial species than non-prosthodontic teeth. There was a higher prevalence of S. gordonii and V. parvula species in PFM with Ni-Cr alloy compared to MZ. There was an increase in IL-1β, TNF-α and CX3CL1 levels in PFM with Ni-Cr alloy compared to MZ. MZ is a candidate biomaterial with fewer negative effects on the periodontium, allowing for longer prostheses longevity in the mouth.
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Affiliation(s)
| | - Natividad Castro-Alarcón
- Department of Microbiology, Faculty of Chemical-Biological Sciences, Autonomous University of Guerrero
| | - Daniel Sandoval-Guevara
- Department of Implantology and Oral Rehabilitation, Faculty of Dentistry, Autonomous University of Guerrero
| | - Mirna Vázquez-Villamar
- Agricultural Microbiology Laboratory, Faculty of Agricultural and Environmental Science, Autonomous University of Guerrero
| | - Karla Fernández-Acosta
- Department of Implantology and Oral Rehabilitation, Faculty of Dentistry, Autonomous University of Guerrero
| | - Mayra Yanet Méndez-Gómez
- Department of Implantology and Oral Rehabilitation, Faculty of Dentistry, Autonomous University of Guerrero
| | - Isela Parra-Rojas
- Obesity and Diabetes Research Laboratory, Faculty of Chemical-Biological Sciences, Autonomous University of Guerrero
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Lehrkinder A, Rydholm O, Wänström A, Nakamura K, Örtengren U. The formation of cariogenic plaque to contemporary adhesive restorative materials: an in vitro study. Odontology 2024:10.1007/s10266-024-00913-5. [PMID: 38502470 DOI: 10.1007/s10266-024-00913-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 02/07/2024] [Indexed: 03/21/2024]
Abstract
The research exploiting the ability of dental materials to induce or prevent secondary caries (SC) development still seems inconclusive. Controlling bacterial adhesion by releasing bacteriostatic ions and improving the surface structure has been suggested to reduce the occurrence of SC. This paper analyses the impact of five distinctively composed dental materials on cariogenic biofilm formation. Forty-five specimens of three composites (CeramX Spectra ST, Admira Fusion, Beautifil II) and two glass-ionomers (Fuji II LC, Caredyne Restore), respectively, were incubated in bacterial suspension composed of Streptococcus mutans, Lactobacillus acidophilus, Streptococcus mitis, Streptococcus sanguinis, and Streptococcus salivarius at pH 7.0 and 5.5. Coverslips were used as a control. Adhered bacteria were collected after 2, 4, 6, 12, 24, and 48 h and analyzed using quantitative polymerase chain reaction (qPCR). Fluoride leakage was measured at each collection. The specimens' surface topography was assessed using interferometry. In the present study, surface roughness seemed to have a partial role in bacterial adhesion and biofilm formation, together with chemical composition of the materials tested. Despite differences in fluoride leakage, biofilm accumulation was similar across materials, but the number of adhered bacteria differed significantly. A release of other ions may also affect adhesion. These variations suggest that certain materials may be more prone to initiating secondary caries.
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Affiliation(s)
- Anna Lehrkinder
- Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Box 450, 405 30, Göteborg, Sweden
| | - Olivia Rydholm
- Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Box 450, 405 30, Göteborg, Sweden
| | - Anna Wänström
- Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Box 450, 405 30, Göteborg, Sweden
| | - Keisuke Nakamura
- Department of Advanced Free Radical Science, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Ulf Örtengren
- Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Box 450, 405 30, Göteborg, Sweden.
- Department of Material Science and Technology, Faculty of Odontology, Malmö University, Malmö, Sweden.
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Liu G, Yang L, Gao L, Ma Y, Wu X, Wang X, Hao Z. Durability of infiltrated resin application on white spot lesions after different challenges: An ex vivo study. J Prosthet Dent 2024; 131:500-507. [PMID: 35256186 DOI: 10.1016/j.prosdent.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 02/02/2022] [Accepted: 02/02/2022] [Indexed: 11/29/2022]
Abstract
STATEMENT OF PROBLEM Infiltrated resin has been widely used as a minimally invasive approach to masking white spot lesions and reinforcing demineralized enamel. Recent evidence confirms its satisfactory effect in the short term, but studies focusing on its long-term performance are lacking. PURPOSE The purpose of this ex vivo study was to evaluate the durability of infiltrated resin on white spot lesions after pH cycling and long-term thermocycling, staining, and toothbrushing. MATERIAL AND METHODS Four axial surfaces of 25 extracted human molars were sectioned and fabricated as specimens. The enamel surface of each specimen was prepared in 3 areas: sound enamel, demineralized enamel (white spot lesions), and demineralized enamel treated by infiltrated resin. Then, 4 specimens of each molar were allocated to different challenges simulating a 10-year follow-up: pH cycling, thermocycling, staining, and toothbrushing. The surface roughness, microhardness, and CIELab color values were measured before and after different treatments. A scanning electron microscope (SEM) was used to observe representative specimens. Linear mixed models were used to evaluate the effect of different treatments on microhardness, roughness, and color differences (ΔE) (α=.05). RESULTS Resin infiltration reduced the surface roughness and increased the microhardness of demineralized lesions, (P<.001) but the values of sound enamel at baseline were not reached. The pH cycling led to the greatest roughness values (515.6 ±56.9 nm) on resin-infiltrated lesions, followed by thermocycling (450.7 ±64.7 nm), toothbrushing (291.2 ±43.5 nm), and staining (183.6 ±49.3 nm) (all P<.001). Only pH cycling significantly decreased the microhardness of resin-infiltrated lesions (81.6 ±14.8 HV 0.2) after progressive demineralization (P<.001). No clinically identified differences were found between resin-infiltrated white spot lesions and sound enamel (ΔE=3.4 ±2.0) at baseline. However, resin-infiltrated lesions demonstrated significantly greater discoloration after pH cycling (ΔE=8.0 ±4.5, P<.001), thermocycling (ΔE=5.4 ±2.0, P=.014), and staining treatments (ΔE=10.4 ±3.2, P<.001) than sound enamel. CONCLUSIONS Infiltrated resin application reduced surface roughness, improved microhardness, and masked white spot lesions immediately. However, it could not reestablish the characteristics of sound enamel completely and resist chemical and mechanical challenges over time.
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Affiliation(s)
- Gen Liu
- Postgraduate student, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Ling Yang
- Associate Chief Physician, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Li Gao
- Associate Chief Physician, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Yuanyuan Ma
- Associate Chief Physician, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Xiangnan Wu
- Assistant Research Fellow, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Xiaodong Wang
- Associate Chief Physician, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Zhichao Hao
- Lecturer, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China.
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Sabino CF, Agarwalla SV, da Silva Rodrigues C, da Silva AC, Campos TMB, Tan KS, Rosa V, de Melo RM. Boron-containing coating yields enhanced antimicrobial and mechanical effects on translucent zirconia. Dent Mater 2024; 40:37-43. [PMID: 37880068 DOI: 10.1016/j.dental.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVES To evaluate the mechanical and antimicrobial properties of boron-containing coating on translucent zirconia (5Y-PSZ). METHODS 5Y-PSZ discs (Control) were coated with a glaze (Glaze), silver- (AgCoat), or boron-containing (BCoat) glasses. The coatings' antimicrobial potential was characterized using S. mutans biofilms after 48 h via viable colony-forming units (CFU), metabolic activity (CV) assays, and quantification of extracellular polysaccharide matrix (EPS). Biofilm architectures were imaged under scanning electron and confocal laser scanning microscopies (SEM and CLSM). The cytocompatibility was determined at 24 h via WST-1 and LIVE&DEAD assays using periodontal ligament stem cells (PDLSCs). The coatings' effects on properties were characterized by Vickers hardness, biaxial bending tests, and fractography analysis. Statistical analyses were performed via one-way ANOVA, Tukey's tests, Weibull analysis, and Pearson's correlation analysis. RESULTS BCoat significantly decreased biofilm formation, having the lowest CFU and metabolic activity compared with the other groups. BCoat and AgCoat presented the lowest EPS, followed by Glaze and Control. SEM and CLSM images revealed that the biofilms on BCoat were thin and sparse, with lower biovolume. In contrast, the other groups yielded robust biofilms with higher biovolume. The cytocompatibility was similar in all groups. BCoat, AgCoat, and Glaze also presented similar hardness and were significantly lower than Control. BCoat had the highest flexural strength, characteristic strength and Weibull parameters (σF: 625 MPa; σ0: 620 MPa; m = 11.5), followed by AgCoat (σF: 464 MPa; σ0: 478 MPa; m = 5.3). SIGNIFICANCE BCoat is a cytocompatible coating with promising antimicrobial properties that can improve the mechanical properties and reliability of 5Y-PSZ.
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Affiliation(s)
| | | | | | - Ana Carolina da Silva
- São Paulo State University, Department of Dental Materials and Prosthodontics, Brazil
| | | | - Kai Soo Tan
- Faculty of Dentistry, National University of Singapore, Singapore
| | - Vinicius Rosa
- Faculty of Dentistry, National University of Singapore, Singapore; ORCHIDS: Oral Care Health Innovations and Designs Singapore, National University of Singapore, Singapore.
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10
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Tu Y, Ren H, He Y, Ying J, Chen Y. Interaction between microorganisms and dental material surfaces: general concepts and research progress. J Oral Microbiol 2023; 15:2196897. [PMID: 37035450 PMCID: PMC10078137 DOI: 10.1080/20002297.2023.2196897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
Bacterial adhesion to dental materials’ surfaces is the initial cause of dental materials-related infections. Therefore, inhibiting bacterial adhesion is a critical step in preventing and controlling these infections. To this end, it is important to know how the properties of dental materials affect the interactions between microorganisms and material surfaces to produce materials without biological contamination. This manuscript reviews the mechanism of bacterial adhesion to dental materials, the relationships between their surface properties and bacterial adhesion, and the impact of bacterial adhesion on their surface properties. In addition, this paper summarizes how these surface properties impact oral biofilm formation and proposes designing intelligent dental material surfaces that can reduce biological contamination.
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Affiliation(s)
- Yan Tu
- Department of Endodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Huaying Ren
- Department of Endodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Yiwen He
- School of Stomatology, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiaqi Ying
- School of Stomatology, Zhejiang University School of Medicine, Hangzhou, China
| | - Yadong Chen
- Department of Endodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
- CONTACT Yadong Chen Department of Endodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou310000, China
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11
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Su G, Zhang Y, Jin C, Zhang Q, Lu J, Liu Z, Wang Q, Zhang X, Ma J. 3D printed zirconia used as dental materials: a critical review. J Biol Eng 2023; 17:78. [PMID: 38129905 PMCID: PMC10740276 DOI: 10.1186/s13036-023-00396-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
In view of its high mechanical performance, outstanding aesthetic qualities, and biological stability, zirconia has been widely used in the fields of dentistry. Due to its potential to produce suitable advanced configurations and structures for a number of medical applications, especially personalized created devices, ceramic additive manufacturing (AM) has been attracting a great deal of attention in recent years. AM zirconia hews out infinite possibilities that are otherwise barely possible with traditional processes thanks to its freedom and efficiency. In the review, AM zirconia's physical and adhesive characteristics, accuracy, biocompatibility, as well as their clinical applications have been reviewed. Here, we highlight the accuracy and biocompatibility of 3D printed zirconia. Also, current obstacles and a forecast of AM zirconia for its development and improvement have been covered. In summary, this review offers a description of the basic characteristics of AM zirconia materials intended for oral medicine. Furthermore, it provides a generally novel and fundamental basis for the utilization of 3D printed zirconia in dentistry.
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Affiliation(s)
- Guanyu Su
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Yushi Zhang
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Chunyu Jin
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Qiyue Zhang
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Jiarui Lu
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Zengqian Liu
- Shi-Changxu Innovation Center for Advanced Materials, Institute of Metal Research, Chinese Academy of Sciences, Shenyang, 110016, China
- School of Materials Science and Engineering, University of Science and Technology of China, Hefei, 230026, China
| | - Qiang Wang
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Xue Zhang
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China.
| | - Jia Ma
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China.
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12
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Le Bars P, Kouadio AA, Amouriq Y, Bodic F, Blery P, Bandiaky ON. Different Polymers for the Base of Removable Dentures? Part II: A Narrative Review of the Dynamics of Microbial Plaque Formation on Dentures. Polymers (Basel) 2023; 16:40. [PMID: 38201705 PMCID: PMC10780608 DOI: 10.3390/polym16010040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 12/04/2023] [Accepted: 12/08/2023] [Indexed: 01/12/2024] Open
Abstract
This review focuses on the current disparities and gaps in research on the characteristics of the oral ecosystem of denture wearers, making a unique contribution to the literature on this topic. We aimed to synthesize the literature on the state of current knowledge concerning the biological behavior of the different polymers used in prosthetics. Whichever polymer is used in the composition of the prosthetic base (poly methyl methacrylate acrylic (PMMA), polyamide (PA), or polyether ether ketone (PEEK)), the simple presence of a removable prosthesis in the oral cavity can disturb the balance of the oral microbiota. This phenomenon is aggravated by poor oral hygiene, resulting in an increased microbial load coupled with the reduced salivation that is associated with older patients. In 15-70% of patients, this imbalance leads to the appearance of inflammation under the prosthesis (denture stomatitis, DS). DS is dependent on the equilibrium-as well as on the reciprocal, fragile, and constantly dynamic conditions-between the host and the microbiome in the oral cavity. Several local and general parameters contribute to this balance. Locally, the formation of microbial plaque on dentures (DMP) depends on the phenomena of adhesion, aggregation, and accumulation of microorganisms. To limit DMP, apart from oral and lifestyle hygiene, the prosthesis must be polished and regularly immersed in a disinfectant bath. It can also be covered with an insulating coating. In the long term, relining and maintenance of the prosthesis must also be established to control microbial proliferation. On the other hand, several general conditions specific to the host (aging; heredity; allergies; diseases such as diabetes mellitus or cardiovascular, respiratory, or digestive diseases; and immunodeficiencies) can make the management of DS difficult. Thus, the second part of this review addresses the complexity of the management of DMP depending on the polymer used. The methodology followed in this review comprised the formulation of a search strategy, definition of the inclusion and exclusion criteria, and selection of studies for analysis. The PubMed database was searched independently for pertinent studies. A total of 213 titles were retrieved from the electronic databases, and after applying the exclusion criteria, we selected 84 articles on the possible microbial interactions between the prosthesis and the oral environment, with a particular emphasis on Candida albicans.
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Affiliation(s)
- Pierre Le Bars
- Department of Prosthetic Dentistry, Faculty of Dentistry, Nantes University, 1 Place Alexis Ricordeau, F-44042 Nantes, France; (A.A.K.); (Y.A.); (F.B.); (P.B.)
- Nantes University, Oniris, University of Angers, CHU Nantes (Clinical Investigation Unit Odontology), INSERM, Regenerative Medicine and Skeleton, RMeS, UMR 1229, F-44000 Nantes, France;
| | - Alain Ayepa Kouadio
- Department of Prosthetic Dentistry, Faculty of Dentistry, Nantes University, 1 Place Alexis Ricordeau, F-44042 Nantes, France; (A.A.K.); (Y.A.); (F.B.); (P.B.)
- Department of Prosthetic Dentistry, Faculty of Dentistry, CHU, Abidjan P.O. Box 612, Côte d’Ivoire
| | - Yves Amouriq
- Department of Prosthetic Dentistry, Faculty of Dentistry, Nantes University, 1 Place Alexis Ricordeau, F-44042 Nantes, France; (A.A.K.); (Y.A.); (F.B.); (P.B.)
- Nantes University, Oniris, University of Angers, CHU Nantes (Clinical Investigation Unit Odontology), INSERM, Regenerative Medicine and Skeleton, RMeS, UMR 1229, F-44000 Nantes, France;
| | - François Bodic
- Department of Prosthetic Dentistry, Faculty of Dentistry, Nantes University, 1 Place Alexis Ricordeau, F-44042 Nantes, France; (A.A.K.); (Y.A.); (F.B.); (P.B.)
- Nantes University, Oniris, University of Angers, CHU Nantes (Clinical Investigation Unit Odontology), INSERM, Regenerative Medicine and Skeleton, RMeS, UMR 1229, F-44000 Nantes, France;
| | - Pauline Blery
- Department of Prosthetic Dentistry, Faculty of Dentistry, Nantes University, 1 Place Alexis Ricordeau, F-44042 Nantes, France; (A.A.K.); (Y.A.); (F.B.); (P.B.)
- Nantes University, Oniris, University of Angers, CHU Nantes (Clinical Investigation Unit Odontology), INSERM, Regenerative Medicine and Skeleton, RMeS, UMR 1229, F-44000 Nantes, France;
| | - Octave Nadile Bandiaky
- Nantes University, Oniris, University of Angers, CHU Nantes (Clinical Investigation Unit Odontology), INSERM, Regenerative Medicine and Skeleton, RMeS, UMR 1229, F-44000 Nantes, France;
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13
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Albaqawi AH, Aljanakh MD, Alshammari BN, Alshammari MA, Alshammari RH, Alshammari GD, Alshammari BZ, AlShammari RA, Alturki RF, Madfa AA. Quality of Fixed Dental Prostheses and Patient Satisfaction in a Sample From Saudi Arabia. Cureus 2023; 15:e51063. [PMID: 38269215 PMCID: PMC10806941 DOI: 10.7759/cureus.51063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND The objective of the study was to retrospectively assess the clinical performance of dental prostheses, single crowns, and three-unit bridges to identify clinical biological and mechanical complications in the Ha'il province of Saudi Arabia. METHODS The study was conducted between March 2021 to October 2021 and included 421 patients who underwent crown and tooth-supported fixed partial denture (FPD) procedures at the Dental Polyclinics Center in the Ha'il region of Saudi Arabia from 2010-2020. The planned sampling approach was applied. Patients who underwent crown and FPD placements at the dental center within the scheduled period were identified through clinical assessments. The inclusion criteria were met by patients with three-unit FPDs and a single crown containing a natural contralateral tooth or teeth. A total of six general dentists conducted clinical exams. Patient satisfaction and technical and biological issues were the evaluation criteria for crowns and FPDs. The frequency and percentage of the various characteristics employed in the current investigation were ascertained using cross-tabulation. The Chi-square test was employed to assess the associations between categorical variables, with p-values ≤ 0.05 considered significant. Results: Marginal integrity was recorded in 332 participants (78.9%), which was satisfactory for the majority of the restoration. The acceptance morphology was present in 252 (59.9%) restorations. The highest rate of the restorations 274 (66.2%) had satisfactory color. In 86 cases (20.4%), there was visible periodontal depth of at least 5 mm. Three hundred and six (72.7%) of the fixed restorations had gingival bleeding connected to them, and 96 (22.8%) teeth had periapical lesions. A total of 311 patients (73.9%) reported they were satisfied with their fixed restorations. CONCLUSIONS The technical and biological complications noted in the current study were not higher compared with other studies of crowns and fixed dental prostheses. The majority of patients were satisfied with the restoration.
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Affiliation(s)
- Ahmed H Albaqawi
- Restorative Dental Science, College of Dentistry, University of Ha'il, Ha'il, SAU
| | - Mohammad D Aljanakh
- Restorative Dental Science, College of Dentistry, University of Ha'il, Ha'il, SAU
| | | | | | | | | | | | | | | | - Ahmed A Madfa
- Restorative Dental Science, College of Dentistry, University of Ha'il, Ha'il, SAU
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14
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Silva-Neto RD, Pelozo LL, Corona SA, Salvador SLDS, Sousa-Neto MD, Souza-Gabriel AE. Antibiofilm and antimicrobial activity of temporary filling materials on root canals: an in situ acid challenge. Braz J Microbiol 2023; 54:2781-2789. [PMID: 37610568 PMCID: PMC10689695 DOI: 10.1007/s42770-023-01103-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/14/2023] [Indexed: 08/24/2023] Open
Abstract
The present study evaluated the antibiofilm and antimicrobial effects of temporary restorative materials on root canals after an intra-oral challenge. Seventy roots were endodontically treated and divided into 5 groups: high-viscosity glass ionomer (HV-GIC), light-activated glass ionomer (RM-GIC), zinc-oxide cement without eugenol (ZO), zinc-oxide cement with eugenol (ZOE), and unsealed roots (negative control). For 28 days, 14 participants used intra-oral devices with five roots, and drops of sucrose were applied onto them. The amount of biofilm and the bacterial counts were analyzed by Kruskal-Wallis and Dunn, and by two-way ANOVA and Tukey (α = 0.05). HV-GIC and RM-GIC better inhibit biofilm, followed by ZO and ZOE. Unsealed roots had the largest biofilm accumulation (p = 0.002) and higher bacterial penetration than restored roots (p = 0.023). A low amount of Streptococcus was found in RM-GIC and ZOE-restored roots without difference from HV-GIC (p = 0.021). The low amount of Enterococcus (p = 0.003) was found in the ZOE-restored roots, without difference from GICs.
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Affiliation(s)
- Reinaldo Dias Silva-Neto
- Department of Restorative Dentistry, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Laís Lima Pelozo
- Department of Restorative Dentistry, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Silmara Aparecida Corona
- Department of Restorative Dentistry, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Sérgio Luiz de Souza Salvador
- Department of Clinical, Toxicological and Bromatological Analyses, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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15
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Lyons KM, Cannon RD, Beumer J, Bakr MM, Love RM. Microbial Analysis of Obturators During Maxillofacial Prosthodontic Treatment Over an 8-Year Period. Cleft Palate Craniofac J 2023; 60:1426-1441. [PMID: 35642284 DOI: 10.1177/10556656221104940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The aim of the study was to investigate the microbial colonization (by Candida species, anaerobic and facultative anaerobic bacteria) of maxillary obturators used for the restoration of maxillary defects, including during radiotherapy. Retrospective cohort study. Fifteen patients requiring a maxillary obturator prosthesis had swabs of their obturators and adjacent tissues taken at different stages of their treatment over a period of 8 years. Identification of microbial species from the swabs was carried out using randomly amplified polymorphic DNA polymerase chain reaction (RAPD PCR) analysis, checkerboard DNA-DNA hybridization, CHROMagar Candida chromogenic agar, and DNA sequencing. Candida species were detected in all patients and all patients developed mucositis and candidiasis during radiotherapy which was associated with an increase in colonization of surfaces with Candida spp., particularly C albicans. Microbial colonization increased during radiotherapy and as an obturator aged, and decreased following a reline, delivery of a new prosthesis, or antifungal treatment during radiotherapy. Microbial colonization of maxillary obturators was related to the stage of treatment, age of the obturator material, radiotherapy and antifungal medications, and antifungal treatment may be recommended if C albicans colonization of palatal tissues is greater than 105 colony-forming units per cm2 following the first week of radiotherapy.
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Affiliation(s)
- Karl M Lyons
- Department of Oral Rehabilitation and Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Richard D Cannon
- Department of Oral Sciences and Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - John Beumer
- Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, CA, USA
| | - Mahmoud M Bakr
- School of Medicine and Dentistry, Griffith University, Queensland, Australia
| | - Robert M Love
- School of Medicine and Dentistry, Griffith University, Queensland, Australia
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16
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Wang K, Wang S, Yin J, Yang Q, Yu Y, Chen L. Long-term application of silver nanoparticles in dental restoration materials: potential toxic injury to the CNS. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2023; 34:52. [PMID: 37855967 PMCID: PMC10587321 DOI: 10.1007/s10856-023-06753-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 09/20/2023] [Indexed: 10/20/2023]
Abstract
Silver nanoparticles (AgNPs) have durable and remarkable antimicrobial effects on pathogenic microorganisms, such as bacteria and fungi, in dental plaques. As such, they are widely added to dental restoration materials, including composite resins, denture bases, adhesives, and implants, to solve the problems of denture stomatitis, peri-implant inflammation, and oral infection caused by the long-term use of these dental restoration materials. However, AgNPs can be absorbed into the blood circulatory system through the nasal/oral mucosa, lungs, gastrointestinal tract, skin, and other pathways and then distributed into the lungs, kidneys, liver, spleen, and testes, thereby causing toxic injury to these tissues and organs. It can even be transported across the blood-brain barrier (BBB) and continuously accumulate in brain tissues, causing injury and dysfunction of neurons and glial cells; consequently, neurotoxicity occurs. Other nanomaterials with antibacterial or remineralization properties are added to dental restoration materials with AgNPs. However, studies have yet to reveal the neurotoxicity caused by dental restoration materials containing AgNPs. In this review, we summarize the application of AgNPs in dental restoration materials, the mechanism of AgNPs in cytotoxicity and toxic injury to the BBB, and the related research on the accumulation of AgNPs to cause changes of neurotoxicity. We also discuss the mechanisms of neurotoxicity caused by AgNPs and the mode and rate of AgNPs released from dental restorative materials added with AgNPs to evaluate the probability of neurotoxic injury to the central nervous system (CNS), and then provide a theoretical basis for developing new composite dental restoration materials. Mechanism of neurotoxicity caused by AgNPs: AgNPs in the blood circulation enter the brain tissue after being transported across the BBB through transendothelial cell pathway and paracellular transport pathway, and continuously accumulate in brain tissue, causing damage and dysfunction of neurons and glial cells which ultimately leads to neurotoxicity. The uptake of AgNPs by neurons, astrocytes and microglia causes damage to these cells. AgNPs with non-neurotoxic level often increases the secretion of a variety of cytokines, up-regulates the expression of metallothionein in glial cells, even up-regulates autophagy and inflammation response to protect neurons from the toxic damage of AgNPs. However, the protective effect of glial cells induced by AgNPs exposure to neurotoxic levels is insufficient, which leads to neuronal damage and dysfunction and even neuronal programmed cell death, eventually cause neurotoxicity.
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Affiliation(s)
- Kaimei Wang
- Guiyang Hospital of Stomatology, Guiyang, Guizhou Province, 563000, China
| | - Shiqi Wang
- The Medical unit of 65651 troops of Chinese people's Liberation Army, Jinzhou, Liaoning Province, 121100, China
| | - Jingju Yin
- Fujian Medical University; Department of Stomatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, 350002, China
| | - Qiankun Yang
- The Southwest Hospital of Army Medical University, Chongqing, 400038, China
| | - Yi Yu
- Guiyang Hospital of Stomatology, Guiyang, Guizhou Province, 563000, China
| | - Lin Chen
- Hospital of Stomatology, Zunyi Medical University, Zunyi, Guizhou Province, 563100, China.
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17
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Krishnan A, Rajendran R, Damodaran D, Manmadhan SK, Krishnan V. Long-term changes in thickness, live/dead bacterial ratio, and mineral content in biofilm on ceramic and stainless steel orthodontic attachments. J Orofac Orthop 2023; 84:251-258. [PMID: 36820892 DOI: 10.1007/s00056-023-00452-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 01/08/2023] [Indexed: 02/24/2023]
Abstract
PURPOSE Fixed orthodontic appliances induce biofilm deposition, which harbors a microbial population harmful to the periodontal health of the individual. The present study evaluated the changes in thickness, live/dead bacterial ratio, and mineral content in dental biofilm over 6 months in patients with either stainless steel or ceramic orthodontic attachments. METHODS Eighty patients who require fixed orthodontic appliance treatment with first premolar extraction for correcting their malocclusion were selected and bonded with either stainless steel or ceramic orthodontic attachments on the buccal side. The attached buttons were retrieved at different periods-1 week, 1 month, 3 months, and 6 months. They were stained and visualized through confocal microscopy to detect biofilm thickness and the ratio of live/dead bacteria. X‑ray diffraction was used to identify the presence of calcium and phosphorous. RESULTS Ceramic attachments showed a greater increase in biofilm thickness in comparison to stainless steel attachments except in the initial 1‑week evaluation. A higher live/dead bacterial ratio was observed in stainless steel attachments than in their ceramic counterparts at all four evaluation periods. Both stainless steel and ceramic surfaces exhibited the presence of mineral deposition (calcium and phosphorous) at all periods. CONCLUSIONS More biofilm adhesion was observed over ceramic surfaces than over stainless steel orthodontic attachments. Stainless steel attachments exhibited biofilm with a higher live/dead bacterial ratio than their ceramic counterparts at all evaluation periods. The presence of calcium and phosphorous in the adhered biofilm, pointing toward its calcification process, was identified.
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Affiliation(s)
- Anjali Krishnan
- Department of Orthodontics, Sri Sankara Dental College, Akathumuri, Varkala, Trivandrum, Kerala, India
| | - Rahul Rajendran
- Department of Orthodontics, Sri Sankara Dental College, Akathumuri, Varkala, Trivandrum, Kerala, India
| | - Deepak Damodaran
- Department of Orthodontics, Sri Sankara Dental College, Akathumuri, Varkala, Trivandrum, Kerala, India
| | - Sreelekshmi K Manmadhan
- Department of Orthodontics, Sri Sankara Dental College, Akathumuri, Varkala, Trivandrum, Kerala, India
| | - Vinod Krishnan
- Department of Orthodontics, Sri Sankara Dental College, Akathumuri, Varkala, Trivandrum, Kerala, India.
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18
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Papa S, Maalouf M, Claudel P, Sedao X, Di Maio Y, Hamzeh-Cognasse H, Thomas M, Guignandon A, Dumas V. Key topographic parameters driving surface adhesion of Porphyromonas gingivalis. Sci Rep 2023; 13:15893. [PMID: 37741851 PMCID: PMC10518006 DOI: 10.1038/s41598-023-42387-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/09/2023] [Indexed: 09/25/2023] Open
Abstract
Dental implant failure is primarily due to peri-implantitis, a consequence of bacterial biofilm formation. Bacterial adhesion is strongly linked to micro-/nano-topographies of a surface; thus an assessment of surface texture parameters is essential to understand bacterial adhesion. In this study, mirror polished titanium samples (Ti6Al4V) were irradiated with a femtosecond laser (fs-L) at a wavelength of 1030 nm (infrared) with variable laser parameters (laser beam polarization, number, spacing and organization of the impacts). Images of 3-D topographies were obtained by focal variation microscopy and analyzed with MountainsMap software to measure surface parameters. From bacteria associated with peri-implantitis, we selected Porphyromonas gingivalis to evaluate its adhesion on Ti6Al4V surfaces in an in vitro study. Correlations between various surface parameters and P. gingivalis adhesion were investigated. We discovered that Sa value, a common measure of surface roughness, was not sufficient in describing the complexity of these fs-L treated surfaces and their bacterial interaction. We found that Sku, density and mean depths of the furrows, were the most accurate parameters for this purpose. These results provide important information that could help anticipate the bacterial adhesive properties of a surface based on its topographic parameters, thus the development of promising laser designed biofunctional implants.
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Affiliation(s)
- Steve Papa
- INSERM, SAINBIOSE U1059, Mines Saint-Etienne, Université Jean Monnet Saint-Étienne, 42023, Saint-Étienne, France.
| | - Mathieu Maalouf
- INSERM, SAINBIOSE U1059, Mines Saint-Etienne, Université Jean Monnet Saint-Étienne, 42023, Saint-Étienne, France
| | - Pierre Claudel
- GIE Manutech-USD, 20 Rue Benoît Lauras, 42000, Saint-Étienne, France
| | - Xxx Sedao
- GIE Manutech-USD, 20 Rue Benoît Lauras, 42000, Saint-Étienne, France
- Laboratory Hubert Curien, UMR 5516 CNRS, Jean Monnet University, University of Lyon, 42000, Saint-Étienne, France
| | - Yoan Di Maio
- GIE Manutech-USD, 20 Rue Benoît Lauras, 42000, Saint-Étienne, France
| | - Hind Hamzeh-Cognasse
- INSERM, SAINBIOSE U1059, Mines Saint-Etienne, Université Jean Monnet Saint-Étienne, 42023, Saint-Étienne, France
| | - Mireille Thomas
- INSERM, SAINBIOSE U1059, Mines Saint-Etienne, Université Jean Monnet Saint-Étienne, 42023, Saint-Étienne, France
| | - Alain Guignandon
- INSERM, SAINBIOSE U1059, Mines Saint-Etienne, Université Jean Monnet Saint-Étienne, 42023, Saint-Étienne, France
| | - Virginie Dumas
- Ecole Centrale de Lyon, CNRS, ENTPE, LTDS, UMR5513, ENISE, Univ Lyon, 42023, Saint-Étienne, France
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19
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Li D, Yang L, Deng H, Li T, Zhang Z. Optimized titanium dioxide nanotubes for dental implants: Estimation of mechanical properties and effects on the biological behaviors of human gingival fibroblasts and oral bacteria. J Mech Behav Biomed Mater 2023; 144:105988. [PMID: 37406484 DOI: 10.1016/j.jmbbm.2023.105988] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 07/07/2023]
Abstract
The long-term successes of implant restorations rely on both appropriate osseointegration and robust soft tissue integration (STI). Numerous studies have reported that titanium dioxide nanotube (TNT) arrays formed by electrochemical anodization (EA) can promote early osteogenesis, but the mechanical stability of such modifications is often ignored and remains underexplored. In addition, relatively little research has been done on their effects on soft tissues integration. In this study, we developed mechanically robust TNT arrays using an optimized EA system. Subsequently, we immobilized a peptide, specifically D-amino K122-4, onto the anodized TNTs via polydopamine (PDA) films to enhance their mechanical properties. Surface morphology and composition were characterized by scanning electron microscopy (SEM), atomic force microscopy, and X-ray photoelectron spectroscopy. Mechanical properties, including the elastic modulus and hardness of TNTs modified Ti surfaces, were assessed using the nano-indention test. The adhesive strength of TNTs films to the substrate was measured using the nano scratch test. Furthermore, we evaluated the adhesion, spreading, and proliferation of human gingival fibroblasts (HGFs) and periodontal pathogenic bacteria such as Streptococcus mutans (S.m) and F. nucleatum (F.n) on the surface. Results showed that the elastic modulus, hardness, and adhesive strength of anodized TNTs were significantly enhanced by the incorporation of the D-amino K122-4 peptide. Live-dead staining and SEM observation suggested a decreased surface colonization by both bacterial species. The antibacterial rate of S.m and F. n was 81.5% and 71.7%, respectively, evaluated by colony counting method. Additionally, results of CCK8 assay showed that modified TNTs slightly stimulated HGFs attachment and proliferation while producing enhanced fluorescence of integrin β1 and F-actin, confirmed by laser confocal microscopy observation. Thus, D-amino K122-4 biofunctionalized TNTs present significantly improved mechanical properties, and the mechanically robust structures modulate HGFs proliferation and alignment, resulting in decreased bacteria growth. This novel strategy has the potential to create a surface coating for implants that exhibits superior mechanical robustness and enhanced surface-to-implant interactions.
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Affiliation(s)
- Dan Li
- Department of Prosthodontics, School of Stomatology, Capital Medical University, Beijing, People's Republic of China
| | - Lian Yang
- Department of Prosthodontics, School of Stomatology, Capital Medical University, Beijing, People's Republic of China; Department of Stomatology, Electric Power Teaching Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Hongyan Deng
- Department of Prosthodontics, School of Stomatology, Capital Medical University, Beijing, People's Republic of China
| | - Tao Li
- Department of Prosthodontics, School of Stomatology, Capital Medical University, Beijing, People's Republic of China.
| | - Zhenting Zhang
- Department of Prosthodontics, School of Stomatology, Capital Medical University, Beijing, People's Republic of China.
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20
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Shou Y, Deng L, Huang X, Peng X, Zhou X, Wang Z, Huang Y, Yang B, Wang H, Zhang M, Cheng L. Effects of Bio-Aging on Mechanical Properties and Microbial Behavior of Different Resin Composites. Biomolecules 2023; 13:1125. [PMID: 37509161 PMCID: PMC10377581 DOI: 10.3390/biom13071125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/08/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Under challenging oral environments, the overall performance of resin composites is affected by bio-aging. This study investigated the effects of saliva biofilm-induced bio-aging on the mechanical properties and microbial behavior of composites with different filler types. Microhybrid, nanohybrid, nano-filled and nano-filled flowable composites were bio-aged with saliva biofilm for 30 days. Surface morphology, roughness, mechanical and aesthetic properties were determined. A 48 h saliva biofilm model was used to evaluate the microbial behavior of different composites in vitro. Biofilm metabolic activity, lactic acid production and live/dead bacterial staining were tested. Six volunteers were selected to wear intra-oral appliances with composite slabs for 24 h and biofilms were collected and analyzed using 16S rRNA sequencing to assess the biofilm formation over those materials in situ. Although there were increasing trends, surface roughness, water resorption and material solubility had no significant changes for all groups after bio-aging (p > 0.05). There were no significant changes in elastic modulus for all groups after aging (p > 0.05). However, a decrease in flexural strength in all groups was observed (p < 0.05), except for the nanoflow composite group (p > 0.05). The Vickers hardness remained stable in all groups after aging (p > 0.05), except for the nano-filled group (p < 0.05). The nanoflow composite showed distinct color changes compared to the micro-hybrid group after aging (p < 0.05). Biofilm metabolic activity and lactic acid production in vitro increased slightly after bio-aging in all groups, but with no statistical significance (p > 0.05). The Shannon index diversity of biofilms in situ decreased after aging (p < 0.05), while no significant difference was shown in species composition at the genus level in all groups (p > 0.05). Resin composites with different sized fillers displayed a relatively stable mechanical performance and uncompromised microbial behavior both in vitro and in situ after 30 days of bio-aging. Based on the results, composites with different filler types can be selected flexibly according to clinical needs. However, a longer time for bio-aging is still needed to confirm the mechanical properties and microbial behaviors of composites in the long run.
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Affiliation(s)
- Yuke Shou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Lanzhi Deng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xiaoyu Huang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xinyu Peng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xinxuan Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Zheng Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yannan Huang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Bina Yang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Haohao Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Min Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Lei Cheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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21
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Alhotan A, Raszewski Z, Alamoush RA, Chojnacka K, Mikulewicz M, Haider J. Influence of Storing Composite Filling Materials in a Low-pH Artificial Saliva on Their Mechanical Properties-An In Vitro Study. J Funct Biomater 2023; 14:328. [PMID: 37367292 DOI: 10.3390/jfb14060328] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/17/2023] [Accepted: 06/18/2023] [Indexed: 06/28/2023] Open
Abstract
Restorative composites are subjected to various influences in the oral cavity environment, such as high or low temperatures, the mechanical force generated during mastication, colonization of various microorganisms, and low pH, which may result from ingested food and the influence of microbial flora. This study aimed to investigate the effect of a recently developed commercial artificial saliva (pH = 4, highly acidic) on 17 commercially available restorative materials. After polymerization, the samples were stored in an artificial solution for 3 and 60 days and subjected to crushing resistance and flexural strength tests. The surface additions of the materials were examined in terms of the shapes and sizes of the fillers and elemental composition. When stored in an acidic environment, the resistance of the composite materials was reduced by 2-12%. Larger compressive and flexural strength resistance values were observed for composites that could be bonded to microfilled materials (invented before 2000). This may result from the filler structure taking an irregular form, which results in a faster hydrolysis of silane bonds. All composite materials meet the standard requirements when stored for a long period in an acidic environment. However, storage of the materials in an acid environment has a destructive impact on the materials' properties.
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Affiliation(s)
- Abdulaziz Alhotan
- Department of Dental Health, College of Applied Medical Sciences, King Saud University, Riyadh P.O. Box 12372, Saudi Arabia
| | | | - Rasha A Alamoush
- Department of Prosthodontics, School of Dentistry, The University of Jordan, Amman 11942, Jordan
| | - Katarzyna Chojnacka
- Department of Advanced Material Technologies, Faculty of Chemistry, Wroclaw University of Science and Technology, Smoluchowskiego 25, 50-372 Wroclaw, Poland
| | - Marcin Mikulewicz
- Division of Facial Abnormalities, Department of Dentofacial Orthopaedics and Orthodontics, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland
| | - Julfikar Haider
- Department of Engineering, Manchester Metropolitan University, Manchester M1 5GD, UK
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22
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Vulović S, Nikolić-Jakoba N, Radunović M, Petrović S, Popovac A, Todorović M, Milić-Lemić A. Biofilm Formation on the Surfaces of CAD/CAM Dental Polymers. Polymers (Basel) 2023; 15:polym15092140. [PMID: 37177285 PMCID: PMC10181064 DOI: 10.3390/polym15092140] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/27/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
Dental polymers are now available as monolithic materials which can be readily used in computer-aided design and computer-aided manufacturing (CAD/CAM) systems. Despite possessing numerous advantages over conventionally produced polymers, the polymers produced by either of these systems fail to exhibit immunity to surface microbial adhesion when introduced into the oral environment, leading to the development of oral diseases. The aim of this study was to analyze the biofilm formation of six microorganisms from the oral cavity and its correlation to the surface characteristics of CAD/CAM dental polymers. A total of ninety specimens were divided into three groups: resin-based composite, polymethyl methacrylate, and polyether ether ketone. The experimental procedure included surface roughness and water contact angle measurements, colony forming unit counting, and scanning electron microscopy analysis of biofilm formed on the surface of the tested materials. The data were analyzed using the Kruskal-Wallis test, with a Dunn's post hoc analysis, and one way analysis of variance, with a Tukey's post hoc test; the correlation between the measurements was tested using Spearman's correlation coefficient, and descriptive statistics were used to present the data. Despite using the same manufacturing procedure, as well as the identical manufacturer's finishing and polishing protocols, CAD/CAM dental polymers revealed significant differences in surface roughness and water contact angle, and the increased values of both parameters led to an increase in biofilm formation on the surface of the materials. The CAD/CAM resin-based composite showed the lowest number of adhered microorganisms compared to CAD/CAM polymethyl methacrylate and CAD/CAM polyether ether ketone.
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Affiliation(s)
- Stefan Vulović
- Department of Prosthodontics, School of Dental Medicine, University of Belgrade, Rankeova 4, 11000 Belgrade, Serbia
| | - Nataša Nikolić-Jakoba
- Department of Periodontology and Oral Medicine, School of Dental Medicine, University of Belgrade, Dr Subotica 4, 11000 Belgrade, Serbia
| | - Milena Radunović
- Department of Microbiology and Immunology, School of Dental Medicine, University of Belgrade, Dr Subotica 1, 11000 Belgrade, Serbia
| | - Sanja Petrović
- Department of Microbiology and Immunology, School of Dental Medicine, University of Belgrade, Dr Subotica 1, 11000 Belgrade, Serbia
| | - Aleksandra Popovac
- Department of Prosthodontics, School of Dental Medicine, University of Belgrade, Rankeova 4, 11000 Belgrade, Serbia
| | - Miloš Todorović
- Department of Pediatric and Preventive Dentistry, School of Dental Medicine, University of Belgrade, Dr Subotica 11, 11000 Belgrade, Serbia
| | - Aleksandra Milić-Lemić
- Department of Prosthodontics, School of Dental Medicine, University of Belgrade, Rankeova 4, 11000 Belgrade, Serbia
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23
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Preparation of a fluorinated dental resin system and its anti-adhesive properties against S. mutans. Dent Mater 2023; 39:402-409. [PMID: 36894413 DOI: 10.1016/j.dental.2023.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 02/22/2023] [Accepted: 03/03/2023] [Indexed: 03/09/2023]
Abstract
OBJECTIVES The purpose of this study was to characterize physicochemical properties and investigate anti-bacterial adhesion effect of dental resins containing fluorinated monomers. METHOD Fluorinated dimethacrylate FDMA was mixed with commonly used reactive diluent triethylene- glycol dimethacrylate (TEGDMA) and fluorinated diluent 1 H,1 H-heptafluorobutyl methacrylate (FBMA) separately at a mass ratio of 60 wt./40 wt. to prepare fluorinated resin systems. Double bond conversion (DC), flexural strength (FS) and modulus (FM), water sorption (WS) and solubility (SL), contact angle and surface free energy, surface element concentration, and anti-adhesion effect against Streptococcus mutans (S. mutans) were investigated according to standard or referenced methods. 2,2-bis[4-(2-hydroxy-3-methacryloy-loxypropyl)-phenyl]propane (Bis-GMA)/TEGDMA (60/40, wt./wt.) was used as control. RESULTS Both fluorinated resin systems had higher DC than Bis-GMA based resin (p < 0.05); compared with Bis-GMA based resin (FS, FDMA/TEGDMA resin system had higher FS (p < 0.05) and comparable FM (p > 0.05), while FDMA/FBMA resins system had lower FS and FM (p < 0.05). Both fluorinated resin systems had lower WS and SL than Bis-GMA based resin (p < 0.05), and FDMA/TEGDMA resin system had the lowest WS (p < 0.05) in all experimental resin systems. Only FDMA/FBMA resin system showed lower surface free energy than Bis-GMA based resin (p < 0.05). When the surface was smooth, FDMA/FBMA resin system had lower amount of adherent S. mutans than Bis-GMA based resin (p < 0.05), while after the surface became roughness, FDMA/FBMA resin system had comparable amount of adherent S. mutans as Bis-GMA based resin (p > 0.05). SIGNIFICANCE Resin system prepared exclusively with fluorinated methacrylate monomers reduced the S. mutans adhesion due to their increased hydrophobicity and decreased surface energy., while flexural properties of it should be improved.
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24
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Evaluation of red-complex bacteria loads in complete denture patients: a pilot study. BDJ Open 2023; 9:7. [PMID: 36801907 PMCID: PMC9938684 DOI: 10.1038/s41405-023-00133-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/28/2023] [Accepted: 02/06/2023] [Indexed: 02/20/2023] Open
Abstract
OBJECTIVE This pilot study aimed to evaluate red-complex bacteria (RCB) loads in edentulous patients, before and after dentures' insertion. MATERIALS AND METHODS Thirty patients were included in the study. Deoxyribonucleic acid (DNA) isolated from bacterial samples were obtained from the dorsum of the tongue before and 3 months after complete dentures (CDs) insertion in order to identify the presence of RCB (Tannerella forsythia, Porphyromonas gingivalis, and Treponema denticola) and quantify their loads, using real-time polymerase chain reaction (RT-PCR). Bacterial loads were represented as "Lg (genome equivalents/sample)" and the data classified according to the "ParodontoScreen" test. RESULTS Significant changes in bacterial loads were observed before and 3 months after the CDs insertion for: P. gingivalis (0.40 ± 0.90 vs 1.29 ± 1.64, p = 0.0007), T. forsythia (0.36 ±0.94 vs 0.87 ± 1.45, p = 0.005), and T. denticola (0.11 ± 0.41 vs 0.33 ± 0.75, p = 0.03). Before the CDs insertion, all patients had a normal bacterial prevalence range (100%) for all analyzed bacteria. Three months after the insertion, 2 (6.7%) of them had a moderate bacterial prevalence range for P. gingivalis, while 28 (93.3%) had a normal bacterial prevalence range. CONCLUSION The use of CDs has a significant impact on increasing RCB loads in edentulous patients.
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25
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Chen WA, Dou Y, Fletcher HM, Boskovic DS. Local and Systemic Effects of Porphyromonas gingivalis Infection. Microorganisms 2023; 11:470. [PMID: 36838435 PMCID: PMC9963840 DOI: 10.3390/microorganisms11020470] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/16/2023] Open
Abstract
Porphyromonas gingivalis, a gram-negative anaerobe, is a leading etiological agent in periodontitis. This infectious pathogen can induce a dysbiotic, proinflammatory state within the oral cavity by disrupting commensal interactions between the host and oral microbiota. It is advantageous for P. gingivalis to avoid complete host immunosuppression, as inflammation-induced tissue damage provides essential nutrients necessary for robust bacterial proliferation. In this context, P. gingivalis can gain access to the systemic circulation, where it can promote a prothrombotic state. P. gingivalis expresses a number of virulence factors, which aid this pathogen toward infection of a variety of host cells, evasion of detection by the host immune system, subversion of the host immune responses, and activation of several humoral and cellular hemostatic factors.
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Affiliation(s)
- William A Chen
- Division of Biochemistry, Department of Basic Sciences, School of Medicine, Loma Linda University, Loma Linda, CA 92350, USA
| | - Yuetan Dou
- Division of Microbiology and Molecular Genetics, Department of Basic Sciences, School of Medicine, Loma Linda University, Loma Linda, CA 92350, USA
| | - Hansel M Fletcher
- Division of Microbiology and Molecular Genetics, Department of Basic Sciences, School of Medicine, Loma Linda University, Loma Linda, CA 92350, USA
| | - Danilo S Boskovic
- Division of Biochemistry, Department of Basic Sciences, School of Medicine, Loma Linda University, Loma Linda, CA 92350, USA
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26
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Potential Impact of Prosthetic Biomaterials on the Periodontium: A Comprehensive Review. Molecules 2023; 28:molecules28031075. [PMID: 36770741 PMCID: PMC9921997 DOI: 10.3390/molecules28031075] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/14/2023] [Accepted: 01/17/2023] [Indexed: 01/24/2023] Open
Abstract
The success of a prosthetic treatment is closely related to the periodontal health of the individual. The aim of this article was to review and present the importance of prosthetic restorative materials on the condition of the periodontium, the changes that occur in the composition of the subgingival microbiota and the levels of inflammatory markers in gingival crevicular fluid. Articles on the influence of different prosthetic restorative materials on subgingival microbiota and proinflammatory cytokines were searched for using the keywords "prosthetic biomaterials", "fixed prosthesis", "periodontal health", "subgingival microbiota", "periodontal biomarkers" and "gingival crevicular fluid" in PubMed/Medline, Science Direct, Scopus and Google Scholar. The type of material used for prosthesis fabrication together with poor marginal and internal fit can result in changes in the composition of the subgingival microbiota, as well as increased accumulation and retention of dentobacterial plaque, thus favoring the development of periodontal disease and prosthetic treatment failure. Biological markers have helped to understand the inflammatory response of different prosthetic materials on periodontal tissues with the main purpose of improving their clinical application in patients who need them. Metal-free ceramic prostheses induce a lower inflammatory response regardless of the fabrication method; however, the use of CAD/CAM systems is recommended for their fabrication. In addition, it is presumed that metal-ceramic prostheses cause changes in the composition of the subgingival microbiota producing a more dysbiotic biofilm with a higher prevalence of periodontopathogenic bacteria, which may further favor periodontal deterioration.
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27
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Oral microbiota in cancer: could the bad guy turn good with application of polyphenols? Expert Rev Mol Med 2022; 25:e1. [PMID: 36511134 DOI: 10.1017/erm.2022.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The human oral cavity is comprised of dynamic and polynomial microbes which uniquely reside in the microenvironments of oral cavities. The cumulative functions of the symbiotic microbial communities maintain normal homeostasis; however, a shifted microbiota yields a dysbiosis state, which produces local and systemic diseases including dental caries, periodontitis, cancer, obesity and diabetes. Recent research reports claim that an association occurs between oral dysbiosis and the progression of different types of cancers including oral, gastric and pancreatic ones. Different mechanisms are proposed for the development of cancer, such as induction of inflammatory reactions, production of carcinogenic materials and alteration of the immune system. Medications are available to treat these associated diseases; however, the current strategies may further worsen the disease by unwanted side effects. Natural-derived polyphenol molecules significantly inhibit a wide range of systemic diseases with fewer side effects. In this review, we have displayed the functions of the oral microbes and we have extended the report regarding the role of polyphenols in oral microbiota to maintain healthy conditions and prevention of diseases with emphasis on the treatment of oral microbiota-associated cancer.
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28
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Terranova ML. Key Challenges in Diamond Coating of Titanium Implants: Current Status and Future Prospects. Biomedicines 2022; 10:biomedicines10123149. [PMID: 36551907 PMCID: PMC9775193 DOI: 10.3390/biomedicines10123149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022] Open
Abstract
Over past years, the fabrication of Ti-based permanent implants for fracture fixation, joint replacement and bone or tooth substitution, has become a routine task. However, it has been found that some degradation phenomena occurring on the Ti surface limits the life or the efficiency of the artificial constructs. The task of avoiding such adverse effects, to prevent microbial colonization and to accelerate osteointegration, is being faced by a variety of approaches in order to adapt Ti surfaces to the needs of osseous tissues. Among the large set of biocompatible materials proposed as an interface between Ti and the hosting tissue, diamond has been proven to offer bioactive and mechanical properties able to match the specific requirements of osteoblasts. Advances in material science and implant engineering are now enabling us to produce micro- or nano-crystalline diamond coatings on a variety of differently shaped Ti constructs. The aim of this paper is to provide an overview of the research currently ongoing in the field of diamond-coated orthopedic Ti implants and to examine the evolution of the concepts that are accelerating the full transition of such technology from the laboratory to clinical applications.
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Affiliation(s)
- Maria Letizia Terranova
- Dipartimento di Scienze e Tecnologie Chimiche, Università di Roma Tor Vergata, Via della Ricerca Scientifica, 00133 Roma, Italy; or
- Centro di Ricerca Interdipartimentale di Medicina Rigenerativa (CIMER), Università di Roma Tor Vergata, Via della Ricerca Scientifica, 00133 Roma, Italy
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29
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Post-processing of DLP-printed denture base polymer: Impact of a protective coating on the surface characteristics, flexural properties, cytotoxicity, and microbial adhesion. Dent Mater 2022; 38:2062-2072. [DOI: 10.1016/j.dental.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/26/2022] [Accepted: 11/11/2022] [Indexed: 11/27/2022]
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30
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Biological and Physicochemical Characterization of Self-Adhesive Protective Coating Dental Restorative Material after Incorporation of Antibacterial Nanoparticles. Polymers (Basel) 2022; 14:polym14204280. [PMID: 36297861 PMCID: PMC9611372 DOI: 10.3390/polym14204280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 11/16/2022] Open
Abstract
This study evaluated the physicochemical and antibacterial properties of EQUIATM coat liquid (E) after incorporation of zinc oxide (ZnO) and titanium dioxide (TiO2) nanoparticles. ZnO and TiO2 (1 wt.% and 2 wt.%) were dispersed in EQUIA coat. Principal component analysis (PCA) and cluster analysis were performed to visualize systemic variation. Antibacterial activity was evaluated by colony-forming units and crystal violet staining using Streptococcusmutans and Lactobacillusacidophilus after 24 h, 48 h, and 72 h, and the microstructure was studied by scanning electron microscopy. The weight change was analyzed at 1 and 21 days. The PCA for TiO2- and ZnO-based groups showed 100% variance at all spectral ranges at 600−800/cm and 800−1200/cm, whereas 1200−1800/cm and 2700−3800/cm spectral regions demonstrated 99% variance. The absorbance values were significant (p < 0.05) for both nanoparticles-based adhesives, and the specimens with 2 wt.% ZnO showed the maximum response by minimum bacterial attachment, and the control group showed the least response by maximum attachment. The weight change percentage was reduced after the incorporation of antibacterial nanoparticles. It is suggested that EQUIATM coat containing nanoparticles exhibits promising results, and it may be recommended to clinically use as an improved coating material.
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31
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Łysik D, Deptuła P, Chmielewska S, Bucki R, Mystkowska J. Degradation of Polylactide and Polycaprolactone as a Result of Biofilm Formation Assessed under Experimental Conditions Simulating the Oral Cavity Environment. MATERIALS (BASEL, SWITZERLAND) 2022; 15:7061. [PMID: 36295125 PMCID: PMC9604997 DOI: 10.3390/ma15207061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/08/2022] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
Polylactide (PLA) and polycaprolactone (PCL) are biodegradable and bioabsorbable thermoplastic polymers considered as promising materials for oral applications. However, any abiotic surface used, especially in areas naturally colonized by microorganisms, provides a favorable interface for microbial growth and biofilm development. In this study, we investigated the biofilm formation of C. krusei and S. mutans on the surface of PLA and PCL immersed in the artificial saliva. Using microscopic (AFM, CLSM) observations and spectrometric measurements, we assessed the mass and topography of biofilm that developed on PLA and PCL surfaces. Incubated up to 56 days in specially prepared saliva and microorganisms medium, solid polymer samples were examined for surface properties (wettability, roughness, elastic modulus of the surface layer), structure (molecular weight, crystallinity), and mechanical properties (hardness, tensile strength). It has been shown that biofilm, especially S. mutans, promotes polymer degradation. Our findings indicate the need for additional antimicrobial strategies for the effective oral applications of PLA and PCL.
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Affiliation(s)
- Dawid Łysik
- Institute of Biomedical Engineering, Bialystok University of Technology, 15-351 Bialystok, Poland
| | - Piotr Deptuła
- Department of Microbiological and Nanobiomedical Engineering, Medical University of Bialystok, 15-222 Bialystok, Poland
| | - Sylwia Chmielewska
- Department of Microbiological and Nanobiomedical Engineering, Medical University of Bialystok, 15-222 Bialystok, Poland
| | - Robert Bucki
- Department of Microbiological and Nanobiomedical Engineering, Medical University of Bialystok, 15-222 Bialystok, Poland
| | - Joanna Mystkowska
- Institute of Biomedical Engineering, Bialystok University of Technology, 15-351 Bialystok, Poland
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The biofilm life cycle: expanding the conceptual model of biofilm formation. Nat Rev Microbiol 2022; 20:608-620. [PMID: 35922483 PMCID: PMC9841534 DOI: 10.1038/s41579-022-00767-0] [Citation(s) in RCA: 256] [Impact Index Per Article: 128.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2022] [Indexed: 01/18/2023]
Abstract
Bacterial biofilms are often defined as communities of surface-attached bacteria and are typically depicted with a classic mushroom-shaped structure characteristic of Pseudomonas aeruginosa. However, it has become evident that this is not how all biofilms develop, especially in vivo, in clinical and industrial settings, and in the environment, where biofilms often are observed as non-surface-attached aggregates. In this Review, we describe the origin of the current five-step biofilm development model and why it fails to capture many aspects of bacterial biofilm physiology. We aim to present a simplistic developmental model for biofilm formation that is flexible enough to include all the diverse scenarios and microenvironments where biofilms are formed. With this new expanded, inclusive model, we hereby introduce a common platform for developing an understanding of biofilms and anti-biofilm strategies that can be tailored to the microenvironment under investigation.
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Ebaya MM, Ali AI, El-Haliem HA, Mahmoud SH. Color stability and surface roughness of ormocer- versus methacrylate-based single shade composite in anterior restoration. BMC Oral Health 2022; 22:430. [PMID: 36167560 PMCID: PMC9513900 DOI: 10.1186/s12903-022-02423-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 08/30/2022] [Indexed: 11/12/2022] Open
Abstract
Background The blending ability of universal shade composites and their stability in the oral environment are of great concern in restoring anterior teeth. This study aims to evaluate and compare the color stability and surface roughness of two single-shade composite restorations, ormocer-based composite (OBC) and methacrylate resin-based composite (RBC), after storing them in different staining media.
Materials and methods In this study, two universal shade composite restorative materials were tested: a nanohybrid OBC (Admira fusion X-tra, Voco) and a supra-nanofilled RBC (Omnichroma, Toukyama). In total, 60 cylindrical centralized cavities (diameter: 5 mm, depth: 2 mm) were prepared in sound extracted-human central incisors and divided into two equal groups according to the restorative material used (n = 30). According to the storage media, the teeth of each group were divided into three subgroups (n = 10): artificial saliva, black tea, and cola. The restoration color was evaluated for all teeth at baseline and after four weeks of storage. The color stability (∆E) was measured using a reflective spectrophotometer (X-Rite, model RM200QC, Neu-Isenburg, Germany). The surface roughness (Ra) was evaluated using three-dimensional optical profilometry (Wyko, Model NT 1100, Veeco, Tucson, USA). Additionally, the extracted data were analyzed using two-way analysis of variance (ANOVA), one-way ANOVA and Student’s t-test.
Results In the baseline evaluation, there were no statistically significant differences with respect to color matching or surface roughness results between the two studied restorative materials. However, the differences were statistically significant after storing them in different media. Conclusion Universal composites showed satisfactory color matching with different teeth colors and accepted surface smoothness, whereas the aging procedure exerted a negative effect on their color stability and surface characteristics.
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Affiliation(s)
- Maha M Ebaya
- Operative Dentistry Department, Faculty of Dentistry, Algomhoria Street, Po (box) 35516, Mansoura, Aldakhlia, Egypt
| | - Ashraf I Ali
- Operative Dentistry Department, Faculty of Dentistry, Algomhoria Street, Po (box) 35516, Mansoura, Aldakhlia, Egypt
| | - Huda Abed El-Haliem
- Operative Dentistry Department, Faculty of Dentistry, Algomhoria Street, Po (box) 35516, Mansoura, Aldakhlia, Egypt
| | - Salah Hasab Mahmoud
- Operative Dentistry Department, Faculty of Dentistry, Algomhoria Street, Po (box) 35516, Mansoura, Aldakhlia, Egypt.
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Oh SH, Jung YS, Lee MJ. Assessment of Zinc-Bound Phosphate-Based Glass-Coated Denture-Relining Material with Antifungal Efficacy for Inhibiting Denture Stomatitis. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:3048. [PMID: 36080085 PMCID: PMC9457723 DOI: 10.3390/nano12173048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/28/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
This study investigated the surface properties, biocompatibility, and antifungal activity against Candida albicans of a denture-relining material coated with zinc-bound phosphate-based glass. First, zinc-bound phosphate-based glass was fabricated. A polymerized denture-relining disk was coated with zinc-bound phosphate-based glass (2%, 4%, and 6%). The surface properties of the control and experimental groups were measured, including the wettability, microhardness, color difference, and gloss. The biocompatibility was evaluated using the MTT assay according to ISO 10993-5. The antifungal activity was investigated by counting the number of colony-forming units of Candida albicans. The results were analyzed using a one-way ANOVA and Tukey's test (p = 0.05). The results of this study indicate that, despite the antimicrobial effect of zinc-bound phosphate-based glass, a coated denture-relining material does not degrade the surface properties and biocompatibility. Therefore, this novel material is considered promising for use as a dental material with antimicrobial properties that can potentially prevent denture stomatitis.
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Affiliation(s)
- Sang-Hwan Oh
- Department of Dental Hygiene, Konyang University, Daejeon 35365, Korea
| | - Yun-Sook Jung
- Department of Dental Hygiene, College of Science & Technology, Kyungpook National University, Sangju 37224, Korea
| | - Myung-Jin Lee
- Department of Dental Hygiene, Division of Health Science, Baekseok University, Cheonan 31065, Korea
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Wei X, Gao L, Wu K, Pan Y, Jiang L, Lin H, Wang Y, Cheng H. In vitro study of surface properties and microbial adhesion of various dental polymers fabricated by different manufacturing techniques after thermocycling. Clin Oral Investig 2022; 26:7287-7297. [PMID: 35976495 DOI: 10.1007/s00784-022-04689-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/11/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The study aims to investigate surface properties and microbial adhesion of various dental polymers fabricated by different manufacturing techniques before and after thermocycling. MATERIALS AND METHODS The following six materials were used to fabricate disk-shaped specimens: conventional denture polymer (Vertex Acrylic Resin, VAR), CAD/CAM denture polymer (Organic PMMA eco Pink, OP), conventional temporary polymer (Protemp™ 4, PT), CAD/CAM temporary polymer (Die Material, DM), conventional denture framework polymer (BioHPP, PB), and CAD/CAM denture framework polymer (breCAM.BioHPP, CB). The specimens were tested before and after thermocycling (5000 and 10,000 cycles, 5 °C/55 °C). Surface roughness (SR), hydrophobicity, and surface topography were determined by profilometry, water contact angle, and scanning electron microscopy (SEM). Then specimens were incubated with Staphylococcus aureus, Streptococcus mutans, and Candida albicans for 24 h, respectively. Microbial adhesion was assessed using colony-forming unit counts, XTT assay, and SEM. RESULTS SR and hydrophobicity of VAR group were higher than that of OP group. S. aureus and C. albicans adhesion on VAR and PT groups were higher than that on OP and DM groups, respectively. There was no difference in surface properties and microbial adhesion between PB and CB groups. After thermocycling, SR (expect OP group) of all materials increased and hydrophobicity decreased, and the amount and activity of S. aureus and C. albicans adhesion also increased. The adhesion of S. aureus and C. albicans showed a moderate positive correlation with SR, independent of hydrophobicity. CONCLUSIONS CAD/CAM denture polymers and temporary polymers showed less S. aureus and C. albicans adhesion when compared to conventional ones, which were mainly affected by surface roughness, independent of hydrophobicity. Thermocycling could increase surface roughness, decrease hydrophobicity, and affect microbial adhesion of the materials. CLINICAL SIGNIFICANCE CAD/CAM dental polymers may be a better choice for the manufacture of temporary restorations and dentures to reduce microbial adhesion.
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Affiliation(s)
- Xia Wei
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, 88 Jiaotong Road, Fuzhou, 350004, Fujian, China
| | - Linjuan Gao
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, 88 Jiaotong Road, Fuzhou, 350004, Fujian, China
| | - Kun Wu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, 88 Jiaotong Road, Fuzhou, 350004, Fujian, China
| | - Yu Pan
- Institute of Stomatology & Research Center of Dental Esthetics and Biomechanics, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, Fuzhou, 350002, Fujian, China
| | - Lei Jiang
- Institute of Stomatology & Research Center of Dental Esthetics and Biomechanics, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, Fuzhou, 350002, Fujian, China
| | - Honglei Lin
- Institute of Stomatology & Research Center of Dental Esthetics and Biomechanics, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, Fuzhou, 350002, Fujian, China
| | - Yinghui Wang
- Institute of Stomatology & Research Center of Dental Esthetics and Biomechanics, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, Fuzhou, 350002, Fujian, China
| | - Hui Cheng
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, 88 Jiaotong Road, Fuzhou, 350004, Fujian, China.
- Institute of Stomatology & Research Center of Dental Esthetics and Biomechanics, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, Fuzhou, 350002, Fujian, China.
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Guo M, Zhang Z, Lu J, Wang D, Yan Y, Zhang S, Yu X, Su S, Yuan L, Li Z, Zhang B. Differences in Supragingival Microbiome in Patients with and without Full-Crown Prostheses. Dent J (Basel) 2022; 10:dj10080152. [PMID: 36005250 PMCID: PMC9406617 DOI: 10.3390/dj10080152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/10/2022] [Accepted: 07/14/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives: To characterize the microflora profile of supragingival biofilm in patients with and without full-crown prostheses. Methods: Plaque samples of full-crown prostheses and teeth in patients with porcelain-fused-to-metal crowns, all-ceramic crowns, and no prostheses were collected (three patients per group), using 16S rRNA high-throughput sequencing technology to conduct DNA sequencing on the samples and using Qiime, R, and PICRUSt2 software to perform bioinformatics analyses and functional analyses on sequencing data. Results: In total, 110,209 valid sequences were obtained in the experiment, corresponding to 11 phyla and 120 genera. The predominant species shared by the three groups were phyla Actinobacteria, Bacteroidetes, Firmicutes, Fusobacteria, and Proteobacteria and genera Rothia, Porphyromonas, Prevotella, Streptococcus, Veillonella, Leptotrichia, Neisseria, Citrobacter, and Pseudomonas. The species-difference analysis showed that genus Hameophilus significantly increased after the patient wore the dental prosthesis. Compared with the no-prosthesis samples, the functional analysis showed that cell motility increased in the samples from full-crown prostheses, while replication and repair, and translation decreased. Conclusions: This study reveals the changes in the oral microbial community of patients with full-crown prostheses, which could provide insights regarding the safety of materials for long-term use in the oral cavity.
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Affiliation(s)
- Manli Guo
- Key Lab of Oral Diseases of Gansu Province, Northwest Minzu University, Lanzhou 730000, China
| | - Zhidong Zhang
- School of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - Jiyuan Lu
- School of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - Di Wang
- School of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - Yimin Yan
- School of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - Shen Zhang
- School of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - Xin Yu
- School of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - Songhua Su
- School of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - Lu Yuan
- School of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - Zhige Li
- School of Stomatology, Lanzhou University, Lanzhou 730000, China
- Hospital of Stomatology Lanzhou University, Lanzhou 730000, China
| | - Baoping Zhang
- School of Stomatology, Lanzhou University, Lanzhou 730000, China
- Hospital of Stomatology Lanzhou University, Lanzhou 730000, China
- Correspondence: ; Tel./Fax: +86-931-8915051
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Moghaddam A, Ranjbar R, Yazdanian M, Tahmasebi E, Alam M, Abbasi K, Hosseini ZS, Tebyaniyan H. The Current Antimicrobial and Antibiofilm Activities of Synthetic/Herbal/Biomaterials in Dental Application. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8856025. [PMID: 35958811 PMCID: PMC9363208 DOI: 10.1155/2022/8856025] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/06/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022]
Abstract
Herbal and chemical products are used for oral care and biofilm treatment and also have been reported to be controversial in the massive trials conducted in this regard. The present review is aimed at evaluating the potential of relevant herbal and chemical products and comparing their outcomes to conventional oral care products and summarizing the current state of evidence of the antibiofilm properties of different products by evaluating studies from the past eleven years. Chlorhexidine gluconate (CHX), essential oils (EOs), and acetylpyridinium chloride were, respectively, the most commonly studied agents in the included studies. As confirmed by all systematic reviews, CHX and EO significantly control the plaque formation and gingival indices. Fluoride is another interesting reagent in oral care products that has shown promising results of oral health improvement, but the evidence quality needs to be refined. The synergy between natural plants and chemical products should be targeted in the future to accede to the formation of new, efficient, and healthy anticaries strategies. Moreover, to discover their biofilm-interfering or biofilm-inhibiting activities, effective clinical trials are needed. In this review article, therapeutic applications of herbal/chemical materials in oral biofilm infections are discussed in recent years (2010-2022).
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Affiliation(s)
- Ali Moghaddam
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Reza Ranjbar
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
- School of Dentistry, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohsen Yazdanian
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Elahe Tahmasebi
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mostafa Alam
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamyar Abbasi
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Sadat Hosseini
- Department of Genetics and Biotechnology, School of Biological Science, Varamin-Pishva Branch, Islamic Azad University, Tehran, Iran
| | - Hamid Tebyaniyan
- Science and Research Branch, Islamic Azad University, Tehran, Iran
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Zhang S, Liao M, Liu F, Huang X, Mai S, He J. Preparation of Bis-GMA free dental resin composites with anti-adhesion effect against Streptococcus mutans using synthesized fluorine-containing methacrylate (DFMA). J Mech Behav Biomed Mater 2022; 131:105263. [DOI: 10.1016/j.jmbbm.2022.105263] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 04/26/2022] [Accepted: 05/01/2022] [Indexed: 12/21/2022]
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Mârțu I, Murariu A, Baciu ER, Savin CN, Foia I, Tatarciuc M, Diaconu-Popa D. An Interdisciplinary Study Regarding the Characteristics of Dental Resins Used for Temporary Bridges. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58060811. [PMID: 35744074 PMCID: PMC9231152 DOI: 10.3390/medicina58060811] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/09/2022] [Accepted: 06/12/2022] [Indexed: 11/29/2022]
Abstract
Background and Objectives: The surface condition of the materials that are used for temporary prostheses influences their microbial colonization, with a direct impact on the oral tissues. This study aims at a comparative analysis of three types of resins for temporary bridges using conventional and digital technologies. The attention was focused on the analysis of the surface characteristics and mechanical strength of these materials. Materials and Methods: The surface condition was assessed for three distinct materials both before and after polishing- heat-curing resin Superpont C + B (SpofaDental, Jicin, Czech Republic) used unconventional technology, Zotion dental milling polymethyl methacrylate (PMMA) block (Zotion, Chongqing, China) for provisional crowns/bridges used in digital subtractive technologies and Freeprint Temp (Detax GmbH & Co. KG, Ettlingen, Germany) resin for temporary crowns and bridges that are used in 3D printing technologies. The two-way ANOVA analysis indicated that polishing leads to a statistically significant increase in roughness coefficients for all the three resins that were tested (p < 0.001). While the highest roughness coefficients were displayed in the 3D cured sample, the largest decrease was reported by the milled sample Results: The results revealed that surface roughness was significantly influenced by both the type of resin that was used (p < 0.001) and the treatment that was induced by finishing and polishing (p < 0.001). Similar p-values were obtained for each of the three resins. Conclusions: The results demonstrated a significant optimization of the surfaces after finishing and polishing and statistically significant differences between the surface parameters and the mechanical properties of the samples. The low values of the roughness and the acceptable values of the mechanical resistance for the conventional samples indicate these materials for the long-term temporary bridge’s realization, allowing the correct restoration of the functions and the rehabilitation at the oral level.
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Affiliation(s)
- Ioana Mârțu
- Department of Oral Implantology, Discipline of Dental Technology, Faculty of Dental Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (I.M.); (M.T.); (D.D.-P.)
| | - Alice Murariu
- Department of Surgery, Discipline of Community Dentistry, Faculty of Dental Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania;
| | - Elena Raluca Baciu
- Department of Oral Implantology, Discipline of Dental Materials, Faculty of Dental Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
- Correspondence: (E.R.B.); (C.N.S.)
| | - Carmen Nicoleta Savin
- Department of Surgery, Discipline of Pediatric Dentistry, Faculty of Dental Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
- Correspondence: (E.R.B.); (C.N.S.)
| | - Iolanda Foia
- Department of Preventive Medicine and Interdisciplinarity, Discipline of Hygiene, Faculty of Dental Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania;
| | - Monica Tatarciuc
- Department of Oral Implantology, Discipline of Dental Technology, Faculty of Dental Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (I.M.); (M.T.); (D.D.-P.)
| | - Diana Diaconu-Popa
- Department of Oral Implantology, Discipline of Dental Technology, Faculty of Dental Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (I.M.); (M.T.); (D.D.-P.)
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Di Stefano M, Polizzi A, Santonocito S, Romano A, Lombardi T, Isola G. Impact of Oral Microbiome in Periodontal Health and Periodontitis: A Critical Review on Prevention and Treatment. Int J Mol Sci 2022; 23:ijms23095142. [PMID: 35563531 PMCID: PMC9103139 DOI: 10.3390/ijms23095142] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 04/29/2022] [Accepted: 05/02/2022] [Indexed: 02/07/2023] Open
Abstract
The skin, oral cavity, digestive and reproductive tracts of the human body harbor symbiotic and commensal microorganisms living harmoniously with the host. The oral cavity houses one of the most heterogeneous microbial communities found in the human organism, ranking second in terms of species diversity and complexity only to the gastrointestinal microbiota and including bacteria, archaea, fungi, and viruses. The accumulation of microbial plaque in the oral cavity may lead, in susceptible individuals, to a complex host-mediated inflammatory and immune response representing the primary etiological factor of periodontal damage that occurs in periodontitis. Periodontal disease is a chronic inflammatory condition affecting about 20-50% of people worldwide and manifesting clinically through the detection of gingival inflammation, clinical attachment loss (CAL), radiographic assessed resorption of alveolar bone, periodontal pockets, gingival bleeding upon probing, teeth mobility and their potential loss in advanced stages. This review will evaluate the changes characterizing the oral microbiota in healthy periodontal tissues and those affected by periodontal disease through the evidence present in the literature. An important focus will be placed on the immediate and future impact of these changes on the modulation of the dysbiotic oral microbiome and clinical management of periodontal disease.
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Affiliation(s)
- Mattia Di Stefano
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy; (M.D.S.); (G.I.)
| | - Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy; (M.D.S.); (G.I.)
- Correspondence: (A.P.); (S.S.); Tel.: +39-095-3782638 (A.P. & S.S.)
| | - Simona Santonocito
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy; (M.D.S.); (G.I.)
- Correspondence: (A.P.); (S.S.); Tel.: +39-095-3782638 (A.P. & S.S.)
| | - Alessandra Romano
- Department of General Surgery and Surgical-Medical Specialties, Unit of Hematology, University of Catania, 95124 Catania, Italy;
| | - Teresa Lombardi
- Department of Health Sciences, Magna Græcia University, 88100 Catanzaro, Italy;
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy; (M.D.S.); (G.I.)
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Sun H, Chan Y, Li X, Xu R, Zhang Z, Hu X, Wu F, Deng F, Yu X. Multi-omics analysis of oral bacterial biofilm on titanium oxide nanostructure modified implant surface: In vivo sequencing-based pilot study in beagle dogs. Mater Today Bio 2022; 15:100275. [PMID: 35572854 PMCID: PMC9098469 DOI: 10.1016/j.mtbio.2022.100275] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 11/30/2022] Open
Abstract
Peri-implantitis, the major cause of implant failure, is an inflammatory destructive disease due to the dysbiotic polymicrobial communities at the peri-implant sites. Therefore, it is highly warranted to develop the implant materials with antimicrobial properties and investigate their effects on oral microbiota. However, most of the relevant studies were performed in vitro, and insufficient to provide the comprehensive assessment of the antimicrobial capacity of the implant materials in vivo. Herein, we introduce an innovative approach to evaluate the in vivo antibacterial properties of the most commonly used implant materials, titanium with different nanostructured surfaces, and investigate their antibacterial mechanism via the next-generation sequencing (NGS) technology. We firstly prepared the titanium implants with three different surfaces, i) mechanical polishing (MP), ii) TiO2 nanotubes (NT) and iii) nanophase calcium phosphate embedded to TiO2 nanotubes (NTN), and then characterized them using scanning electron microscopy (SEM), energy-dispersive X-ray spectrometer (EDS), X-ray photoelectron spectroscopy (XPS), confocal laser scanning microscopy (CLSM) and surface hydrophilicity analysis. Afterwards, the implants were placed in the beagle dogs’ mouths to replace the pre-extracted premolar and molar teeth for eight weeks through implant surgery. The supra- and sub-mucosal plaques were collected and subjected to 16S rRNA gene/RNA sequencing and data analysis. It was found that the nanostructured surfaces in NT and NTN groups showed significantly increased roughness and decreased water contact angles compared to the MP group, while the XPS data further confirmed the successful modifications of TiO2 nanotubes and the subsequent deposition of nanophase calcium phosphate. Notably, the nanostructured surfaces in NT and NTN groups had limited impact on the diversity and community structure of oral microbiota according to the 16S rRNA sequencing results, and the nanostructures in NTN group could down-regulate the genes associated with localization and locomotion based on Gene Ontology (GO) terms enrichment analysis. Moreover, the differentially expressed genes (DEGs) were associated with microbial metabolism, protein synthesis and bacterial invasion of epithelial cells. Taken together, this study provides a new strategy to evaluate the antibacterial properties of the biomedical materials in vivo via the high-throughput sequencing and bioinformatic approaches, revealing the differences of the composition and functional gene expressions in the supra- and sub-mucosal microbiome.
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de Brito OFF, Sandes JM, de Lima FCG, Oliveira JB, Alves LC, Brayner FA, de Melo Monteiro GQ. The Influence of Cement Removal Techniques on In Situ Bacterial Adhesion and Biodegradation at the Marginal Interface of Ceramic Laminates. Oper Dent 2022; 47:190-201. [DOI: 10.2341/20-269-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2021] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objectives
This in situ study aimed to analyze the influence of different resin cement removal techniques on bacterial adhesion and biodegradation at the marginal interface of ceramic laminates.
Methods and Materials
Eighty feldspathic ceramic (F) blocks were prepared and cemented onto bovine enamel slabs (7×2.5×2 mm). Excess cement was removed using a microbrush (MBR), a scalpel blade (SCP), or a Teflon spatula (TSP). For the biodegradation analysis, 40 disc-shaped resin cement specimens were prepared (7×1.5 mm) using a Teflon mold. The specimens were randomly allocated into two groups: (1) No finishing procedure (only Mylar strip), and (2) with finishing and polishing procedures using the Jiffy system (Ultradent, South Jordan, UT, USA) (n=20). The in situ phase consisted of using an intraoral palatal device by 20 volunteers for 7 days. Each device contained five cylindrical wells (8×3 mm), where three dental blocks and two cement specimens were included in the wells. Surface roughness (Ra) was measured using a contact profilometer. A micromorphological analysis was performed under a stereomicroscope and a scanning electron microscope. Bacterial adhesion was quantitated based on the number of colony-forming units (CFU/mL) and their biofilm development potential.
Results
The cement removal techniques directly affected surface roughness at the marginal interface (p<0.001), and the SCP technique produced higher mean roughness, regardless of the surface area analyzed. Surface polishing protected cement specimens from further biodegradation (p=0.148). There were no differences in CFU counts between the groups after the in situ phase (p=0.96). All specimens showed CFU with a strong ability to develop a biofilm.
Conclusions
The techniques used for cement removal increased the surface roughness of ceramic laminates, particularly SCP, but they did not affect bacterial adhesion at the marginal interface. Surface polishing of the resin cement is recommended to mitigate biodegradation.
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Affiliation(s)
- OFF de Brito
- *Oscar Felipe Fonseca de Brito, DDS, MSc, PhD, Dental School, University of Pernambuco, FOP/UPE, Brazil
| | - JM Sandes
- Jana Messias Sandes, BSc, MSc, PhD, Electronic Microscopy, Laboratory of Immunopathology Keizo Asami, Federal University of Pernambuco, Brazil
| | - FCG de Lima
- Fernanda Cristina Gomes de Lima, BSc, MSc, PhD, Laboratory of Molecular and Cellular Biology, Department of Parasitology, Institute Aggeu Magalhães – Fiocruz, Pernambuco, Brazil
| | - JB Oliveira
- Jorge Belém Oliveira Júnior, BSc, MSc, Laboratory of Molecular and Cellular Biology, Department of Parasitology, Institute Aggeu Magalhães - Fiocruz, Pernambuco, Brazil
| | - LC Alves
- Luiz Carlos Alves, Biol, MSc, PhD, Electronic Microscopy, Laboratory of Immunopathology Keizo Asami, Federal University of Pernambuco and Laboratory of Molecular and Cellular Biology, Department of Parasitology, Institute Aggeu Magalhães - Fiocruz, Pernambuco, Brazil
| | - FA Brayner
- Fábio André Brayner, Biol, MSc, PhD, Electronic Microscopy, Laboratory of Immunopathology Keizo Asami, Federal University of Pernambuco and Laboratory of Molecular and Cellular Biology, Department of Parasitology, Institute Aggeu Magalhães - Fiocruz, Pernambuco, Brazil
| | - GQ de Melo Monteiro
- Gabriela Queiroz de Melo Monteiro, DDS, MSc, PhD, Dental School, University of Pernambuco, FOP/UPE, Brazil
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Jin J, Bhat R, Mangal U, Seo JY, Min Y, Yu J, Kim DE, Kuroda K, Kwon JS, Choi SH. Molecular weight tuning optimizes poly(2-methoxyethyl acrylate) dispersion to enhance the aging resistance and anti-fouling behavior of denture base resin. Biomater Sci 2022; 10:2224-2236. [PMID: 35344987 DOI: 10.1039/d2bm00053a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Poly(methyl methacrylate) (PMMA)-based denture base resins easily develop oral bacterial and fungal biofilms, which may constitute a significant health risk. Conventional bacterial-resistant additives and coatings often cause undesirable changes in the resin. Reduced bacterial resistance over time in the harsh oral environment is a major challenge in resin development. Poly(2-methoxyethyl acrylate) (PMEA) has anti-fouling properties; however, due to the oily/rubbery state of this polymer, and its surface aggregation tendency in a resin mixture, its direct use as a resin additive is limited. This study aimed to optimize the use of PMEA in dental resins. Acrylic resins containing a series of PMEA polymers with various molecular weights (MWs) at different concentrations were prepared, and the mechanical properties, surface gloss, direct transmittance, and cytotoxicity were evaluated, along with the distribution of PMEA in the resin. Resins with low-MW PMEA (2000 g mol-1) (PMEA-1) at low concentrations satisfied the clinical requirements for denture resins, and the PMEA was homogeneously distributed. The anti-fouling performance of the resin was evaluated for protein adsorption, bacterial and fungal attachment, and saliva-derived biofilm formation. The PMEA-1 resin most effectively inhibited biofilm formation (∼50% reduction in biofilm mass and thickness compared to those of the control). Post-aged resins maintained their mechanical properties and anti-fouling activity, and polished surfaces had the same anti-biofilm behavior. Based on wettability and tribological results, we propose that the PMEA additive creates a non-stick surface to inhibit biofilm formation. This study demonstrated that PMEA additives can provide a stable and biocompatible anti-fouling surface, without sacrificing the mechanical properties and aesthetics of denture resins.
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Affiliation(s)
- Jie Jin
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
| | - Rajani Bhat
- Department of Biologic & Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, 1011 N. University Ave., Ann Arbor, MI 48109, USA
| | - Utkarsh Mangal
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
| | - Ji-Young Seo
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
| | - YouJin Min
- Department of Mechanical Engineering, Yonsei University, Seoul, 03722, Republic of Korea
| | - Jaehun Yu
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea. .,BK21 FOUR Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
| | - Dae-Eun Kim
- Department of Mechanical Engineering, Yonsei University, Seoul, 03722, Republic of Korea
| | - Kenichi Kuroda
- Department of Biologic & Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, 1011 N. University Ave., Ann Arbor, MI 48109, USA
| | - Jae-Sung Kwon
- BK21 FOUR Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea. .,Department and Research Institute of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Sung-Hwan Choi
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea. .,BK21 FOUR Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
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Effect of Printing Layer Thickness and Postprinting Conditions on the Flexural Strength and Hardness of a 3D-Printed Resin. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8353137. [PMID: 35237691 PMCID: PMC8885203 DOI: 10.1155/2022/8353137] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 01/17/2022] [Accepted: 01/27/2022] [Indexed: 01/11/2023]
Abstract
Background Recently, dentists can utilize three-dimensional printing technology in fabricating dental restoration. However, to date, there is a lack of evidence regarding the effect of printing layer thicknesses and postprinting on the mechanical properties of the 3D-printed temporary restorations with the additive manufacturing technique. So, this study evaluated the mechanical properties of a 3D-printed dental resin material with different printing layer thicknesses and postprinting methods. Methods 210 specimens of a temporary crown material (A2 EVERES TEMPORARY, SISMA, Italy) were 3D-printed with different printing layer thicknesses (25, 50, and 100 μm). Then, specimens were 3D-printed using DLP technology (EVERES ZERO, DLP 3D printer, SISMA, Italy) which received seven different treatment conditions after printing: water storage for 24 h or 1 month, light curing or heat curing for 5 or 15 minutes, and control. Flexural properties were evaluated using a three-point bending test on a universal testing machine (ISO standard 4049). The Vickers hardness test was used to evaluate the microhardness of the material system. The degree of conversion was measured using an FT-IR ATR spectrophotometer. Statistical analysis was performed using two-way analysis of variance (ANOVA) and Tukey's honestly significant difference (HSD) test (p ≤ 0.05). Results The 100 μm printing layer thickness had the highest flexural strength among the other thickness groups. As a combined effect printing thickness and postprinting conditions, the 100 μm with the dry storage group has the highest flexural strength among the tested groups (94.60 MPa). Thus, the group with 100 μm thickness that was heat cured for 5 minutes (HC 5 min 100 μm) has the highest VHN value (VHN = 17.95). Also, the highest mean DC% was reported by 50 μm layer thickness (42.84%). Conclusions The thickness of the 100 μm printing layer had the highest flexural strength compared to the 25 μm and 50 μm groups. Also, the postprinting treatment conditions influenced the flexural strength and hardness of the 3D-printed resin material.
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Fixed Prosthetic Restorations and Periodontal Health: A Narrative Review. J Funct Biomater 2022; 13:jfb13010015. [PMID: 35225978 PMCID: PMC8883934 DOI: 10.3390/jfb13010015] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/26/2022] [Accepted: 01/29/2022] [Indexed: 12/18/2022] Open
Abstract
Periodontal health plays an important role in the longevity of prosthodontic restorations. The issues of comparative assessment of prosthetic constructions are complicated and not fully understood. The aim of this article is to review and present the current knowledge regarding the various technical, clinical, and molecular aspects of different prosthetic biomaterials and highlight the interactions between periodontal health and prosthetic restorations. Articles on periodontal health and fixed dental prostheses were searched using the keywords “zirconium”, “CAD/CAM”, “dental ceramics”, “metal–ceramics”, “margin fit”, “crown”, “fixed dental prostheses”, “periodontium”, and “margin gap” in PubMed/Medline, Scopus, Google Scholar, and Science Direct. Further search criteria included being published in English, and between January 1981 and September 2021. Then, relevant articles were selected, included, and critically analyzed in this review. The margin of discrepancy results in the enhanced accumulation of dental biofilm, microleakage, hypersensitivity, margin discoloration, increased gingival crevicular fluid flow (GCF), recurrent caries, pulp infection and, lastly, periodontal lesion and bone loss, which can lead to the failure of prosthetic treatment. Before starting prosthetic treatment, the condition of the periodontal tissues should be assessed for their oral hygiene status, and gingival and periodontal conditions. Zirconium-based restorations made from computer-aided design and computer-aided manufacturing (CAD/CAM) technology provide better results, in terms of marginal fit, inflammation reduction, maintenance, and the restoration of periodontal health and oral hygiene, compared to constructions made by conventional methods, and from other alloys. Compared to subgingival margins, supragingival margins offer better oral hygiene, which can be maintained and does not lead to secondary caries or periodontal disease.
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Santos EO, Oliveira PLE, de Mello TP, dos Santos ALS, Elias CN, Choi SH, de Castro ACR. Surface Characteristics and Microbiological Analysis of a Vat-Photopolymerization Additive-Manufacturing Dental Resin. MATERIALS (BASEL, SWITZERLAND) 2022; 15:425. [PMID: 35057143 PMCID: PMC8781660 DOI: 10.3390/ma15020425] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/24/2021] [Accepted: 12/29/2021] [Indexed: 01/27/2023]
Abstract
The wide application of additive manufacturing in dentistry implies the further investigation into oral micro-organism adhesion and biofilm formation on vat-photopolymerization (VP) dental resins. The surface characteristics and microbiological analysis of a VP dental resin, printed at resolutions of 50 μm (EG-50) and 100 μm (EG-100), were evaluated against an auto-polymerizing acrylic resin (CG). Samples were evaluated using a scanning electron microscope, a scanning white-light interferometer, and analyzed for Candida albicans (CA) and Streptococcus mutans (SM) biofilm, as well as antifungal and antimicrobial activity. EG-50 and EG-100 exhibited more irregular surfaces and statistically higher mean (Ra) and root-mean-square (rms) roughness (EG-50-Ra: 2.96 ± 0.32 µm; rms: 4.05 ± 0.43 µm/EG-100-Ra: 3.76 ± 0.58 µm; rms: 4.79 ± 0.74 µm) compared to the CG (Ra: 0.52 ± 0.36 µm; rms: 0.84 ± 0.54 µm) (p < 0.05). The biomass and extracellular matrix production by CA and SM and the metabolic activity of SM were significantly decreased in EG-50 and EG-100 compared to CG (p < 0.05). CA and SM growth was inhibited by the pure unpolymerized VP resin (48 h). EG-50 and EG-100 recorded a greater irregularity, higher surface roughness, and decreased CA and SM biofilm formation over the CG.
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Affiliation(s)
- Ericles Otávio Santos
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro 21941617, RJ, Brazil;
| | - Pedro Lima Emmerich Oliveira
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Escola Superior São Francisco de Assis, Santa Teresa 29650000, ES, Brazil;
| | - Thaís Pereira de Mello
- Laboratory for Advanced Studies of Emerging and Resistant Microorganisms, Department of General Microbiology, Institute of Microbiology Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro 21941902, RJ, Brazil; (T.P.d.M.); (A.L.S.d.S.)
| | - André Luis Souza dos Santos
- Laboratory for Advanced Studies of Emerging and Resistant Microorganisms, Department of General Microbiology, Institute of Microbiology Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro 21941902, RJ, Brazil; (T.P.d.M.); (A.L.S.d.S.)
| | - Carlos Nelson Elias
- Department of Mechanical Engineering and Materials Science, Military Institute of Engineering, Rio de Janeiro 22290270, RJ, Brazil;
| | - Sung-Hwan Choi
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul 03772, Korea
| | - Amanda Cunha Regal de Castro
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro 21941617, RJ, Brazil;
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Nath S, Zilm P, Jamieson L, Kapellas K, Goswami N, Ketagoda K, Weyrich LS. Development and characterization of an oral microbiome transplant among Australians for the treatment of dental caries and periodontal disease: A study protocol. PLoS One 2021; 16:e0260433. [PMID: 34843568 PMCID: PMC8629173 DOI: 10.1371/journal.pone.0260433] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 11/08/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Oral microbiome transplantation (OMT) is a novel concept of introducing health-associated oral microbiota into the oral cavity of a diseased patient. The premise is to reverse the state of oral dysbiosis, and restore the ecological balance to maintain a stable homeostasis with the host immune system. This study will assess the effectiveness, feasibility, and safety of OMT using an interdisciplinary approach. METHODS/DESIGN To find donors suitable for microbial transplantation, supragingival plaque samples will be collected from 600 healthy participants. Each sample (200μL) will subsequently be examined in two ways: 1) 100μL of the sample will undergo high-throughput 16S rRNA gene amplicon sequencing and shotgun sequencing to identify the composition and characterisation of a healthy supragingival microbiome, 2) the remaining 100μL of the plaque sample will be mixed with 25% artificial saliva medium and inoculated into a specialised in-vitro flow cell model containing a hydroxyapatite disk. To obtain sufficient donor plaque, the samples would be grown for 14 days and further analysed microscopically and sequenced to examine and confirm the growth and survival of the microbiota. Samples with the healthiest microbiota would then be incorporated in a hydrogel delivery vehicle to enable transplantation of the donor oral microbiota. The third step would be to test the effectiveness of OMT in caries and periodontitis animal models for efficacy and safety for the treatment of oral diseases. DISCUSSION If OMTs are found to be successful, it can form a new treatment method for common oral diseases such as dental caries and periodontitis. OMTs may have the potential to modulate the oral microbiota and shift the ecological imbalances to a healthier state.
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Affiliation(s)
- Sonia Nath
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, SA, Australia
| | - Peter Zilm
- Oral Microbiology Laboratory, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, SA, Australia
| | - Kostas Kapellas
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, SA, Australia
| | - Nirmal Goswami
- Materials Chemistry Department, CSIR-Institute of Minerals and Materials Technology, Acharya Vihar, Bhubaneswar, India
| | - Kevin Ketagoda
- Oral Microbiology Laboratory, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - Laura S. Weyrich
- Department of Anthropology and the Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA, United States of America
- Australian Centre for Ancient DNA, School of Biological Sciences and the Environment Institute, University of Adelaide, Adelaide, SA, Australia
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Evaluation of the Behavior of Two CAD/CAM Fiber-Reinforced Composite Dental Materials by Immersion Tests. MATERIALS 2021; 14:ma14237185. [PMID: 34885342 PMCID: PMC8658643 DOI: 10.3390/ma14237185] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/20/2021] [Accepted: 11/22/2021] [Indexed: 01/15/2023]
Abstract
Fiber-reinforced composites are used as restorative materials for prosthetic oral rehabilitation. Gastroesophageal reflux disease (GERD) is an accustomed affection with various oral manifestations. This study aimed to evaluate the behavior of two high-performance CAD/CAM milled reinforced composites (Trinia™, TriLor) in artificial saliva at different pH levels through immersion tests, and to determine if changes in mass or surface morphology at variable pH, specific for patients affected by GERD, appear. After investigating the elemental composition and surface morphology, the specimens were immersed in Carter Brugirard artificial saliva for 21 days at different pH values (5.7, 7.6, and varying the pH from 5.7 to 3). The values of the weighed masses during the immersion tests were statistically processed in terms of mean and standard deviation. Results suggested that irrespective of the medium pH, the two composites presented a similar mass variation in the range of −0.18 (±0.01)–1.82 (±0.02) mg after immersion, suggesting their stability when in contact with artificial saliva, an aspect which was also highlighted by scanning electron microscope (SEM) analysis performed on the immersed surfaces. Novel composite biomaterials can be a proper alternative for metal alloys used for prosthetic frameworks in patients suffering from GERD.
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Zhang Y, Gulati K, Li Z, Di P, Liu Y. Dental Implant Nano-Engineering: Advances, Limitations and Future Directions. NANOMATERIALS (BASEL, SWITZERLAND) 2021; 11:2489. [PMID: 34684930 PMCID: PMC8538755 DOI: 10.3390/nano11102489] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/08/2021] [Accepted: 09/18/2021] [Indexed: 12/27/2022]
Abstract
Titanium (Ti) and its alloys offer favorable biocompatibility, mechanical properties and corrosion resistance, which makes them an ideal material choice for dental implants. However, the long-term success of Ti-based dental implants may be challenged due to implant-related infections and inadequate osseointegration. With the development of nanotechnology, nanoscale modifications and the application of nanomaterials have become key areas of focus for research on dental implants. Surface modifications and the use of various coatings, as well as the development of the controlled release of antibiotics or proteins, have improved the osseointegration and soft-tissue integration of dental implants, as well as their antibacterial and immunomodulatory functions. This review introduces recent nano-engineering technologies and materials used in topographical modifications and surface coatings of Ti-based dental implants. These advances are discussed and detailed, including an evaluation of the evidence of their biocompatibility, toxicity, antimicrobial activities and in-vivo performances. The comparison between these attempts at nano-engineering reveals that there are still research gaps that must be addressed towards their clinical translation. For instance, customized three-dimensional printing technology and stimuli-responsive, multi-functional and time-programmable implant surfaces holds great promise to advance this field. Furthermore, long-term in vivo studies under physiological conditions are required to ensure the clinical application of nanomaterial-modified dental implants.
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Affiliation(s)
- Yifan Zhang
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China;
| | - Karan Gulati
- School of Dentistry, The University of Queensland, Herston, QLD 4006, Australia;
| | - Ze Li
- School of Stomatology, Chongqing Medical University, Chongqing 400016, China;
| | - Ping Di
- School of Dentistry, The University of Queensland, Herston, QLD 4006, Australia;
| | - Yan Liu
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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Influence of Curing Time on the Microbiological Behavior of Bulk-Fill Nanohybrid Resin Composites. Polymers (Basel) 2021; 13:polym13172948. [PMID: 34502989 PMCID: PMC8434565 DOI: 10.3390/polym13172948] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/18/2021] [Accepted: 08/26/2021] [Indexed: 11/22/2022] Open
Abstract
This in vitro study aimed to evaluate the influence of curing time on surface characteristics and microbiological behavior of three bulk-fill resin-based composites (RBCs). Materials were light-cured for either 10 s or 80 s, then finished using a standard clinical procedure. They were characterized by surface morphology (SEM), surface elemental composition (EDS), surface roughness (SR), and surface free energy (SFE). Microbiological behavior was assessed as S. mutans adherence (2 h) and biofilm formation (24 h) using a continuous-flow bioreactor. Statistical analysis included a two-way ANOVA and Tukey’s test (p < 0.05). Materials differed substantially as filler shape, dimension, elemental composition and resin matrix composition. Significant differences between materials were found for SR, SFE, and microbiological behavior. Such differences were less pronounced or disappeared after prolonged photocuring. The latter yielded significantly lower adherence and biofilm formation on all tested materials, similar to conventional RBCs. Improved photoinitiators and UDMA-based resin matrix composition may explain these results. No correlation between surface characteristics and microbiological behavior can explain the similar microbiological behavior of bulk-fill materials after prolonged photocuring. This different performance of bulk-fill materials compared with conventional RBCs, where surface characteristics, especially surface chemistry, influence microbiological behavior, may have important implications for secondary caries occurrence and restoration longevity.
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