Bioactive Glass Applications in Dentistry

A meta-analysis of calcium silicate-based cements and calcium hydroxide as promoters of hard tissue bridge formation

BACKGROUND

The formation of a reparative hard tissue bridge is a key indicator of defensive pulp response and successful vital pulp treatment (VPT); however, there is a lack of comprehensive information regarding the impact of bioactive materials on hard tissue formation.

OBJECTIVES

This systematic review with meta-analyses aimed to evaluate the hard tissue bridge formation in direct pulp capping and pulpotomies in humans, comparing the use of ProRoot MTA with other calcium silicate-based cements (CSCs) and calcium hydroxide.

METHODS

The search was conducted in six electronic databases, until May 2024. The selection process followed the PICOS criteria. Clinical trials that evaluated the hard tissue bridge formation in VPTs using ProRoot MTA compared with other CSCs or calcium hydroxide, were included. The quality of the studies was assessed using the RoB-2 tool for randomized clinical trials, and ROBINS-I for nonrandomized trials. Meta-analyses were performed to compare the frequency of complete bridge formation using RevMan software 5.3. The GRADE tool was used to determine the overall certainty of evidence.

RESULTS

Twenty-six studies were included, and the majority showed high risk of bias. Meta-analyses revealed that using ProRoot MTA resulted in significantly higher frequency of complete hard tissue bridge formation compared with using other CSCs and calcium hydroxide. Subgroup analyses indicated that using ProRoot MTA led to higher complete bridge formation compared with Biodentine. The certainty of evidence was low.

CONCLUSIONS

The use of ProRoot MTA resulted in significantly higher frequency of complete hard tissue bridge formation, greater hard tissue thickness and better morphology compared with various other CSCs and calcium hydroxide. Almost all studies were performed in premolars extracted due to orthodontic reasons or third molars. This scenario does not represent the clinical setting and therefore results should be interpreted with caution.

Biomaterials for Guided Tissue Regeneration and Guided Bone Regeneration: A Review

This review aims to provide an overview of the types of membranes, bone substitutes, and mucosal substitutes used for GTR and GBR and briefly explores recent innovations for tissue regeneration and their future perspectives. Since this is a narrative review, no systematic search, meta-analysis, or statistical analysis was conducted. Using biomaterials for GTR and GBR provides a reduction in postoperative morbidity, as it contributes to less invasive clinical procedures, serving as an alternative to autogenous grafts. Moreover, randomized clinical trials (RCTs) and systematic reviews are essential for the evaluation of new biomaterials. These studies provide more robust evidence and help guide clinical practice in the selection of safer and more effective biomaterials, allowing for the personalization of treatment protocols for each patient.

Surface Micromorphology of Experimental Composites Doped with Bioactive Glass After Different Storage Times

OBJECTIVE

To evaluate the surface micromorphology of bioactive glass-modified resin composite materials after storage in simulated body fluid for different periods of time and ultrasonic cleaning.

MATERIALS AND METHODS

A resin composite material (Heliomolar Flow, Ivoclar Vivadent) was modified by incorporating 10 or 20 wt% of bioactive glass 45S5. The unmodified conventional composite (0 wt% bioactive glass) served as the control. Surface morphology of light-cured composite specimens was examined by profilometry both before and after storage in simulated body fluid (SBF; pH = 7.4, t = 37 °C) for 0, 3, 7, or 30 days, and surface roughness (Ra) was recorded. After storage, ultrasonic cleaning (UC) of the specimens was performed for 10 min in an ultrasonic bath filled with deionized water, and the profilometric measurements were subsequently repeated. In addition, the surfaces of specimens were examined by scanning electron microscopy (SEM).

RESULTS

Directly after specimen preparation, the Ra values of the composites modified with bioactive glass were similar to those of the conventional composite (0 wt% bioactive glass). A longer immersion in SBF and higher added concentrations of bioactive glass led to an increase in surface roughness. SEM examination revealed that precipitates were formed on the surfaces of specimens containing bioactive glass after exposure to SBF for at least 7 days. The density of these precipitates increased with exposure time and added bioactive glass content. After subsequent ultrasonic cleaning, a significant Ra reduction was observed for specimens containing 10 and 20 wt% bioactive glass and stored for 30 days (p < 0.001). For the resin composite material doped with 20 wt% bioactive glass particles, UC revealed a significant Ra reduction at all time points.

CONCLUSION

The increase in the surface roughness of bioactive glass-modified composites after storage in SBF might be partly attributed to precipitate formation on their surfaces. After ultrasonic cleaning, surface roughness was still increased, indicating poorer surface quality compared to conventional composite.

Bioceramics in Endodontics: Limitations and Future Innovations-A Review

Bioceramic materials for endodontic treatments have gradually transformed over the years into materials with enhanced biocompatibility and chemical and mechanical properties compared to earlier generations. In endodontics procedures, these materials are used as restorative material in applications such as root-end fillings, pulp capping, perforations repair, and apexification repair procedures. However, they have far from ideal mechanical and handling properties, biocompatibility issues, aesthetic concerns due to tooth discolouration, limited antibacterial activity, and affordability, which are amongst several key limitations. Notably, bioceramic materials are popular due to their biocompatibility, sealing ability, and durability, consequently surpassing traditional materials such as gutta-percha and zinc oxide-eugenol sealers. A lack of recent advancements in the field, combined with nanomaterials, has improved the formulations of these materials to overcome these limitations. The existing literature emphasises the benefits of bioceramics while underreporting their poor mechanical properties, handling difficulties, cost, and various other drawbacks. The key gaps identified in the literature are the insufficient coverage of emerging materials, narrow scope, limited insights into future developments, and underreporting of failures and complications of the existing materials. Consequently, this review aims to highlight the key limitations of various endodontic materials, primarily focusing on calcium silicate, calcium phosphate, and bioactive glass-based materials, which are the most abundantly used materials in dentistry. Based on the literature, bioceramic materials in endodontics have significantly improved over recent years, with different combinations of materials and technology compared to earlier generations while preserving many of their original properties, with some having affordable costs. This review also identified key innovations that could shape the future of endodontic materials, highlighting the ongoing evolution and advancements in endodontic treatments.

A photo-thermal dual crosslinked chitosan-based hydrogel membrane for guided bone regeneration

Alveolar bone defects caused by inflammation or trauma jeopardize patients' oral functions. Guided bone regeneration (GBR) is widely used in repairing periodontal tissue, with barrier membranes play a crucial role in preserving the bone regeneration space. In this study, an injectable dual-crosslinked hydrogel was developed to improve the existing barrier membranes in flexibility and functionality. The hydrogel matrix, composed of methacrylated carboxymethyl chitosan (CMCS) reinforced with robust silk fibroin (SF), was further functionalized with bioactive glass (BG) particles to promote bone regeneration. The pre-gel solution achieved a fast-curing process under visible light and at body temperature. Further, the composite hydrogels presented good biocompatibility, biodegradability, resilience, alongside in vitro barrier effect against human gingival fibroblasts (HGFs). It significantly enhanced osteogenic differentiation and angiogenesis of bone marrow mesenchymal stem cells (BMSCs), facilitate the tube formation of human umbilical vein endothelial cells (HUVECs), and inhibit Staphylococcus aureus and Porphyromonas gingivalis. In a rat skull defect model, the osteogenic performance of hydrogels was comparable with that of collagen membranes (Bio-Gide®). Overall, this in-situ gel-forming barrier material served as a stable carrier for bioactive ions and a biomineralized scaffold for tissue ingrowth, supporting the enhancement of GBR technique.

Antibacterial and metalloproteinase-inhibited zinc-doped bioactive glass nanoparticles for enhancing dentin adhesion

OBJECTIVES

Novel zinc-doped bioactive glass nanoparticles (ZnBGNs) were designed for dental adhesive to enable multifunctional properties for dentin bonding durability.

METHODS

ZnBGNs were synthesized via the sol-gel template method and characterized via TEM, SEM and EDS. ZnBGNs were added from 2.5wt% to 10wt% to Adper™ Single Bond 2 adhesive (SB2). The effects of ZnBGNs on the degree of conversion, contact angle and antibacterial activity were measured. Endogenous matrix metalloproteinases (MMPs) activity, Young's modulus of the hybrid layer, microtensile bond strength and interfacial nanoleakage were investigated after 24 h and 3 months ageing in artificial saliva.

RESULTS

ZnBGNs exhibited good monodispersity, bioactivity activity and superior antimicrobial activity. Adding no >5 wt% ZnBGNs had no adverse effects on the degree of conversion and contact angle of the SB2 Control (p > 0.05). Incorporating ZnBGNs dramatically reduced the endogenous MMPs activity, facilitated remineralization and increased the Young's modulus of the hybrid layer after 3 months ageing (p < 0.05). Dentin bond strength had 44 % loss with increased nanoleakage after 3 months of ageing for SB2 Control. However, SB2+2.5 wt% ZnBGNs showed no loss in bond strength and the least degree of nanoleakage after 3 months ageing (p < 0.05).

CONCLUSIONS

Incorporating ZnBGNs into dental adhesive systems can provide antimicrobial, anti-metalloproteinase and remineralization microenvironments, which indicates a suitable strategy to prevent the degradation of hybrid layers.

CLINICAL SIGNIFICANCE

ZnBGNs with multifunctional properties will likely be used to prevent the degradation of hybrid layers, thereby extending the longevity of resin-dentin bonds.

Advances in macro-bioactive materials enhancing dentin bonding

The long-term stability of dentin bonding is equally crucial for minimally invasive aesthetic restoration. Although the dentin bonding meets clinical standards at the initial stage, its long-term efficacy remains suboptimal owing to the impact of physiological factors. Herein, we present a comprehensive analysis of macro-bioactive materials, including nanomaterials and polymer materials, to improve the longevity of dentin bonding and extend the lifespan of adhesive prosthetics through various mechanisms to achieve sustained and stable dentin bonding effects over an extended period. On the one hand, the macro-bioactive materials directly inhibit the enzymatic activity of matrix metalloproteinases (MMPs) or impede the acidogenic abilities of cariogenic microorganisms, thereby enhancing the local pH within the oral cavity. On the other hand, they indirectly prevent the activation of MMPs, thereby safeguarding the structural integrity of the resin-dentin bonding interface and efficiently improve its long-term stability. Moreover, these macro-bioactive materials establish cross-links with collagen fibers, promoting bionic remineralization and protecting the exposed collagen fibers within the hybrid layer from degradation. These processes ultimately enhance the mechanical properties of the resin-dentin bonding interface and efficiently improve its long-term stability.

Effect of Bioactive Glass into Mineral Trioxide Aggregate on the Biocompatibility and Mineralization Potential of Dental Pulp Stem Cells

Introduction: Previous studies have shown that bioactive glass (BG) can enhance the formation of hydroxyapatite under simulated body fluid (SBF) conditions when combined with mineral trioxide aggregate (MTA). This study aims to assess the impact of BG-supplemented MTA on the biocompatibility and mineralization potential of dental pulp stem cells (DPSCs). Methods: We prepared ProRoot MTA (MTA) and MTA supplemented with 2% and 4% BG. Five passages of DPSCs were utilized for the experiments. The DPSCs were subjected to various tests to determine their morphology, viability, cell migration, and adhesion assay. Additionally, mineralization ability was assessed through SBF immersion treatment, alkaline phosphatase (ALP) activity test, Alizarin red S (ARS) staining, and real-time quantitative polymerase chain reaction (RT-qPCR) analysis. Results: The biocompatibility of BG-supplemented MTA was found to be comparable to that of conventional MTA, as demonstrated by the cell counting kit-8 (CCK-8) assay, cell migration, adhesion assays, and cell morphology on cement surfaces. Under SBF treatment, MTA supplemented with BG, particularly at a concentration of 4%, exhibited higher mineralization potential than conventional MTA in the ALP activity assay. This was supported by denser ARS staining, increased ALP activity, and higher expression of dentin sialophosphoprotein (DSPP), ALP, and bone morphogenetic protein-2 (BMP-2) in the SBF-treated MTABG group. Conclusion: Our study revealed that the biocompatibility of BG-supplemented MTA is similar to that of conventional MTA. Additionally, under SBF treatment, BG-supplemented MTA displayed enhanced mineralization potential, indicating that BG supplementation can augment the mineralization capabilities of MTA.

Physio-Mechanic and Microscopic Analyses of Bioactive Glass-Based Resin Infiltrants

This study aimed to investigate the efficacy and durability of bioactive glass-based dental resin infiltrants. Resin infiltrants were formulated by combining photoinitiated dimethacrylate monomers with three variations of bioactive glass: 45S5 Bioglass (RIS), boron-substituted (RIB), fluoride-substituted (RIF), and pure resins (PR), whereby TOOTH group (TH) and ICON (CN) served as commercial control groups. Teeth samples were prepared, and experimental and control infiltrants were applied on demineralized human-extracted teeth. All the samples were subjected to immersion in artificial saliva and pH cycling for 30 days. The samples from another group underwent tooth brushing simulation for 9600 cycles. Following artificial saliva immersion, the samples' hardness values showed that RIB had the highest values (318.44 ± 3.83) while PR (212.52 ± 9.02) had the lowest values. After immersing into the pH cycling solution, the RIF showed the highest hardness (286.86 ± 5.11), while the lowest values for the CN (143.76 ± 3.50). After the tooth brushing simulation, the teeth samples with RIB showed maximum microhardness values (312.06 ± 16.30) and the weakest for the TH (189.60 ± 6.43). The commercial and experimental enamel resin infiltrants showed almost similar results overall, with RIB demonstrating better microhardness and comparable surface roughness. In contrast, RIF proved more resistant to pH cycling, exhibited higher microhardness, and performed better in surface roughness analysis. These findings suggest that resin infiltrant materials, especially RIF, have promising potential for effectively and esthetically managing white spot lesions.

Comparative In Vitro Study of Sol-Gel-Derived Bioactive Glasses Incorporated into Dentin Adhesives: Effects on Remineralization and Mechanical Properties of Dentin

To overcome limitations of dentin bonding due to collagen degradation at a bonded interface, incorporating bioactive glass (BAG) into dentin adhesives has been proposed to enhance remineralization and improve bonding durability. This study evaluated sol-gel-derived BAGs (BAG79, BAG87, BAG91, and BAG79F) and conventional melt-quenched BAG (BAG45) incorporated into dentin adhesive to assess their remineralization and mechanical properties. The BAGs were characterized by using field-emission scanning electron microscopy (FE-SEM) and transmission electron microscopy for surface morphology. The surface area was measured by the Brunauer-Emmett-Teller method. X-ray diffraction (XRD) analysis was performed to determine the crystalline structure of the BAGs. Adhesive surface analysis was performed after approximating each experimental dentin adhesive and demineralized dentin by using FE-SEM. The elastic modulus of the treated dentin was measured after BAG-containing dentin adhesive application. The sol-gel-derived BAGs exhibited larger surface areas (by 400-600 times) than conventional BAG, with BAG87 displaying the largest surface area. XRD analysis indicated more pronounced and rapid formation of hydroxyapatite in the sol-gel BAGs. Dentin with BAG87-containing adhesive exhibited the highest elastic modulus. The incorporation of sol-gel-derived BAGs, especially BAG87, into dentin adhesives enhances the remineralization and mechanical properties of adhesive-dentin interfaces.

Biological Behavior of Bioactive Glasses SinGlass (45S5) and SinGlass High (F18) in the Repair of Critical Bone Defects

This study evaluated the osteogenic potential of the bioactive glasses SinGlass (45S5) and SinGlass High (F18) in regenerating critical bone defects in rat calvaria. Both biomaterials promoted new bone formation around the particles, with the SinGlass High (F18) group exhibiting a higher rate of bone maturation. Histomorphological and birefringence analyses revealed better organization of the newly formed bone in the biomaterial-treated groups, and immunohistochemistry indicated the expression of osteogenic markers such as osteocalcin, immunostaining for bone morphogenetic protein 2 (BMP 2), and immunostaining for bone morphogenetic protein 4 (BMP 4). Microtomography computadorized (Micro-CT) revealed centripetal bone formation in both groups, with greater integration of the particles into the surrounding bone tissue. The superior performance of SinGlass High (F18) was attributed to its higher potassium and magnesium content, which enhance osteoconductivity. After 42 days, the SinGlass High (F18) group showed the highest percentage of new bone formation, in line with previous studies. Although our results are promising, the limited follow-up period and use of a single animal model highlight the need for further research to validate clinical applicability. SinGlass High (F18) appears to be a viable alternative to autografts in bone repair, with potential to improve tissue integration and accelerate recovery.

An Evaluation of the Biocompatibility and Chemical Properties of Two Bioceramic Root Canal Sealers in a Sealer Extrusion Model of Rat Molars

This study assessed the biocompatibility and chemical properties of two bioceramic root canal sealers, EndoSequence BC Sealer (EBC) and Nishika Canal Sealer BG (NBG), using a sealer extrusion model. Eight-week-old male Wistar rats were used. The mesial root canals of the upper first molars were pulpectomized and overfilled with EBC, NBG, or, as reference, epoxy resin-based AH Plus (AHP). After 28 days, periapical tissue reactions were assessed using microcomputed tomography and histological staining. The elemental composition and chemical composition of the extruded EBC and NBG were analyzed at Day 1 and 28 using an electron probe microanalyzer and micro-Raman spectroscopy. No periapical lesions were observed with the sealer extrusion. Additionally, inflammation around the extruded EBC and NBG was minimal to mild on Day 28, whereas moderate inflammation was found around the extruded AHP. Silicon concentration in the extruded EBC and NBG decreased significantly from Day 1 to 28, with almost no silicon present on Day 28. Furthermore, the extruded EBC and NBG became calcium- and phosphorus-rich, showing a Raman band for hydroxyapatite on Day 28. In conclusion, EBC and NBG demonstrated favorable biocompatibility and the ability to release silicon elements and produce hydroxyapatite when extruded into the periapical tissues. AHP showed moderate periapical tissue irritancy.

Clinical Radiographic and Histological Evaluation of Zinc Bioactive Glass as a Pulpotomy Medicament in Primary Molar Teeth: An In Vivo Study

Background

In the past 20 years, research into pulpotomy materials has transitioned into the "biological era," marked by the emergence of innovative dental materials such as bioactive glass, which are bio-inductive and supportive of regeneration. This evolution represents significant advancements in dentistry.

Aim

To evaluate the clinical, radiographic, and histological success rate of zinc (Zn) bioactive glass as a pulpotomy medicament for primary molars.

Patients and methods

A total sample size of 40 primary molars was selected from 36 children aged 6-9 years. A regular conventional pulpotomy procedure was followed by the placement of Zn bioactive glass over the radicular orifice. The pulp chamber was filled with reinforced zinc oxide eugenol (ZOE). Patient recall was scheduled at 3, 6, 9, and 12 months, respectively. Further evaluation was done by scanning electron microscopy (SEM). Data were tabulated and subjected to statistical analysis.

Results

The present study shows 100, 97.44, 94.74, and 94.74% clinical success at the end of 3, 6, 9, and 12 months, respectively. The radiographic success was 100, 94.87, 92.11, and 92.11% at 3, 6, 9, and 12 months, respectively. SEM analysis showed a well-defined dentinal bridge formation between Zn bioactive glass and the pulp chamber.

Conclusion

Quite promising clinical, radiographic, and histological results of Zn bioactive glass in the present study show its potential as an additional pulpotomy medicament to the presently existing pulpotomy agents.

How to cite this article

Reddy VN, Reddy D, Snehitha K, et al. Clinical Radiographic and Histological Evaluation of Zinc Bioactive Glass as a Pulpotomy Medicament in Primary Molar Teeth: An In Vivo Study. Int J Clin Pediatr Dent 2025;18(1):34-39.

Applications and interventions of polymers and nanomaterials in alveolar bone regeneration and tooth dentistry

Inflammatory diseases exert a significant influence on the periodontium, serving as a primary contributor to the development of periodontitis. The advancement of periodontitis, characterized by manifestations, such as gingival recession, increased periodontal pocket depth and resorption across the alveolar bone, cementum and periodontal ligaments, poses a significant risk of dental detachment. Untreated or delayed treatment further worsens these deleterious outcomes. This emphasizes the critical importance of timely and effective interventions in reducing the consequences associated with periodontitis. Addressing these challenges requires to focus on the fabrication of bioactive materials, particularly scaffolds, as pivotal elements in tissue engineering processes aimed at alveolar bone regeneration. The incorporation of natural polymers, particularly their amalgamation with clays and clay minerals, such as montmorillonite and LAPONITE®, has been identified as a prospective pathway for advancing biomaterials in the realm of dentistry. This amalgamation holds significant potential for the production of biomaterials with enhanced properties, underscoring its relevance and applicability in dental research. This review paper explores the current advancements in natural polymer-based biomaterials employed in various dental applications, including oral caries, regenerative medicine and alveolar bone regeneration. The principal aim of this investigation is to briefly compile and present the existing knowledge while updating information on the utilization of natural polymers in the formulation of biomaterials. Additionally, the paper aims to elucidate their applications within contemporary research trends and developments in the field of odontology. This article extensively delves into pertinent research to assess the progress of nanotechnology in the context of tissue regeneration and the treatment of oral diseases.

Effect of Fluoride-incorporated Bioactive Glass Toothpaste on Remineralization of Primary Enamel Lesions: An In-Vitro Study

Aims

This study aimed to evaluate the enamel remineralization effect of fluoride-incorporated bioactive glass (F-BG) toothpaste on artificial subsurface caries in primary teeth.

Materials and Methods

Forty sound primary maxillary incisors were subjected to a demineralizing solution for four days to induce artificial enamel caries. The teeth were randomly divided into four experimental groups (n = 10 per group): Group I, F-BG toothpaste (530 ppm fluoride) (BiominF®); Group II, 0.22% sodium fluoride toothpaste (1000 ppm fluoride) (Colgate®); Group III, 0.32% sodium fluoride toothpaste (1450 ppm fluoride) (Colgate®); and Group IV, deionized water as a control. Over the course of seven days, each specimen was treated with a slurry of the respective toothpaste twice daily, followed by pH cycling to simulate oral conditions. Mineral density (MD) values were measured at depths of 0, 40, 80, and 120 μm using micro-computed tomography (micro-CT) before and after the pH cycling. The percentage of remineralization was calculated based on changes in MD. Statistical comparisons among the groups were made using one-way analysis of variance (ANOVA), followed by post-hoc Bonferroni tests, with a significance level set at P < 0.05.

Results

At depths of 0, 40, and 80 μm, both F-BG toothpaste (Group I) and the 1450 ppm fluoride toothpaste (Group III) demonstrated significantly higher remineralization than the 1000 ppm fluoride toothpaste (Group II) and the control group (Group IV) (P < 0.05). No significant difference in remineralization was observed between Group I and Group III (P > 0.05). At a depth of 120 μm, none of the test groups showed significant remineralization compared to the control group.

Conclusions

The fluoride-incorporated bioactive glass toothpaste (530 ppm fluoride) demonstrated remineralization effects on enamel comparable to those of the 1450 ppm fluoride toothpaste in terms of both surface and subsurface enamel restoration in primary teeth. Clinically, this suggests that F-BG toothpaste may be a viable alternative for remineralization therapy in pediatric populations, especially in situations where lower fluoride concentrations are preferred for young children. Further long-term studies are needed to assess the clinical durability and efficacy of F-BG toothpaste in caries prevention and management.

Limitations, challenges and prospective solutions for bioactive glasses-based nanocomposites for dental applications: A critical review

Several nanomaterials have been recently used to overcome various challenges in the dental domain. Bioactive glasses, a class of bioceramics, with their outstanding properties including but not limited to their strong biocompatibility, antibacterial characteristics, and bioactivity inside the body's internal milieu have made them valuable biomaterials in a variety of dental domains. The utilization of nanomaterials has improved the performance of teeth, and the incorporation of bioactive glasses has the field of dentistry at an unsurpassed level in different categories such as esthetic and restorative dentistry, periodontics and dental implants, orthodontics, and endodontics. The current study discusses the most recent developments of the bioactive glasses' creation and implementation for dental applications, as well as the challenges and opportunities still facing the field. This work provides an overview of the current obstacles and potential future prospects for bioactive glasses-based nanocomposites to improve their dental uses. It also emphasizes the great potential synergistic effects of bioactive glasses used with other nanomaterials for dental applications.

Recent development and applications of electrodeposition biocoatings on medical titanium for bone repair

Bioactive coatings play a crucial role in enhancing the osseointegration of titanium implants for bone repair. Electrodeposition offers a versatile and efficient technique to deposit uniform coatings onto titanium surfaces, endowing implants with antibacterial properties, controlled drug release, enhanced osteoblast adhesion, and even smart responsiveness. This review summarizes the recent advancements in bioactive coatings for titanium implants used in bone repair, focusing on various electrodeposition strategies based on material-structure synergy. Firstly, it outlines different titanium implant materials and bioactive coating materials suitable for bone repair. Then, it introduces various electrodeposition methods, including electrophoretic deposition, anodization, micro-arc oxidation, electrochemical etching, electrochemical polymerization, and electrochemical deposition, discussing their applications in antibacterial, osteogenic, drug delivery, and smart responsiveness. Finally, it discusses the challenges encountered in the electrodeposition of coatings for titanium implants in bone repair and potential solutions.

Biomaterial Scaffolds for Periodontal Tissue Engineering

Advanced periodontitis poses a significant threat to oral health, causing extensive damage and loss of both hard and soft periodontal tissues. While traditional therapies such as scaling and root planing can effectively halt the disease's progression, they often fail to fully restore the original architecture and function of periodontal tissues due to the limited capacity for spontaneous regeneration. To address this challenge, periodontal tissue engineering has emerged as a promising approach. This technology centers on the utilization of biomaterial scaffolds, which function as three-dimensional (3D) templates or frameworks, supporting and guiding the regeneration of periodontal tissues, including the periodontal ligament, cementum, alveolar bone, and gingival tissue. These scaffolds mimic the extracellular matrix (ECM) of native periodontal tissues, aiming to foster cell attachment, proliferation, differentiation, and, ultimately, the formation of new, functional periodontal structures. Despite the inherent challenges associated with preclinical testing, the intensification of research on biomaterial scaffolds, coupled with the continuous advancement of fabrication technology, leads us to anticipate a significant expansion in their application for periodontal tissue regeneration. This review comprehensively covers the recent advancements in biomaterial scaffolds engineered specifically for periodontal tissue regeneration, aiming to provide insights into the current state of the field and potential directions for future research.

Modification of polymethylmethacrylate bone cement with halloysite clay nanotubes

BACKGROUND

Polymethylmethacrylate (PMMA) bone cement is used in orthopedics and dentistry to get primary fixation to bone but doesn't provide a mechanically and biologically stable bone interface. Therefore, there was a great demand to improve the properties of the PMMA bone cement to reduce its clinical usage limitations and enhance its success rate. Recent studies demonstrated that the addition of halloysite nanotubes (HNTs) to a polymeric-based material can improve its mechanical and thermal characteristics.

OBJECTIVES

The purpose of the study is to assess the compressive strength, flexural strength, maximum temperature, and setting time of traditional PMMA bone cements that have been manually blended with 7 wt% HNT fillers.

METHODS

PMMA powder and monomer liquid were combined to create the control group, the reinforced group was made by mixing the PMMA powder with 7 wt% HNT fillers before liquid mixing. Chemical characterization of the HNT fillers was employed by X-ray fluorescence (XRF). The morphological examination of the cements was done using a scanning electron microscope (SEM). Analytical measurements were made for the compressive strength, flexural strength, maximum temperature, and setting time. Utilizing independent sample t-tests, the data was statistically assessed to compare mean values (p < 0.05).

RESULTS

The findings demonstrated that the novel reinforced PMMA-based bone cement with 7 wt% HNT fillers showed higher mean compressive strength values (93 MPa) and higher flexural strength (72 MPa). and lower maximum temperature values (34.8 °C) than the conventional PMMA bone cement control group, which was (76 MPa), (51 MPa), and (40 °C), respectively (P < 0.05). While there was no significant difference in the setting time between the control and the modified groups.

CONCLUSION

The novel PMMA-based bone cement with the addition of 7 wt% HNTs can effectively be used in orthopedic and dental applications, as they have the potential to enhance the compressive and flexural strength and reduce the maximum temperatures.

A Comparative Evaluation of Arginine Complex Combined With Flouride and Two Standard Non-Fluoridated Remineralizing Agents: An In Vitro Study

Background Dental caries represents a dynamic process, often reversible in its early stages. Fluoride has conventionally served as the cornerstone for remineralization and early caries arrest. However, excessive fluoride intake can lead to both local and systemic toxicity. Hence, there's a pressing need to develop adjunct therapies that enhance fluoride's efficacy while minimizing its dosage. This study aims to assess and compare the remineralization potential of a novel combination comprising arginine bicarbonate and fluoride against established technologies such as Bioactive glass (NovaMin Technology; Sensodyne Repair and Protect, GlaxoSmithKline, UK) and CPP-ACP technology (GC Tooth Mousse; Tokyo Japan). Materials and methods The experiment utilized extracted premolars designated for orthodontic extraction. The initial evaluation employed the DIAGNOdentTM fluorescence method. Subsequently, teeth underwent demineralization and were measured for values. Following this, the teeth were subjected to seven cycles of remineralization, after which moment values were reassessed. Statistical analysis was performed on the recorded values. Results Participants were divided into six groups (BR-A, AR-A, BR-B, AR-B, BR-C, AR-C). T-tests demonstrated significant reductions in moment values within each group, indicating the effectiveness of all remineralizing agents. Group C exhibited the most substantial difference (-6.900 ± 0.4), followed by Group A and Group B. ANOVA analysis revealed statistically significant differences among all three groups (p=0.016). Tables showed significant distinctions between the remineralizing values of Groups A and C and Groups B and C (p=0.02 and 0.002, respectively), with no discernible distinction between Groups A and B. Conclusion The study elucidates the superior efficacy of the arginine complex with fluoride combination compared to CPP-ACP and Bioactive Glass individually. This finding underscores the potential of the novel combination therapy in enhancing remineralization while minimizing fluoride dosage, thus presenting a promising strategy for addressing early-stage dental caries.

Performance evaluation of carbon quantum dots impregnated glass ionomer cement to avoid peri-implant disease

Dental cement residues exacerbate peri-implant tissue irritation and peri-implantitis. The present study aims to evaluate the cytotoxicity, physiochemical, optical, and rheological properties of carbon quantum dots (CQDs) impregnated glass ionomer cement (GIC). Surface passivated fluorescent CQDs were synthesized using citric acid via thermal decomposition and blended with GIC. Characterization studies and rheological measurements were made to evaluate their performance. 3D-printed dental implant models cemented with GIC and GIC-CQD were compared to analyze excess cement residues. MTT assay was performed with human dental pulp stem cells (hDPSCs) and statistically analyzed using ANOVA and Tukey's test. CQDs with a particle dimension of ∼2 nm were synthesized. The amorphous property of GIC-CQD was confirmed through XRD. The fluorescence properties of GIC-CQD showed three times higher emission intensity than conventional GIC. GIC-CQD attained maturation with a setting time extended by 64 s than GIC. Cement residue of size 2 mm was detected with a UV light excitation at a distance between 5 to 10 cm. Biocompatibility at 0.125 mg ml-1dilution concentrations of GIC-CQD showed viability greater than 80% to hDPSCs. For the first time, we report that CQDs-impregnated GIC is a unique and cost-effective strategy for in-situ detection of excess cement rapidly using a hand-held device. A novel in-situ rapid detection method enables the dentist to identify residual cement of size less than 2 mm during the implantation. Therefore, GIC-CQD would replace conventional GIC and help in the prevention of peri-implant diseases.

Assessment of sealing efficacy, radiopacity, and surface topography of a bioinspired polymer for perforation repair

Background

Root perforation repair presents a significant challenge in dentistry due to inherent limitations of existing materials. This study explored the potential of a novel polydopamine-based composite as a root repair material by evaluating its sealing efficacy, radiopacity, and surface topography.

Methods

Confocal microscopy assessed sealing ability, comparing the polydopamine-based composite to the gold standard, mineral trioxide aggregate (MTA). Radiopacity was evaluated using the aluminium step wedge technique conforming to ISO standards. Surface roughness analysis utilized atomic force microscopy (AFM), while field emission scanning electron microscopy (FESEM) visualized morphology.

Results

The polydopamine-based composite exhibited significantly superior sealing efficacy compared to MTA (P < 0.001). Radiopacity reached 3 mm aluminium equivalent, exceeding minimum clinical requirements. AFM analysis revealed a smooth surface topography, and FESEM confirmed successful composite synthesis.

Conclusion

This study demonstrates promising properties of the polydopamine-based composite for root perforation repair, including superior sealing efficacy, clinically relevant radiopacity, and smooth surface topography. Further investigation is warranted to assess its clinical viability and potential translation to endodontic practice.

Assessment of physical properties of bioactive glass-modified universal multimode adhesive and its bonding potential to artificially induced caries affected dentin

BACKGROUND

To evaluate the physical properties of bioactive glass-modified universal multimode adhesive and its micro-tensile bond strength (µTBS) to artificially induced caries-affected dentin.

METHODS

All bond universal adhesive was used in the study. Specimens were divided into 2 main groups: control unmodified adhesive and 5 wt% BAG modified adhesive. The degree of conversion, pH, bioactivity, and viscosity of the adhesives were tested with n = 5 for each test. Micro-tensile bond strength evaluation was done in etch & rinse (ER) and selective-etch (SE) modes, where 24 human molar teeth were used (n = 3), 12 teeth for immediate bond strength, and the other 12 were tested after 6 months of storage in simulated body fluid (SBF).

RESULTS

No significant difference was found between the control and the 5wt% BAG groups regarding the degree of conversion (61.01 ± 0.43 and 60.44 ± 0.61 respectively) and the viscosity (109.77 ± 22.3 and 124.3 ± 9.92 respectively). The control group revealed significantly lower pH values than the 5wt% BAG group (3.16 ± 0.5 and 4.26 ± 0.09 respectively). Immediate bond strength results revealed that the 5wt% BAG in the ER mode had the highest bond strength followed by the control group in the ER mode (44.16 ± 7.53 and 44.00 ± 7.96 respectively). SE groups showed that the immediate strength of the 5wt% BAG group was higher than the control group (42.09 ± 6.02 and 39.29 ± 6.64 respectively). After 6 months of storage, bond strength results revealed a decrease in bond strength values for the control groups but not for the 5wt% BAG in both application modes.

CONCLUSIONS

The incorporation of BAG (5wt%) improved the universal adhesive micro-tensile bond strength and bond durability for both adhesive application modes without affecting its degree of conversion or viscosity.

Bioactive Biosilicate Cements in Pediatric Dentistry - A Review of the Latest Materials

Pediatric dentistry plays a critical role in ensuring the oral health and well-being of children and adolescents. The quest for effective dental materials that are safe, biocompatible, and capable of promoting natural remineralization has led to the emergence of biosilicate cements as a promising advancement in this field. Biosilicate cements are bioactive materials composed of amorphous silica, calcium oxide, phosphorus pentoxide, and other trace elements. The bioactivity of biosilicate cements allows them to interact with living tissues, promoting remineralization and stimulating the formation of hydroxyapatite, a vital component of teeth and bones. Their ability to release essential ions, such as calcium, phosphate, and fluoride, supports the natural healing processes, aiding in the preservation of pulp vitality and reducing the risk of secondary caries. Biosilicate cements offer versatility in pediatric dentistry, finding application indirect pulp capping, indirect pulp capping, and small-sized restorations. Their rapid setting time proves advantageous when treating young patients with limited cooperation. Furthermore, the continuous release of fluoride contributes to caries prevention and enhances the long-term oral health of children. While the advantages of biosilicate cements in pediatric dentistry are promising, this manuscript also discusses the limitations and challenges associated with their use. Some biosilicate cements may have different handling characteristics compared to traditional materials, necessitating adaptations in clinical techniques. In addition, long-term clinical data on the performance of these materials in pediatric patients are still limited, requiring further research to establish their efficacy and longevity. This manuscript explores the potential of biosilicate cements in pediatric dentistry.

Additive Manufacturing of Iron Carbide Incorporated Bioactive Glass Scaffolds for Bone Tissue Engineering and Drug Delivery Applications

In this study, we have synthesized a bioactive glass with composition 45SiO2-20Na2O-23CaO-6P2O5-2.5B2O3-1ZnO-2MgO-0.5CaF2 (wt %). Further, it has been incorporated with 0.4 wt % iron carbide nanoparticles to prepare magnetic bioactive glass (MBG) with good heat generation capability for potential applications in magnetic field-assisted hyperthermia. The MBG scaffolds have been fabricated using extrusion-based additive manufacturing by mixing MBG powder with 25% Pluronic F-127 solution as the binder. The saturation magnetization of iron carbide nanoparticles in the bioactive glass matrix has been found to be 80 emu/g. The morphological analysis (pore size distribution, porosity, open pore network modeling, tortuosity, and pore interconnectivity) was done using an in-house developed methodology that revealed the suitability of the scaffolds for bone tissue engineering. The compressive strength (14.3 ± 1.6 MPa) of the MBG scaffold was within the range of trabecular bone. The in vitro test using simulated body fluid (SBF) showed the formation of apatite indicating the bioactive nature of scaffolds. Further, the drug delivery behaviors of uncoated and polycaprolactone (PCL) coated MBG scaffolds have been evaluated by loading an anticancer drug (Mitomycin C) onto the scaffolds. While the uncoated scaffold demonstrated the drug's burst release for the initial 80 h, the PCL-coated scaffold showed the gradual release of the drug. These results demonstrate the potential of the proposed MBG for bone tissue engineering and drug delivery applications.

A Review on Enhancing the Life of Teeth by Toothpaste Containing Bioactive Glass Particles

Purpose of Review

Dental caries or tooth decay is one of the communal problems in the world which can affect not only the oral health but also the general health conditions. The main objective of this systematic review is to explore the efficacy of bioactive glass-based toothpastes against cariogenic bacteria.

Recent Findings

Bioactive glass particulates containing toothpaste show better remineralization potential on demineralized enamel and dentin when compared with toothpaste containing various bioactive constituents such as fluoride and potassium chloride. These constituents in conventional toothpaste can rapidly streak off due to acidic impact in the oral environment as the bioactive glass provides minerals for demineralized enamel and dentin by forming a strong hydroxyapatite (HAp) layer on its surface. Further, the therapeutic ions present in the bioglass can resist plaque formation by raising the pH of the surrounding environment or saliva and create amicable media for healthier teeth.

Summary

Toothpaste containing bioactive glass particles undoubtedly displayed the remineralizing potentiality of the dental hard tissues. Dynamics of the mineralization through different bioactive glass materials needs further investigations. In order to prevent dental cavities and improve oral health, it is important to identify and study different effective bioglass particles in toothpaste.

Effect of bioactive glass particles on mechanical and adhesion properties of resin cements

PURPOSE

The aim of this study is to evaluate the mechanical and adhesive properties of three different resin cements with bioactive glass (BAG) incorporated in two different ratios.

METHODS

BAG was added to different resin cements (3M Rely-X Ultimate, GC Link Ace, and GC Link Force) in different ratios (5% and 10% by weight). The three-point flexural strength, microhardness, and bond strength properties were evaluated. The fracture types of the groups were then analyzed using a stereo microscope. The data were analyzed using a multifactorial analysis of variance and Tukey's post-hoc tests (α < 0.05).

RESULTS

The addition of BAG reduced the flexural strength of the resin cements (P < 0.05).The effect of BAG addition on the Vickers microhardness value was significantly different for each cement group (P < 0.05). In addition, with the exception of the GC link force group (10% BAG addition), the BAG addition decreased the bond strength of cements to dentin in all the groups (P = 0.171).

CONCLUSIONS

The results of this study confirmed that different resin cements comprising different ratios of BAG exhibited different flexural strength, hardness, and bond-strength properties. Since the bond strength values increased with the addition of 10% BAG in the GC Link Force cement group, the effects of different BAG compositions could be worth investigating in future studies.

Effect of strontium fluorophosphate bioactive glass on color, microhardness and surface roughness of bleached enamel

BACKGROUND

Undesirable effects of tooth bleaching can alter the biomechanical properties of enamel.

OBJECTIVE

To determine the influence of strontium fluorophosphate bioactive glass (Sr-FPG) on color, microhardness and surface roughness of enamel bleached with 35% hydrogen peroxide.

METHODS

The labial enamel of 36 extracted intact human anterior teeth were divided into 3 groups (n= 12), group 1 (HP): bleaching with 35% hydrogen peroxide only, group 2 (Sr-HP): bleaching with Sr-FPG incorporated 35% hydrogen peroxide and group 3 (HP-SrFPG): bleaching with 35% hydrogen peroxide followed by remineralization with Sr-FPG. Four consecutive eight-minute applications of the bleaching gel were done twice in all the groups. Color change (ΔE), microhardness and surface roughness were evaluated at baseline, post-bleaching and post-remineralization using spectrophotometer, Vickers hardness tester and profilometric analysis respectively.

RESULTS

The mean ΔE among the groups was statistically similar (p> 0.05). Bleaching with HP significantly reduced microhardness (p< 0.05), whereas bleaching with Sr-HP and HP-SrFPG did not (p> 0.05). Post-bleaching microhardness in Sr-HP was significantly higher than HP-SrFPG (p< 0.05). An increased surface roughness was seen in Sr-HP bleached samples (p< 0.05).

CONCLUSION

The addition of Sr-FPG to hydrogen peroxide significantly improved enamel microhardness than its use post-bleaching. An increase in surface roughness was seen post-bleaching with HP and Sr-HP.

The Preparation and Effects of Organic-Inorganic Antioxidative Biomaterials for Bone Repair

Reactive oxygen species (ROS) has great influence in many physiological or pathological processes in organisms. In the site of bone defects, the overproduced ROS significantly affects the dynamic balance process of bone regeneration. Many antioxidative organic and inorganic antioxidants showed good osteogenic ability, which has been widely used for bone repair. It is of great significance to summarize the antioxidative bone repair materials (ABRMs) to provide guidance for the future design and preparation of osteogenic materials with antioxidative function. Here, this review introduced the major research direction of ABRM at present in nanoscale, 2-dimensional coating, and 3-dimensional scaffolds. Moreover, the referring main active substances and antioxidative properties were classified, and the positive roles of antioxidative materials for bone repair have also been clearly summarized in signaling pathways, antioxidant enzymes, cellular responses and animal levels.

Evaluation of Eruption of Permanent Teeth in Beagle Dog Extraction Sites Filled with Carbonate Apatite

Autologous bone grafting is the primary method for treating alveolar clefts. However, bone grafting materials are desired as alternatives to autogenous bone to reduce surgical invasiveness. Here, we present an animal study evaluating the effect of carbonate apatite (CA) on the spontaneous eruption of permanent teeth. The bone grafting materials included CA, natural bovine bone (BB), and hydroxyapatite (HA). In 15 8-week-old male beagle dogs, the left mandibular deciduous premolars (DP) two and three were extracted and subsequently filled with CA, BB, and HA. The animals were euthanized after a predetermined number of days, and samples were collected for microcomputed tomography and histological evaluation. Spontaneous eruption of the succeeding permanent teeth (P3 and P4) was observed in the CA group at 14 weeks. Delayed eruption of the succeeding permanent teeth was observed in the BB and HA groups. CA could serve as a viable alternative to autogenous bone for treating alveolar clefts.

The Impact of 45S5-Bioactive Glass on Synovial Cells in Knee Osteoarthritis-An In Vitro Study

Synovial inflammation in osteoarthritis (OA) is characterized by the release of cartilage-degrading enzymes and inflammatory cytokines. 45S5-bioactive glass (45S5-BG) can modulate inflammation processes; however, its influence on OA-associated inflammation has hardly been investigated. In this study, the effects of 45S5-BG on the release of cartilage-degrading metalloproteinases and cytokines from synovial membrane cells (SM) isolated from patients with knee OA was assessed in vitro. SM were cultivated as SM monocultures in the presence or absence of 45S5-BG. On day 1 (d1) and d7 (d7), the concentrations of Matrix Metalloproteinases (MMPs) and cytokines were assessed. In 45S5-BG-treated SM cultures, MMP9 concentration was significantly reduced at d1 and d7, whilst MMP13 was significantly increased at d7. Concentrations of interleukin (IL)-1B and C-C motif chemokine ligand 2 (CCL2) in 45S5-BG-treated SM cultures were significantly increased at both time points, as were interferon gamma (IFNG) and IL-6 at d7. Our data show an effect of 45S5-BG on SM activity, which was not clearly protective, anti-inflammatory, or pro-inflammatory. The influence of 45S5-BG on MMP release was more suggestive of a cartilage protective effect, but 45S5-BG also increased the release of pro-inflammatory cytokines. Further studies are needed to analyze the effect of BGs on OA inflammation, including the anti-inflammatory modification of BG compositions.

Biomaterials for Alveolar Ridge Preservation as a Preoperative Procedure for Implant Treatment: History and Current Evidence

In implant treatment, the reduction and structural changes in the alveolar ridge that occur after tooth extraction limit the length, width, and placement position of the implant body, impair esthetics, and, in some cases, make implant placement difficult. To solve these problems, an alveolar ridge preservation (ARP) technique, which is performed simultaneously with tooth extraction, generally aims to promote bone regeneration and prevent alveolar ridge reduction by filling the extraction socket with bone graft material and then covering it with a barrier membrane to protect against the invasion of epithelial tissue. The extraction socket provides a favorable environment for bone regeneration throughout the healing period because the blood supply is abundant, and it effectively retains the bone graft material by using the remaining bone wall of the socket. In recent years, advances in bioengineering technology have led to the development of graft materials with various biological properties, but there is currently no clear consensus regarding the selection of surgical techniques and materials depending on the condition of the alveolar ridge. This review will provide a comprehensive survey of the evidence accumulated to date on ARP, present many cases according to the clinical situation, and discuss various treatment options.

Herbalism and glass-based materials in dentistry: review of the current state of the art

Half a million different plant species are occurring worldwide, of which only 1% has been phytochemically considered. Thus, there is great potential for discovering novel bioactive compounds. In dentistry, herbal extracts have been used as antimicrobial agents, analgesics, and intracanal medicaments. Glass-ionomer cement (GIC) and bioactive glass (BAG) are attractive materials in dentistry due to their bioactivity, adhesion, and remineralisation capabilities. Thus, this review summarizes the evidence around the use of phytotherapeutics in dental glass-based materials. This review article covers the structure, properties, and clinical uses of GIC and BAG materials within dentistry, with an emphasis on all the attempts that have been made in the last 20 years to enhance their properties naturally using the wisdom of traditional medicines. An extensive electronic search was performed across four databases to include published articles in the last 20 years and the search was concerned only with the English language publications. Publications that involved the use of plant extracts, and their active compounds for the green synthesis of nanoparticles and the modification of GIC and BAG were included up to May 2023. Plant extracts are a potential and effective candidate for modification of different properties of GIC and BAG, particularly their antimicrobial activities. Moreover, natural plant extracts have shown to be very effective in the green synthesis of metal ion nanoparticles in an ecological, and easy way with the additional advantage of a synergistic effect between metal ions and the phytotherapeutic agents. Medicinal plants are considered an abundant, cheap source of biologically active compounds and many of these phytotherapeutics have been the base for the development of new lead pharmaceuticals. Further research is required to assess the safety and the importance of regulation of phytotherapeutics to expand their use in medicine.

Formulating an altered dentin substrate to improve dentin bonding

STATEMENT OF PROBLEM

Secondary caries is a major factor in the failure of dental restorations. However, studies on the fabrication of acid-resistant and antibacterial dentin to improve dentin bonding are sparse.

PURPOSE

The purpose of this in vitro study was to compare the effects of 2 types of fluoride-containing etchants on dentin bonding and explore the feasibility of formulating an altered dentin substrate to improve dentin bonding.

MATERIAL AND METHODS

NaF-containing and SnF2-containing etchants were developed by adding sodium fluoride and stannous fluoride to a 35% phosphoric acid aqueous solution. Two groups (N1 and N2) containing NaF, 10 and 30 mg/mL respectively, and 2 groups (S1 and S2) containing SnF2, 18.6 and 55.8 mg/mL respectively, were formulated. The etchant of the control group (C) was 35% phosphoric acid gel. Scanning electron microscopy (SEM), energy dispersive spectrometry (EDS), Fourier transform infrared spectroscopy (FTIR), microhardness, antierosion, and antibacterial tests were performed on the treated dentin. Moreover, the microtensile bond strength (µTBS) of each group was tested, and the fracture mode was determined after testing. Statistical analysis was performed with the 2-way ANOVA test (α=.05).

RESULTS

The exposed collagen fiber was observed in group C, and minerals were formed on the dentin in the experimental groups. SEM, FTIR, and the microhardness test indicated more remineralization in the SnF2-containing etchant groups. The µTBS of S1 (77.5 ±10.36 MPa) was the highest in all groups, and group C (38.5 ±9.01 MPa) was the lowest. Moreover, the antierosion and antibacterial properties of the S2 group were the best among all groups (P<.05).

CONCLUSIONS

Compared with NaF-containing etchant, SnF2-containing etchant could improve the dentin substrate, increase remineralization, improve bonding strength, and enhance antibacterial ability, especially by increasing resistance to acid erosion.

A better roadmap for designing novel bioactive glasses: effective approaches for the development of innovative revolutionary bioglasses for future biomedical applications

The introduction of bioactive glasses (BGs) precipitated a paradigm shift in the medical industry and opened the path for the development of contemporary regenerative medicine driven by biomaterials. This composition can bond to live bone and can induce osteogenesis by the release of physiologically active ions. 45S5 BG products have been transplanted effectively into millions of patients around the world, primarily to repair bone and dental defects. Over the years, many other BG compositions have been introduced as innovative biomaterials for repairing soft tissue and delivering drugs. When research first started, many of the accomplishments that have been made today were unimaginable. It appears that the true capacity of BGs has not yet been realized. Because of this, research involving BGs is extremely fascinating. However, to be successful, it requires interdisciplinary cooperation between physicians, glass chemists, and bioengineers. The present paper gives a picture of the existing clinical uses of BGs and illustrates key difficulties deserving to be faced in the future. The challenges range from the potential for BGs to be used in a wide variety of applications. We have high hopes that this paper will be of use to both novice researchers, who are just beginning their journey into the world of BGs, as well as seasoned scientists, in that it will promote conversation regarding potential additional investigation and lead to the discovery of innovative medical applications for BGs.

Design of customized implants and 3D printing of symmetric and asymmetric cranial cavities

A methodology has been developed in this work to design customized cranial implants from computed tomography (CT) scan images for symmetric as well as asymmetric defects. The two-dimensional CT scan images were converted into three-dimensional geometric models using software packages. Two cases of cranial cavities at different locations were considered for implant design using two different approaches. Case 1 is having a symmetric cranial cavity while Case 2 has an asymmetric frontal cranial cavity. The craniums with defects were 3D reconstructed. Customized cranial implants were made for the two cases. In Case 1, symmetry was used to design the cranial implant. Symmetry cannot be used in Case 2. In Case 2, the implant was designed by blending from the surface available adjacent to the missing portion of the cranium. 3D reconstructed bone models and customized implants were 3D printed in poly-lactic acid (PLA) using a fused deposition modeling process for form and fit evaluation. Finite element analysis was performed to compare the mechanical behavior of bone, and the two biomaterials - polyether ether ketone (PEEK), and Ti6Al4V. Static structural finite element analysis was performed to simulate the impact of falling off a bicycle with an impact on the cranial implants in the two cases. The load was modeled as a normal force acting on the surface of the implant. It was found that the stresses in the titanium alloy are comparable to those of PEEK for both the cases. However, the strains and deformation were found to be much smaller compared to those in PEEK. Therefore, the titanium alloy is the material of choice for both the cases among the materials under consideration. The designed implants are solid hence may face the challenge in bone ingrowth. In future studies, the implant can be made porous by incorporating a lattice structure to enhance osseointegration and promote bone ingrowth. Implants for both symmetric and asymmetric defect cases in cranium were successfully designed.

An Evaluation of Experimental Calcium Ion-Leachable Nanocomposite Glass Ionomer Cements

Glass ionomer cements (GICs) are among the main restorative dental materials used broadly in daily clinical practice. The incorporation of clay nanoparticles as reinforcing agents is one potential approach to improving GIC properties. This study aims to investigate whether the incorporation of calcium-modified clay (Ca-clay) nanoparticles in conventional GICs alters their structural characteristics, along with their physicochemical and mechanical properties. Scanning electron microscopy (SEM) and X-ray diffraction (XRD) analyses were performed to assess the surface characterization of GIC nanocomposites, whereas a setting reaction was carried out via an attenuated total reflection Fourier transform infrared spectrometer (ATR-FTIR). A universal testing machine was used for compression tests, while calcium ion release was quantified using inductively coupled plasma optical emission spectrometry (ICP-OES). GIC composite groups reinforced with Ca-clay were found to release a fine amount of calcium ions (5.06-9.91 ppm), with the setting reaction being unaffected for low Ca-clay loadings. The median compressive strength of 3 wt% in the Ca-clay group (68.97 MPa) was nearly doubled compared to that of the control group (33.65 MPa). The incorporation of Ca-clay nanoparticles in GICs offers a promising alternative among dental restorative materials regarding their chemical and mechanical properties.

Application of Mineralized Chitosan Scaffolds in Bone Tissue Engineering

Chitosan (CS) is a natural cationic polysaccharide obtained via the N-deacetylation of chitin. It has various outstanding biological properties such as nontoxicity, biodegradability, biocompatibility, and antimicrobial properties. Minerals can be deposited on the CS template using different methods to construct composites with structures and functions similar to those of natural bone tissue. These ideal scaffolds can produce bone via osteogenesis, osteoinduction, and osteoconduction, with good biocompatibility and mechanical properties, and are thus considered promising novel biomaterials for repairing hard tissue defects. In the last decade, the field of mineralized CS scaffolds has provided novel fundamental knowledge and techniques to better understand the aforementioned fascinating phenomenon. This study mainly focused on the basic structures and properties of mineralized CS scaffolds to understand the current research progress and explore further development. Further, it summarizes the types, preparation methods, components, properties, and applications of mineralized CS scaffolds in bone tissue engineering during the last 5 years. The defects and shortcomings of the scaffolds are discussed, and possible improvement measures are put forward. We aimed to provide complete research progress on mineralized CS scaffolds in bone tissue engineering for researchers and clinicians, and also ideas for the next generation of mineralized CS scaffolds.

Effect of bioactive glass-containing dentin adhesives on microshear bond strength of composite restorations

Background

In general, bioactive glasses (BAGs) can react with tissue minerals and promote remineralization. However, the application of BAG in bonding agents and its impact on bond strength remain uncertain due to insufficient information and limited research in this area.

Materials and Methods

This study employed a randomized controlled design to assess the effects of composite-bonding agents with varying BAG contents on shear bond strength and fracture pattern in sound and demineralized teeth, with and without thermocycling. Thus, 80 healthy third molars were randomly divided into two groups: sound teeth and demineralized teeth. Five bonding agents were applied to the prepared dentin surfaces, including four experimental composite-bonding agents with varying BAG content (0, 0.2, 0.5, and 2 wt%) and the Adper Single Bond commercial bonding as control. The shear bond strength of all samples was measured using a universal tester. The type of failure of each specimen was determined using a stereomicroscope. Kruskal-Wallis nonparametric test was performed on the obtained shear bond strength data followed by Mann-Whitney post hoc test with Bonferroni correction to determine statistical significance. The level of significance was considered P ≤ 0.05 for all tests and was adjusted by Bonferroni correction.

Results

Demineralization significantly decreased shear bond strength in the teeth samples. Adper Single Bond exhibited the highest shear bond strength values. The addition of BAG did not have a significant influence on shear bond strength, regardless of demineralization or thermocycling condition. Adhesive failure was the predominant type of failure in all groups.

Conclusion

The incorporation of BAG filler up to 2 wt% did not result in significant changes in shear bond strength. Experimental adhesive bonding agents with 2 wt% BAG content demonstrated shear bond strengths comparable to the commercial bonding agent in sound nontreated, sound thermocycled, demineralized nontreated, and demineralized thermocycled groups.

Evaluation of Abfraction Lesions Restored with Three Dental Materials: A Comparative Study

BACKGROUND

Abfraction lesions are manifested as damage to hard tissues in the cervical area of dental crowns. The study aimed to assess the direct restoration of abfraction lesions according to the modified United States Public Health Service (USPHS) criteria for 24 months. The restorations were accomplished with Fuji Bulk-GC, Omnichroma Flow-Tokuyama, and Beautifil® II-Shofu dental materials, and the therapy was or was not associated with wearing thermoformed mouthguards.

METHODS

From the 53 selected and analyzed patients (n = 53), 28 patients (with restorations of abfraction lesions) belonged to the 1st group and 25 patients (with 105 restorations, who also wore mouthguards) belonged to the 2nd group. Blind determination assessments were effectuated at baseline and after 2, 6, 12, 18, and 24 months. Results showed that, regardless of the rating score, there are no significant statistical differences in the evaluation criteria between the two groups of patients Conclusions: For each material, the scores of USPHS criterion presented good clinical performances after 24 months, with no significant statistical differences between the fillings and the applied therapy in the two groups of patients.

Evaluation of Bioactive Glass Treatment for Dentin Hypersensitivity: A Systematic Review

The aim of this systematic review is to compare home and office desensitizers containing bioactive glass with control groups in randomized controlled trials (RCT) conducted between 2018 and 2022. According to PRISMA guidelines, three electronic databases (Scopus, PubMed, and Cochrane Library) were searched for published scientific articles in October 2022. RCT with adult participants with dentin hypersensitivity (DH) diagnosed by evaporative, mechanical, or thermal stimulation, with a follow-up period and quantified pain assessment were included in the study. Studies that reported DH due to tooth restoration, crown preparation, bleaching, or periodontal surgery or used bioactive glass-ceramics were excluded. The quality of the studies was assessed using version 2 of the Cochrane Risk-of-Bias Tool for randomized studies (RoB 2 tool). Articles that were duplicative or unrelated to this study were excluded. Nine articles were selected for full-text evaluation, whereas two articles were rejected. The remaining seven reports were included in this review. The calcium sodium phosphosilicate group (CSPS) was not significantly different from the positive control groups. Compared with the control groups, fluoro calcium phosphosilicate (FCPS) may be the most effective long-term treatment option. In terms of DH symptom reduction, the FCPS group performed better than the CSPS group. CSPS at a concentration of 5-15% and FCPS at a concentration of 5% are effective in treating DH in adult participants.

Experimental Composite Resin with Myristyltrimethylammonium Bromide (MYTAB) and Alpha-Tricalcium Phosphate (α-TCP): Antibacterial and Remineralizing Effect

The aim of this study was to develop an experimental composite resin with the addition of myristyltrimethylammonium bromide (MYTAB) and α -tricalcium phosphate (α-TCP) as an antibacterial and remineralizing material. Experimental composite resins composed of 75 wt% Bisphenol A-Glycidyl Methacrylate (BisGMA) and 25 wt% Triethylene Glycol Dimethacrylate (TEGDMA) were produced. Some 1 mol% Trimethyl benzoyl-diphenylphosphine oxide (TPO) was used as a photoinitiator, and butylated hydroxytoluene (BTH) was added as a polymerization inhibitor. Silica (1.5 wt%) and barium glass (65 wt%) particles were added as inorganic fillers. For remineralizing and antibacterial effect, α-TCP (10 wt%) and MYTAB (5 wt%) were incorporated into the resin matrix (α-TCP/MYTAB group). A group without the addition of α-TCP/MYTAB was used as a control. Resins were evaluated for their degree of conversion (n = 3) by Fourier Transform Infrared Spectroscopy (FTIR). The flexural strength (n = 5) was assessed based on ISO 4049:2019 requirements. Microhardness was assessed to calculate softening in solvent (n = 3) after ethanol immersion. The mineral deposition (n = 3) was evaluated after immersion in SBF, while cytotoxicity was tested with HaCaT cells (n = 5). Antimicrobial activity (n = 3) was analyzed against S. mutans. The degree of conversion was not influenced by the antibacterial and remineralizing compounds, and all groups reached values > 60%. The α-TCP/MYTAB addition promoted increased softening of polymers after immersion in ethanol and reduced their flexural strength and the viability of cells in vitro. A reduction in S. mutans viability was observed for the α-TCP/MYTAB group in biofilm formation and planktonic bacteria, with an antibacterial effect > 3log₁₀ for the developed materials. Higher intensity of phosphate compounds on the sample's surface was detected in the α-TCP/MYTAB group. The addition of α-TCP and MYTAB promoted remineralizing and antibacterial effects on the developed resins and may be a strategy for bioactive composites.

Bioactive glass for periodontal regeneration: a systematic review

BACKGROUND

One of the major clinical challenges of this age could be represented by the possibility to obtain a complete regeneration of infrabony defects. Over the past few years, numerous materials and different approaches have been developed to obtain bone and periodontal healing. Among all biomaterials, bioglasses (BG) are one of the most interesting due to their ability to form a highly reactive carbonate hydroxyapatite layer. Our aim was to systematically review the literature on the use and capability of BG for the treatment of periodontal defects and to perform a meta-analysis of their efficacy.

METHODS

A search of MEDLINE/PubMed, Cochrane Library, Embase and DOSS was conducted in March 2021 to identify randomized controlled trials (RCTs) using BG in the treatment of intrabony and furcation defects. Two reviewers selected the articles included in the study considering the inclusion criteria. The outcomes of interest were periodontal and bone regeneration in terms of decrease of probing depth (PD) and gain of clinical attachment level (CAL). A network meta-analysis (NMA) was fitted, according to the graph theory methodology, using a random effect model.

RESULTS

Through the digital search, 46 citations were identified. After duplicate removal and screening process, 20 articles were included. All RCTs were retrieved and rated following the Risk of bias 2 scale, revealing several potential sources of bias. The meta-analysis focused on the evaluation at 6 months, with 12 eligible articles for PD and 10 for CAL. As regards the PD at 6 months, AUTOGENOUS CORTICAL BONE, BIOGLASS and PLATELET RICH FIBRIN were more efficacious than open flap debridement alone, with a statistically significant standardized mean difference (SMD) equal to -1.57, -1.06 and - 2.89, respectively. As to CAL at 6 months, the effect of BIOGLASS is reduced and no longer significant (SMD = -0.19, p-value = 0.4) and curiously PLATELET RICH FIBRIN was more efficacious than OFD (SMD =-4.13, p-value < 0.001) in CAL gain, but in indirect evidence.

CONCLUSIONS

The present review partially supports the clinical efficacy of BG in periodontal regeneration treatments for periodontal purposes. Indeed, the SMD of 0.5 to 1 in PD and CAL obtained with BG compared to OFD alone seem clinically insignificant even if it is statistically significant. Heterogeneity sources related to periodontal surgery are multiple, difficult to assess and likely hamper a quantitative assessment of BG efficacy.

Application of laser on enamel surface with three types of bioactive glasses-based resin infiltrants: An in vitro study

OBJECTIVE

The study aimed to evaluate and compare the surface micro-hardness, roughness, color, and morphology of enamel after Er,Cr:YSGG laser irradiation, followed by application of three types of bioactive glasses-based resin infiltrants, and the samples groups were challenged with the pH cycle.

METHODOLOGY

Experimental photoactivated resin infiltrants were synthesized using dimethacrylate resins, whereby three different types of bioactive glasses (BGs), i.e., 45S5, fluoridated-BG (F-BG), and borosilicate-BG (B-BG), were incorporated into the resin system. Initially, white spot lesions were created artificially on the toosth enamel surface, then irradiated with Er,Cr:YSGG laser. Then, the resin-only and BG-based resins were infiltrated on the enamel surface. All samples were pH challenged for 14 days, and the micro-hardness, surface roughness, surface morphology, and color stability (ΔE) analyses were conducted before and after the 14 days pH challenge.

RESULTS

After laser irradiation, the micro-hardness was significantly high with 45S5 group compared to resin-only (p = 0.021), F-BG (p = 0.042), and B-BG (p = 0.001) groups. After the pH challenge, the micro-hardness values for all groups were reduced significantly (p ≤ 0.05). The surface roughness was least with the resin-only group and showed a non-significant difference with F-BG (p = 0.34) and significant differences with both B-BG (p = 0.005), and 45S5 (p = 0.010) groups. After the pH cycle, the roughness of all groups was increased significantly (p ≤ 0.05), except B-BG group showed a non-significant difference (p = 0.528). The B-BG group showed significantly high ΔE between day 0 and baseline compared to resin-only (p = 0.0008), F-BG (p = 0.017), and 45S5 (p = 0.029), whereas between day 14 and baseline, the lowest ΔE value was observed for B-BG (14.2 ± 2.10) and maximum for the resin-only (20.57 ± 2.47) group. The SEM images showed pitting on the surface of all resin infiltrant groups after 14 days of pH challenge.

CONCLUSION

The morphological difference was observed after the laser irradiation on the enamel surface. The differences in micro-hardness, surface roughness, and color were observed after the application of experimental resin infiltrants and significant differences were observed after the pH challenge.

The effect of motivational interviewing based on the transtheoretical model on oral cleaning behavior of patients with periodontitis who have undergone implant restoration

BACKGROUND

Implant-restored patients with periodontitis have a higher risk of developing peri-implantitis, and helping them develop oral cleaning habits is significant.

OBJECTIVE

To evaluate the effectiveness of motivational interviewing based on the transtheoretical model on the modification of oral cleaning behaviors of implant-restored patients with periodontitis.

METHODS

Patients with periodontitis (n= 70) who would receive dental implant treatment were included. And they were randomly divided into two groups: experimental (n= 35) and control (n= 35). Control patients received routine oral hygiene education, and those in the experimental group received motivational interviewing based on the transtheoretical model. Oral cleaning behavior was compared between the two groups before and after intervention. In addition, periodontal health status was compared on the day of implant restoration and three months later.

RESULTS

Compared to the control, the experimental group demonstrated significantly better oral hygiene behavior after intervention (P< 0.05). Three months after implant restoration, significantly better results were obtained by the experimental group in terms of mPLI and mSBI (P< 0.05).

CONCLUSION

Motivational interviewing based on the transtheoretical model can effectively improve the oral cleaning behavior and periodontal health of implant-restored patients with periodontitis.

Sol-gel synthesis of lithium doped mesoporous bioactive glass nanoparticles and tricalcium silicate for restorative dentistry: Comparative investigation of physico-chemical structure, antibacterial susceptibility and biocompatibility

Introduction: The sol-gel method for production of mesoporous bioactive glass nanoparticles (MBGNs) has been adapted to synthesize tricalcium silicate (TCS) particles which, when formulated with other additives, form the gold standard for dentine-pulp complex regeneration. Comparison of TCS and MBGNs obtained by sol-gel method is critical considering the results of the first ever clinical trials of sol-gel BAG as pulpotomy materials in children. Moreover, although lithium (Li) based glass ceramics have been long used as dental prostheses materials, doping of Li ion into MBGNs for targeted dental applications is yet to be investigated. The fact that lithium chloride benefits pulp regeneration in vitro also makes this a worthwhile undertaking. Therefore, this study aimed to synthesize TCS and MBGNs doped with Li by sol-gel method, and perform comparative characterizations of the obtained particles.

Methods: TCS particles and MBGNs containing 0%, 5%, 10% and 20% Li were synthesized and particle morphology and chemical structure determined. Powder concentrations of 15mg/10 mL were incubated in artificial saliva (AS), Hank’s balanced saline solution (HBSS) and simulated body fluid (SBF), at 37°C for 28 days and pH evolution and apatite formation, monitored. Bactericidal effects against S. aureus and E. coli, as well as possible cytotoxicity against MG63 cells were also evaluated through turbidity measurements.

Results: MBGNs were confirmed to be mesoporous spheres ranging in size from 123 nm to 194 nm, while TCS formed irregular nano-structured agglomerates whose size was generally larger and variable. From ICP-OES data, extremely low Li ion incorporation into MBGNs was detected. All particles had an alkalinizing effect on all immersion media, but TCS elevated pH the most. SBF resulted in apatite formation for all particle types as early as 3 days, but TCS appears to be the only particle to form apatite in AS at a similar period. Although all particles had an effect on both bacteria, this was pronounced for undoped MBGNs. Whereas all particles are biocompatible, MBGNs showed better antimicrobial properties while TCS particles were associated with greater bioactivity.

Conclusion: Synergizing these effects in dental biomaterials may be a worthwhile undertaking and realistic data on bioactive compounds targeting dental application may be obtained by varying the immersion media.

Influence of strontium containing fluorophosphate glass onto structural and mechanical behavior of MTA network

OBJECTIVE

This study aimed to evaluate the effect of incorporation of strontium based fluoro phosphate glass (SrFPG) 48P₂O₅-29CaO-14NaO-3CaF₂-6SrO on physico chemical and biological properties of mineral trioxide aggregate (MTA).

METHODS

Optimized SrFPG glass powder were prepared using planetary ball mill and incorporated into MTA in varying proportion (1, 5, 10 wt%) to obtain SrMT1, SrMT5, SrMT10 bio-composite respectively. The bio-composites were characterized using XRD, FTIR and SEM-EDAX before and after soaking for 28 days in stimulated body fluid (SBF) solution. To assess the mechanical properties and biocompatibility of the prepared bio-composite, density, pH analysis, compressive strength and cytotoxicity evaluation using MTT assay were done before and after soaking for 28 days in SBF solution.

RESULTS

A nonlinear variation in compressive strength and pH values was noted. Of the bio-composites, SrMT10 was evidenced with rich apatite formation in XRD, FTIR and SEM with EDAX analysis. MTT assay showed increased cell viability in all the samples before and after in vitro studies.

Zinc and Strontium-Substituted Bioactive Glass Nanoparticle/Alginate Composites Scaffold for Bone Regeneration

The global population is growing older and entering an aging society. Aging results in severe tissue disorder and organ dysfunction. Bone-related injuries are particularly significant. The need for alternative bone replacement materials for human implants has grown over the past few decades. Alginate has the potential for use as a cell scaffold for bone tissue engineering due to its high bio-compatibility. To improve the bioactivity of alginate scaffolds, zinc- and strontium-containing sol-gel-derived bioactive glass nanoparticles (Zn-Sr-BGNPs) with sizes ranging from 100 to l40 nm were incorporated. Zn-Sr-BGNPs synthesized through the sol-gel process have a high sur-face-to-volume ratio, homogeneity, and purity, resulting in faster degradation. The therapeutic bivalent ions released from Zn-Sr-BGNPs strengthen the cell scaffold and improve the stimulation of the production and development of bone cells. Zn-Sr-BGNPs with different Zn to Si nominal ratios of 0, 1, and 1.5 were mixed with alginate in this research. The ratio of Zn in Zn-Sr-BGNPs and the ratio of Zn-Sr-BGNPs in scaffolds impact the pore size, swelling, and biological properties of synthesized composite scaffolds. The surface area and pore volume of a 1:1 1Zn-Sr-BGNP:Alg composite scaffold were 22.58 m²/g and 0.055 cm³/g, respectively. The incorporation of Zn-Sr-BGNPs improved the mechanical performance of the scaffolds up to 4.73 ± 0.48 MPa. The swelling rate decreased slightly from 2.12 (pure Alg) to 1.50 (1Zn-Sr-BGNP:Alg (1:1)). The 1Zn-Sr-BGNP:Alg (1:1) composite scaffold promoted bioactivity through apatite layer formation, increased bone cell proliferation via the dissolution products released from the scaffold, enhanced calcium deposition, and facilitated cell attachment. Thus, 1Zn-Sr-BGNP:Alg (1:1) composite scaffold is proposed as a possible artificial bone scaffold in bone tissue regeneration.

Using Femtosecond Laser Light-Activated Materials: The Biomimetic Dentin Remineralization Was Monitored by Laser-Induced Breakdown Spectroscopy

Introduction: The purpose of this study is to investigate and compare the effects of the antimicrobial agents Moringa oleifera and bioactive glass nanoparticles activated by femtosecond laser light on the biomimetic dentin remineralization using teeth having carious dentin ICDAS code 3. Methods and Materials: A total of 27 dentin surface samples were divided into three groups: the first group was treated with a Moringa oleifera extract, while the second group was treated with bioactive glass nanoparticles, and as for the control group, the third group received no additional agent. All groups were subjected to femtosecond laser light at three different wavelengths: 390 nm, 445 nm, and 780 nm. The photoactivation of each sample was achieved using the femtosecond laser light for 5 min with an average power rating of 300 mW, a pulse duration of 100 fs, and a pulse repetition rate of 80 Hz. The mineral content of the samples was obtained and analyzed using the laser-induced breakdown spectroscopy (LIBS). The LIBS analysis was conducted with the following laser light parameters: average power of ~215 mW, wavelength of 532 nm, pulse duration of 10 ns, and a pulse repetition rate of 10 Hz. Results: Most studied samples exhibited a relative increase in the mineral content that may enhance biomimetic remineralization. Moringa oleifera photoactivated by femtosecond laser light at 445 nm achieved a significant increase in mineral content. Conclusion: Using the femtosecond laser light to activate the relatively cheap and commercially available antimicrobial agent Moringa oleifera supports the strategy of minimal invasive approaches for the treatment and biomimetic remineralization of carious dentin ICDAS code 3.

Biomimicry and 3D-Printing of Mussel Adhesive Proteins for Regeneration of the Periodontium-A Review

Innovation in the healthcare profession to solve complex human problems has always been emulated and based on solutions proven by nature. The conception of different biomimetic materials has allowed for extensive research that spans several fields, including biomechanics, material sciences, and microbiology. Due to the atypical characteristics of these biomaterials, dentistry can benefit from these applications in tissue engineering, regeneration, and replacement. This review highlights an overview of the application of different biomimetic biomaterials in dentistry and discusses the key biomaterials (hydroxyapatite, collagen, polymers) and biomimetic approaches (3D scaffolds, guided bone and tissue regeneration, bioadhesive gels) that have been researched to treat periodontal and peri-implant diseases in both natural dentition and dental implants. Following this, we focus on the recent novel application of mussel adhesive proteins (MAPs) and their appealing adhesive properties, in addition to their key chemical and structural properties that relate to the engineering, regeneration, and replacement of important anatomical structures in the periodontium, such as the periodontal ligament (PDL). We also outline the potential challenges in employing MAPs as a biomimetic biomaterial in dentistry based on the current evidence in the literature. This provides insight into the possible increased functional longevity of natural dentition that can be translated to implant dentistry in the near future. These strategies, paired with 3D printing and its clinical application in natural dentition and implant dentistry, develop the potential of a biomimetic approach to overcoming clinical problems in dentistry.