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

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

Novel biocompatible denture material incorporating type I collagen with improved functional properties for oral health

The use of collagen is the recent development in various medical fields. Huge quantities of hide and skin trimmings are generated during the leather processing are wasted or underutilized. Trimmings contain collagen which can be beneficially extracted and utilized for high value products. Poly methyl methacrylate based denture materials exhibit serious concerns such as high porosity, presence of residual monomer, shrinkage, distortion and high rate of deterioration of the materials. This study aims to incorporate extracted Type I collagen with polymer to obtain denture base and investigate its chemical and mechanical properties. The present research methodology also reduces the quantity of monomer and acrylic resin usage. The collagen was extracted from animal skin and hide trimmings which are otherwise disposed as wastes. This study investigated the effect of visco-elastic characteristics of resulted specimens and their transition temperature, mechanical properties, decomposition temperature and leachability. The collagen-based specimens have better tensile strength with high decomposition temperature compared to control specimens. Scanning Electron Microscopy analysis revealed that the experimental specimens was cohesive and homogeneous which explained the higher tensile and decomposition values. The study suggests that collagen cross-linked acrylic denture base exhibit better mechanical and thermal resistance properties when compared to control specimens. The study indicates that biomaterials are emerging as smart products of value in human health.

Hard tissue formation in pulpotomized primary teeth in dogs with nanomaterials MCM-48 and MCM-48/hydroxyapatite: an in vivo animal study

BACKGROUND

This animal study sought to evaluate two novel nanomaterials for pulpotomy of primary teeth and assess the short-term pulpal response and hard tissue formation in dogs. The results were compared with mineral trioxide aggregate (MTA).

METHODS

This in vivo animal study on dogs evaluated 48 primary premolar teeth of 4 mongrel female dogs the age of 6-8 weeks, randomly divided into four groups (n = 12). The teeth underwent complete pulpotomy under general anesthesia. The pulp tissue was capped with MCM-48, MCM-48/Hydroxyapatite (HA), MTA (positive control), and gutta-percha (negative control), and the teeth were restored with intermediate restorative material (IRM) paste and amalgam. After 4-6 weeks, the teeth were extracted and histologically analyzed to assess the pulpal response to the pulpotomy agent.

RESULTS

The data were analyzed using the Kruskal‒Wallis, Fisher's exact, Spearman's, and Mann‒Whitney tests. The four groups were not significantly different regarding the severity of inflammation (P = 0.53), extent of inflammation (P = 0.72), necrosis (P = 0.361), severity of edema (P = 0.52), extent of edema (P = 0.06), or connective tissue formation (P = 0.064). A significant correlation was noted between the severity and extent of inflammation (r = 0.954, P < 0.001). The four groups were significantly different regarding the frequency of bone formation (P = 0.012), extent of connective tissue formation (P = 0.047), severity of congestion (P = 0.02), and extent of congestion (P = 0.01). No bone formation was noted in the gutta-percha group. The type of newly formed bone was not significantly different among the three experimental groups (P = 0.320).

CONCLUSION

MCM-48 and MCM-48/HA are bioactive nanomaterials that may serve as alternatives for pulpotomy of primary teeth due to their ability to induce hard tissue formation. The MCM-48 and MCM-48/HA mesoporous silica nanomaterials have the potential to induce osteogenesis and tertiary (reparative) dentin formation.

Development of zirconia-based polymer-infiltrated ceramic network for dental restorative material

Polymer-infiltrated ceramic network (PICN) materials have gained considerable attention as tooth restorative materials owing to their mechanical compatibility with human teeth. However, the mechanical strength of contemporary PICN materials is lower than those of conventional resin composites and ceramics. This study aims to develop novel high-strength PICN for use as a dental restorative material. Zirconia-based PICN (EXP) was fabricated using 3 mol% yttria tetragonal polycrystalline zirconia powder and resin monomers via slip casting, followed by sintering and polymer infiltration. Comprehensive analyses of the microstructure, mechanical properties, and physicochemical properties of EXP were performed using scanning electron microscopy with energy-dispersive X-ray spectroscopy, Fourier transform infrared spectroscopy, inorganic content measurements, three-point bending test, Vickers hardness test, two-body wear test, shear bond strength (SBS) test, surface free energy analysis, and water sorption/solubility test. Commercially available computer-aided design/computer-aided manufacturing (CAD/CAM) materials, including resin composite (CERASMART), silicate-based PICN (ENAMIC), and zirconia ceramic (e.max ZirCAD), were used for comparison. The analyses highlight the dual network structure of EXP, which comprised a zirconia skeleton and an infiltrated resin phase. EXP exhibits a flexural strength of 346.0 ± 46.0 MPa, flexural modulus of 44.0 ± 3.7 GPa, and Vickers hardness of 440.1 ± 51.2 VHN. The mechanical properties of EXP are significantly higher than those of CERASMART and ENAMIC but lower than those of ZirCAD. Notably, the EXP hardness closely mimics that of the human enamel. The wear volume, SBS, and water sorption/solubility of EXP are comparable to those of CERASMART and ENAMIC. Therefore, EXP has potential applications as a tooth restorative material.

Mechanosignaling-related angiocrine factors drive osteoblastic phenotype in response to zirconia

BACKGROUND

The growing use of zirconia as a ceramic material in dentistry is attributed to its biocompatibility, mechanical properties, esthetic appearance, and reduced bacterial adhesion. These favorable properties make ceramic materials a viable alternative to commonly used titanium alloys. Mimicking the physiological properties of blood flow, particularly the mechanosignaling in endothelial cells (ECs), is crucial for enhancing our understanding of their role in the response to zirconia exposure.

METHODS

In this study, EC cultures were subjected to shear stress while being exposed to zirconia for up to 3 days. The conditioned medium obtained from these cultures was then used to expose osteoblasts for a duration of 7 days. To investigate the effects of zirconia on osteoblasts, we examined the expression of genes associated with osteoblast differentiation, including Runx2, Osterix, bone sialoprotein, and osteocalcin genes. Additionally, we assessed the impact of mechanosignaling-related angiocrine factors on extracellular matrix (ECM) remodeling by measuring the activities of matrix metalloproteinases 2 and 9 (MMP2 and MMP9) during the acquisition of the osteogenic phenotype, which precedes mineralization.

RESULTS

Our data revealed that mechanosignaling-related angiocrine factors play a crucial role in promoting an osteoblastic phenotype in response to zirconia exposure. Specifically, exposed osteoblasts exhibited significantly higher expression levels of genes associated with osteoblast differentiation, such as Runx2, Osterix, bone sialoprotein, and osteocalcin genes. Furthermore, the activities of MMP2 and MMP9, which are involved in ECM remodeling, were modulated by mechanosignaling-related angiocrine factors. This modulation is likely an initial event preceding the mineralization phase.

CONCLUSION

Based on our findings, we propose that mechanosignaling drives the release of angiocrine factors capable of modulating the osteogenic phenotype at the biointerface with zirconia. This process creates a microenvironment that promotes wound healing and osseointegration. Moreover, these results highlight the importance of considering the mechanosignaling of endothelial cells in the modulation of bone healing and osseointegration in the context of blood vessel effects. Our data provide new insights and open avenues for further investigation into the influence of mechanosignaling on bone healing and the osseointegration of dental devices.

Comparison of mechanical properties and color stability of various vacuum-formed orthodontic retainers: An in vitro study

Vacuum-formed retainer (VFR) is the most used retainer due to its higher aesthetic properties and lower cost, their mechanical properties of are important in determining the stability and long-term use of appliances made out of them.

AIM

This study aimed to evaluate and compare the flexural modulus, surface hardness, and color stability of three different VFR materials.

METHODS

Three different VFR materials, namely Duran, Keystone, and Zendura, of 1 mm thickness, were tested after thermoforming for flexural modulus, hardness, and color stability. They were formed over a stainless-steel model of 12 mm diameter and 6 mm height.

RESULTS

There were significant statistical differences (p = 0.000) in the flexural modulus and hardness of the three materials. Regarding color stability, Zendura exhibited significantly higher ΔE* values than Keystone and Duran (p < 0.05).

CONCLUSIONS

Zendura had the highest flexural modulus and hardness compared with Duran and Keystone; however, it is more susceptible to color change compared to the other tested materials.

Does speed-sintering affect the optical and mechanical properties of yttria-stabilized zirconia? A systematic review and meta-analysis of in-vitro studies

Zirconia restorations are increasingly popular in dental treatment. Yttria-stabilized zirconia (YSZ) needs to be sintered for clinical applications and novel speed-sintering protocols are being developed for chairside treatments. Whether the properties of speed-sintered YSZ meet clinical requirements, however, remains unclear. Therefore, we conducted a systematic review and meta-analysis on the influence of speed-sintering on the optical and mechanical properties of dental YSZ according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A literature search was conducted using PubMed, Embase, and Web of Science databases for relevant articles published between January 1, 2010 and February 28, 2022 in English, Chinese, or Japanese. After full-text evaluation and quality assessment, 26 articles were selected. Meta-analysis revealed that speed-sintering does not significantly affect the CIEDE2000-based translucency parameter, contrast ratio, three-point flexural strength, biaxial flexural strength, or fracture toughness of YSZ (p < 0.01) compared to conventional sintering. However, the CIELab-based translucency parameter of conventionally sintered YSZ is higher than that of speed-sintered YSZ. The descriptive analysis indicated that speed-sintering does not affect the hardness of YSZ compared to that of conventionally sintered YSZ. The results indicate that speed-sintering is suitable for preparing YSZ for dental restorations.

Bone regeneration property of tooth-derived bone substitute prepared chairside for periodontal bone defects: an experimental study

BACKGROUND

Periodontitis often leads to progressive destruction and loss of alveolar bone, the reconstruction of which remains difficult in periodontal therapy. As a novel bone graft material, tooth-derived bone substitute (TDBS) processed from extracted teeth has been previously reported about its osteoconductivity and promising results in bone regeneration. This study was to investigate the biological effects and bone regeneration properties of TDBS in vitro and in vivo using rat periodontal bone defect model.

METHODS

Three groups of materials were used in the experiments: TDBS, TDBS treated with ethylene diamine tetraacetic acid (EDTA) (TDBS-E), and allogeneic bone materials. Calcium (Ca) and phosphate (P) ion dissolutions were quantified by spectrophotometer for seven days. The releases of bone morphogenetic protein-2 (BMP-2) and transforming growth factor-β1 (TGF-β1) were identified by enzyme-linked immunosorbent assay (ELISA). Human osteoblast proliferation, migration, and differentiation were detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, cell counting, alkaline phosphatase activity (ALP), and alizarin red staining (ARS), respectively. Furthermore, the osteogenic effects of TDBS on periodontal furcation bone defects were evaluated at eight weeks postoperatively using micro-computed tomography (Micro-CT) and histological analysis.

RESULTS

The dissolution of both Ca and P ions in TDBS increased over time. The BMP-2 released from TDBS was significantly higher than that from TDBS-E and allografts, while the TGF-β1 release from TDBS and TDBS-E groups was higher than that in the allografts. The TDBS-E group could induce the highest level of osteoblast proliferation compared to other groups. Cell migration with allografts co-culture was significantly induced compared to the blank control. However, all groups demonstrated similar positive effects on osteoblast differentiation. Furthermore, in the periodontal model, all materials could effectively enhance bone regeneration in the furcation defect.

CONCLUSIONS

The TDBS prepared chairside as an autogenous bone graft, demonstrating osteoinductivity, which enhances the osteogenic biological characteristics. Therefore, TDBS is suggested as an economical and biocompatible material for periodontal bone regeneration.

A new CAD/CAM tooth mobility simulating model for dental in vitro investigations

OBJECTIVES

To validate a new tooth mobility simulating in vitro model for biomechanical tests of dental appliances and restorations.

MATERIAL AND METHODS

Load-deflection curves for teeth in CAD/CAM models (n = 10/group, 6 teeth/model) of the anterior segment of a lower jaw with either low tooth mobility (LM) or high tooth mobility (HM) were recorded with a universal testing device and a Periotest device. All teeth were tested before and after different ageing protocols. Finally, vertical load capacity (Fmax) was tested in all teeth.

RESULTS

At F = 100 N load, vertical/horizontal tooth deflections before ageing were 80 ± 10 µm/400 ± 40 µm for LM models and 130 ± 20 µm/610 ± 100 µm for HM models. Periotest values were 1.6 ± 1.4 for LM models and 5.5 ± 1.5 for HM models. These values were within the range of physiological tooth mobility. No visible damage occurred during ageing and simulated ageing had no significant effect on tooth mobility. Fmax values were 494 ± 67 N (LM) and 388 ± 95 N (HM).

CONCLUSION

The model is practical, easy to manufacture and can reliably simulate tooth mobility. The model was also validated for long-term testing, so is suitable for investigating various dental appliances and restorations such as retainers, brackets, dental bridges or trauma splints.

CLINICAL RELEVANCE

Using this in-vitro model for high standardised investigations of various dental appliances and restorations can protect patients from unnecessary burdens in trials and practice.

Effect of the type of resin cement on the fracture resistance of chairside CAD-CAM materials after aging

PURPOSE

The study objective was to evaluate the influence of the type of resin cement on the flexural strength and load to fracture of two chairside CAD-CAM materials after aging.

MATERIALS AND METHODS

A polymer-infiltrated ceramic network (PICN) and a nanoceramic resin (RNC) were used to produce the specimens. Two types of dual-cure resin cements, a self-adhesive and a universal, were investigated. Bilayer specimens were produced (n = 10) and aged for 6 months in a humid environment before the biaxial flexural strength test (σ_f). Bonded specimens were subjected to a mechanical aging protocol (50 N, 2 Hz, 37℃ water, 500,000 cycles) before the compressive load test (L_f). σ_f and L_f data were analyzed using two-way ANOVA and Tukey tests (α = .05). Chi-square test was used to analyze the relationship between failure mode and experimental group (α = .05).

RESULTS

The type of resin cement and the interaction between factors had no effect on the σ_f and L_f of the specimens, while the type of restorative material was significant. RNC had higher σ_f and L_f than PICN. There was a significant association among the type of cracks identified for specimens tested in L_f and the restorative material.

CONCLUSION

The type of resin cement had no effect on the flexural strength and load to fracture of the two investigated CAD-CAM chairside materials after aging.

Reinforcement of resin-modified glass-ionomer cement with glass fiber and graphene oxide

OBJECTIVE

To evaluate the effect of adding glass fiber and graphene oxide to a resin-modified glass ionomer cement (RMGIC).

METHODS

Experimental RMGICs were prepared by adding separately and simultaneously glass fibers (5, 10, and 20 wt%) and graphene oxide (1, 3, and 5 wt%) to the powder of RMGIC with different ratios. The samples were examined under SEM and XRD. The surface roughness, flexural strength, Vickers microhardness, water sorption, and solubility were investigated. Data were analyzed using ANOVA and Tukey tests (p = 0.05).

RESULTS

Adding fiber and graphene oxide to RMCIS increased the surface roughness, flexural strength, and microhardness. The highest surface roughness value was obtained in the 20% fiber+5% graphene oxide adding group and the lowest in the control group (p < 0.05). The highest microhardness and flexural strength values were acquired in the 20% fiber-adding group and the lowest in the control group (p < 0.05). 10% and 20% fiber addition increased water sorption and solubility (p < 0.05). Adding 3%, 5% graphene oxide, and 20% fiber+5% graphene oxide reduced water sorption (p < 0.05). The highest water sorption was found in the 20% fiber-adding group and the lowest in the 5% graphene oxide and %20 fiber+5% graphene oxide-adding groups (p < 0.05). Graphene oxide alone and together with fiber did not affect the solubility (p > 0.05).

CONCLUSION

The results show that reinforcement of RMGIC with glass fiber and graphene oxide may improve the mechanical properties. But the glass fibers may cause more water sorption and solubility. Graphene oxide may decrease water sorption of RMGIC and fiber-reinforced RMGIC.

Frequency of occurrence of taurodontism in the historical population of Radom (11th-19th centuries)

OBJECTIVE

The aim of the work was to trace possible changes in the frequency of taurodontism in individuals who inhabited historical Radom from the early Middle Ages to modern periods.

DESIGN

The research was based on the analysis of X-ray images of 640 molars of individuals from the 11th/12th c. (n = 120), 14th/17th c. (n = 76), and 18th/19th c. (n = 444). Radiological images were made with the use of a portable X-ray machine, and the results were biometrically analysed using the Shiffman and Chanannel index.

RESULTS

The highest frequency of taurodontism was observed in the 18th/19th c. (31 %, 138/444). In the 11th/12th and 14th/17th centuries, this percentage was significantly lower (22 %, 26/120 vs. 16 %, 12/76). In subsequent chronological periods, no statistically significant differences between sexes in the occurrence of taurodontism were observed. The highest number of taurodontal teeth was observed among the second and first upper molars (73 % and 52 %, respectively), and the lowest number was observed among the first and second lower molars (16 % and 23 %, respectively). In all historical periods, hypotaurodont forms were most often observed.

CONCLUSIONS

Variations in the frequency of taurodontism may result from many reasons, for example environmental factors. However, it cannot be ruled out that the observed differences result from the increased migration of people to Radom in the 18th/19th century.

Clinical evaluation of bulk-fill and universal nanocomposites in class II cavities: Five-year results of a randomized clinical split-mouth trial

AIM

Evaluating the clinical survival and quality parameters of class-II restorations using 3M™ Filtek^TM Bulk Fill Posterior Restorative compared to 3M™ Filtek^TM Supreme XTE Universal Restorative over a period of five years.

MATERIALS AND METHODS

A longitudinal, randomized, prospective split-mouth study with 60 patients (29 female, 31 male; mean age 44 y; range 20-77 y) and a total of 120 load-bearing class II restorations (TEST: n=60 Filtek Bulk Fill Posterior Restorative; CONTROL: n=60 Filtek Supreme XTE Universal Restorative) was conducted. Clinical evaluation was performed by blinded evaluators according to FDI criteria. Kaplan-Meier method was used for survival analysis and an intergroup comparison (Mann-Whitney-U-Test) was carried out. A basic significance level of 0.05 was corrected by the Bonferroni method to account for multiple testing (significance after correction: p<0.00067).

RESULTS

The mean overall survival of restorations was 92% after 56.98±1.51 months in the TEST group (95 CI= 54.02;59.94) and 92% after 57.25±1.46 months (95 CI= 54.39; 60.12) in the CONTROL group (log-rank p=0.995). In total, four failures occurred in both TEST and CONTROL group during the observation period (mean annual failure rate: 1.6%). The most common reasons for failure were chipping-fractures, debonding, cracked-tooth-syndrome and recurrent decay. With regard to the FDI criteria, no significant differences between TEST and CONTROL material occurred for any of the evaluated variables. In the TEST group two restorations had to be repaired and two had to be replaced, in the CONTROL group four restorations had to be replaced.

CONCLUSION

Both materials showed acceptable clinical performance and survival during the 5-year observation period.

CLINICAL SIGNIFICANCE

The use of a nanofilled bulk-fill composite proved to be an aesthetically, functionally and biologically satisfactory alternative in posterior dentition.

In Vitro Biological Testing of Dental Materials

Dental materials are specially fabricated materials designed for use in dentistry. A variety of materials may be used, including cements, impression, lining, and dental restorative materials. Some of these dental materials provide temporary dressings while others are more permanent and are in contact with host tissue for prolonged periods of time. Consequently, newly developed dental materials not only require mechanical, chemical, and physical testing but also require in vitro analysis to ensure their safety and biocompatibility. The current chapter provides background on dental material characterization and a protocol for its in vitro biological testing.

The antimicrobial, physical, and chemical properties of a riboflavin-loaded dental resin intended for antimicrobial photodynamic therapy

BACKGROUND

Dental caries remain a significant global health challenge. Unfortunately, current dental materials lack sufficient antimicrobial power to address the pathogenic species involved in this disease. In this study the potential to load a dental resin blend (RB) with riboflavin (B2) for use in an antimicrobial photodynamic therapy (aPDT) approach was investigated.

METHODS

B2 was added to our experimental RB (0.1 - 10 wt%). Upon investigating the degree of conversion and specimen integrity of the RB as a function of B2 concentration, it was determined that loading should be restricted to 0.1, 1.0, and 1.5 wt%. Subsequent investigation included water sorption (WS) and solubility (SL), as well as shear bond strength (SBS) and flexural strength (FS) of the specimens after 24 h and 28-day water storage. Lastly, the antimicrobial response of Streptococcus mutans (S. mutans) biofilm following 6 h growth and 60 s of blue LED light (1.3 J/cm²) in an aPDT-based approach was measured.

RESULTS AND CONCLUSIONS

Adding up to 1.5 wt% B2 had minimal impact on the FS or SBS of the RB. However, aging for 28-days notably increased the FS by as much as 50% for the 1.5 wt% B2-loaded RB. In addition, adding 1.5 wt% B2 resulted in a significant reduction in WS/SL of the RB. Lastly, while adding B2 did not change the antimicrobial response, this was an initial study under these conditions and future investigation will seek to optimize light parameters to produce a more agonistic response. Overall, a riboflavin-loaded dental resin shows significant promise for utilization in restorative dentistry with aPDT.

Adsorption of Candida albicans on Ti-6Al-4V surface and its corrosion effects in artificial saliva

In this study, the corrosion behavior and mechanism of Ti-6Al-4V in artificial saliva with Candida albicans were investigated using electrochemical and surface analysis techniques. Fluorescence microscopy (FM) and confocal laser scanning microscopy (CLSM) showed that C. albicans could easily adsorb on the surface of Ti-6Al-4V alloy to form non-dense biofilm. The non-compact biofilm provided necessary conditions for pitting corrosion on Ti-6Al-4V alloys by scanning electron microscopy (SEM) observation. The potentiodynamic polarization (PDP) curves and electrochemical impedance spectroscopy (EIS) revealed that C. albicans significantly reduced the corrosion resistance of Ti-6Al-4V alloys. The cyclic voltammetry (CV) and differential pulse voltammetry (DPV) results indicated that C. albicans biofilm promoted electron transfer from the anodic sites to cathodic depolarizer during the corrosion process, showing that the role of oral fungi must be considered when evaluating the performance of oral materials. This study may provide a new clue for evaluating the corrosion resistance of dental implant materials in the oral environment.

Evaluation of residual monomer release after polymerization of different restorative materials used in pediatric dentistry

BACKGROUND

The choice of the restorative resin material to be used in pediatric dentistry is of a great importance due to the cytotoxic effects caused by residual monomers. In this study, it was aimed to investigate the amount of residual monomer released over time from different resin-based restorative materials, which are widely used in pediatric dentistry, by using high performance liquid chromatography with photodiode array detector (HPLC-PDA).

METHODS

The compomers in all colors (Twinky Star and Glasiositte A₂), two composites with different hybrid properties (Arabesk-GrandioSO), and RMGIC (Ionolux) samples with 2 × 5 mm diameters were prepared. The samples were polymerized with an LED light unit (CELALUX 2, VOCO, Cuxhaven, Germany) and then finishing-polishing procedures were applied. A total of 156 samples were obtained, 13 samples in each of the 12 groups. The amount of residual monomer (BIS-GMA; HEMA, TEGDMA, UDMA) (µg/mL) released into the 75% ethanol solution was determined at different times, (1st hour, 1st, 7th, 14th, and 21st day) by using HPLC-PDA.

RESULTS

The residual monomer release continued on day 21 and BIS-GMA was the most released monomer in all groups. HEMA release showed a maximum increase in all the materials at day 7. The highest amount of residual monomer was detected in the gold-colored compomer. HEMA and BIS-GMA release from RMGIC was less than others in all time frames.

CONCLUSIONS

The color and composition of resin-based restorative materials affect the amount of residual monomer. Pediatric dentists should prefer gold-colored compomers less than others as a restorative material, especially in deep cavities. More studies are needed about the subject.

Sol-gel bioactive glass containing biomaterials for restorative dentistry: A review

OBJECTIVE

Bioactive glasses (BAGs) have been researched extensively for dentistry due to their favourable biocompatibility and hard tissue bonding ability. However, the specific application of BAGs produced through sol-gel synthesis in restorative dentistry has not been reviewed previously. This review provides a comprehensive account of the principles behind sol-gel derived BAGs and their investigation for dental tissue restoration materials.

METHODS

A search for in vitro and in vivo studies was performed using the databases Web of Science®, Medline®, Scopus® and Google Scholar®. Articles published over the past 20 years were selected and data on the BAG composition and morphology was extracted. Analysis of the effect of specific BAG additives on the properties of experimental dental materials was also performed.

RESULTS

A majority of BAG particles investigated were spheres ranging in size from 5 nm to ~650 µm. Sol-gel BAGs are mainly applied in the treatment of hypersensitive dentine and for pulp-dentine tissue engineering, while a handful have been used in target drug delivery. BAG fillers are promising additives that result in improved biological properties, antibacterial effects, hardness, acid buffering and remineralization. Unfortunately, some detrimental effects on optical properties have been observed with BAG addition. Additionally, in vivo data, investigations into radiopacity and standardization of test protocols are identified as areas for improvement and further studies.

SIGNIFICANCE

Future work should consider the pertinent issues raised in order to improve the quality of available data and expand knowledge in this area of dental biomaterials research and development.

Characterization of polymethylmethacrylate microspheres loaded with silver and doxycycline for dental materials applications

OBJECTIVES

The manufacturing of polymethylmethacrylate(PMMA) microspheres loaded with doxycycline(DOX) and/or silver sulfate(Ag₂SO₄) to be incorporated into glass ionomer cement(GIC).

METHODS

PMMA microspheres were manufactured with Ag₂SO₄(1-5%) and/or DOX(5-15%). Particle size, encapsulation efficiency and drug release were measured by light microscope, ICP, and HPLC. Microspheres were added to a dental GIC(20%w/w). Drug release and DTS were investigated. Minimum inhibitory concentration and antibacterial effects of PMMA microspheres into GIC materials were tested.

RESULTS

The median diameter of 50 µm was obtained for microspheres. DOX was encapsulated at an efficiency of 8.3% using a theoretical loading of 15%DOX + 5%Ag₂SO₄. The Ag₂SO₄ encapsulation efficiency was 0.63% using a theoretical loading of 5%AgSO₄. All groups showed burst release within the first day and continued released up to 15 days, with 60-83% of DOX and approximately 30% of silver. For GIC, approximately 15% of DOX and 0.18% of silver were released in a 7-day period. Microbiological results showed an antimicrobial effect against S. mutans when the lead formulation of microspheres was added. The DTS was reduced by the inclusion of microspheres.

SIGNIFICANCE

PMMA microspheres containing DOX and Ag₂SO₄ offer a sustained antimicrobial activity for dental applications and promising potential for the biomedical field.

Influence of different postcuring parameters on mechanical properties and biocompatibility of 3D printed crown and bridge resin for temporary restorations

This study analyzed the flexural properties, Vickers hardness, degree of conversion (DC), and cell viability of 3D printed crown and bridge resin postcured using various types of postcuring equipment (PCE). 3D printed specimens were postcured for various times using different types of 3D printing PCE [for 5, 15, and 30 min using LC 3D Print Box (LC), Form Cure (FC), Cure M (CM), and Veltz 3D (VE) devices] and the VALO handheld light-curing (VA) device for 20, 40, and 60 s. Neither the flexural strength (132.27-145.79 MPa) nor the flexural modulus (1.52-1.83 GPa) differed significantly when postcuring for 30 min using the LC, FC, CM, or VE device, or for 20, 40, or 60 s of postcuring using the VA device (p > 0.05). The Vickers hardness was highest after 30 min of postcuring for all groups, and varied significantly with the postcuring time in the LC (p < 0.001) and CM (p < 0.001) groups. DC was significantly higher for the 5-min CM group (84.97 ± 4.02%) than for the GS, 30-min FC, 5-min VE, and 20-s VA groups. Cell viability of the postcured resin specimens was 56.46-92.29%, and varied significantly in the CM and VE groups according to the postcuring time (p < 0.05). Confocal laser scanning microscopy observations showed well-developed cell morphology and numerous cell-cell contacts in all groups except the GS group. This study found that the use of different types of PCE did not significantly affect the flexural properties of 3D printed crown and bridge resin, whereas there were significant variations in DC, Vickers hardness, and cell viability.

Minimally-invasive dentistry via dual-function novel bioactive low-shrinkage-stress flowable nanocomposites

The objectives of this in vitro study were to develop a novel low-shrinkage-stress flowable nanocomposite with antibacterial properties through the incorporation of dimethylaminohexadecyl methacrylate (DMAHDM) and nanoparticles of amorphous calcium phosphate (NACP), and investigate the mechanical and oral biofilm properties, to be used in minimally-invasive techniques.

METHODS

The light-cured low-shrinkage-stress flowable resin was formulated by mixing urethane dimethacrylate (UDMA) and triethylene glycol divinylbenzyl ether (TEG-DVBE) at a 1:1 mass ratio. Different mass fractions of glass, and either 5% DMAHDM or 20%NACP or both were incorporated. Paste flowability, ultimate micro tensile strength and surface roughness were evaluated. The antibacterial response of DMAHDM resin was assessed by using biofilms of human saliva-derived microcosm model. Virtuoso flowable composite was used as a control.

RESULTS

(45% resin+5% DMAHDM+20% NACP+30% glass) formula yielded the needed outcomes. It had flow rate within the range of ISO requirement. The micro tensile strength was (39.1 ± 4.3) MPa, similar to (40.1 ± 4.0) MPa for commercial control (p > 0.05). The surface roughness values of the novel composite (0.079 ± 0.01) µm similar to commercial composite (0.09 ± 0.02) µm (p > 0.05). Salivary microcosm biofilm colony forming unit values were reduced by 5-6 logs (p < 0.05). Biofilm metabolic activity was also substantially reduced, compared to control composite (p < 0.05).

SIGNIFICANCE

The novel bioactive flowable nanocomposite achieved strong antibacterial activities without compromising the mechanical properties. It is promising to be used as pit and fissure sealants, and as fillings in conservative cavities to inhibit recurrent caries and increase restoration longevity.

Wear of bulk-fill resin composites

OBJECTIVE

Bulk-fill resin composites are a special group of restorative materials designed to reduce chair time needed to insert a direct composite restoration. However, other factors determine the clinical success of a restorative material. Clinically the major reasons for failure of direct restorations are secondary caries and fracture of the restoration or the tooth itself. In the long-term composite resin restorations in posterior teeth may be prone to wear. As bulk-fill materials have their own composition that will determine their mechanical properties, the wear resistance may be affected as well. The aim of this in vitro study was to evaluate the wear of bulk-fill composites in comparison with a conventional hybrid composite. The null hypothesis was that there are no differences between the four bulk-fill materials and one traditional highly filled nanohybrid composite for posterior use when subjected to a two-body wear rate test and hardness measurement.

METHODS

Four bulk-fill composites SDR Smart Dentin Replacement (SDR), X-tra base (XBA), FiltekBulk Fill (FUP), Dual-Curing Bulk Composite (FBFL) and conventional nanohybrid resin composite Grandio (GDO) subjected to a two-body wear test against a stainless steel (SS) antagonist wheel. Scanning Electron Microscopy analysis was performed to detect the surface alterations. Microhardness of all samples was tested (n = 5) with a Vickers diamond indenter (5 indentations in each specimen). One-way ANOVA and Tukey's post hoc test (P < 0.01) were used to analyze differences in wear values. The hardness data were submitted to one-way ANOVA test, followed by the Tukey post hoc test (α = 0.05). T-test was applied to compare wear rate in time interval between one day and one month.

RESULTS

The highest wear rate values were recorded for SDR and the lowest wear rate values were for GDO. Hardness was the highest for GDO and the lowest for FBFL.

SIGNIFICANCE

The bulk-fill composites have a higher wear rate and lower hardness than the conventional nanohybrid composite, making them less suitable for stress-bearing restorations.

Corrosion behavior of high nitrogen nickel-free austenitic stainless steel in the presence of artificial saliva and Streptococcus mutans

High nitrogen nickel-free austenitic stainless steels (HNSs) have great potentials to be used in dentistry owing to its exceptional mechanical properties, high corrosion resistance, and biocompatibility. In this study, HNSs with nitrogen of 0.88 wt% and 1.08 wt% displayed much lower maximum pit depths than 316L stainless steel (SS) after 21 d of immersion in abiotic artificial saliva (2.2 μm and 1.7 μm vs. 4.5 μm). Microbiologically influenced corrosion (MIC) evaluations revealed that Streptococcus mutans biofilms led to much severer corrosion of 316L SS than HNSs. Corrosion current densities of HNSs were two orders of magnitude lower than that of 316L SS after incubation of 7 d (37.5 nA/cm² and 29.9 nA/cm² vs. 5.63 μA/cm²). The pitting potentials of HNSs were at least 550 mV higher than that of 316L SS in the presence of S. mutans, confirming the better MIC resistance of HNSs. Cytotoxicity assay confirmed that HNSs were not toxic to MC3T3-E1 cells and allowed better sessile cell growth on them than on 316L SS. It can be concluded that HNSs are more suitable dental materials than the conventional 316L SS.

Glass ionomer cement modified by a imidazolium salt: adding antifungal properties to a biomaterial

We present the structural modification of a commercially available glass ionomer cement by inserting the imidazolium salt 1-n-hexadecyl-3-methylimidazolium chloride (C₁₆MImCl), composing a new biomaterial with antifungal biofilm activity. Test specimens were prepared using a commercial glass ionomer cement to which 10 ppm of cetylpyridinium chloride (reference ionic antifungal agent) or C₁₆MImCl were added. The feasibility and hypoallergenicity of the new biomaterial were assessed by microhardness plastic deformation and chorioallantoic membrane assays. Colony counting and scanning electron microscopy were used to evaluate the modified specimens' antibiofilm activity against three multidrug-resistant Candida species. The modified glass ionomer cement presented a strong antibiofilm activity against Candida spp., without losing its original micromechanical and hypoallergenic properties, rendering it a promising candidate for further application in dentistry.

Surface degradation effects of carbonated soft drink on a resin based dental compound

Dental compounds and restorative materials undergo surface degradation and erosion from exposure to a variety of dietary substances. In this study we investigated changes in the surface properties of Rebaron, a hard denture reline material (HDRM), following timed immersion in carbonated soft drinks to determine its durability in a common acidic environment. Samples were prepared and immersed in a carbonated soft drink (or its components) for 6, 12, or 24 h. Surface structure and mechanical properties were characterized using Atomic Force Microscopy (AFM). Raman spectroscopy was used to identify changes in the HDRM surface chemistry following exposure to the test solutions. AFM revealed that prolonged exposure led to pit formation and a subsequent increase in surface roughness, from 302.02 ± 30.20 to 430.59 ± 15.07 nm Ra, following a 24 h exposure. Young's modulus values decreased from 9.3 ± 7.0 to 0.53 ± 0.26 GPa under the same conditions, demonstrating a softening and embrittlement of the HDRM sample. Raman results revealed that immersion in the carbonated soft drink or acidic solution changed the nature of the HDRM structure, converting the HDRM surface chemistry from primarily hydrophobic to hydrophilic. Our study indicates that sustainability and durability of Rebaron HDRM are significantly reduced by prolonged exposure to carbonated (acidic) soft drink, resulting in deformation and degradation of the material surface.

Influence of 2-hydroxyethyl methacrylate (HEMA) exposure on angiogenic differentiation of dental pulp stem cells (DPSCs)

OBJECTIVE

The angiogenic differentiation of dental pulp stem cells (DPSCs) is important for tissue homeostasis and wound healing. In this study the influence of 2-hydroxyethyl methacrylate (HEMA) on angiogenic differentiation was investigated.

METHODS

To evaluate HEMA effects on angiogenic differentiation, DPSCs were cultivated in angiogenic differentiation medium (ADM) in the presence or absence of non-toxic HEMA concentrations (0.1 mM and 0.5 mM). Subsequently, angiogenic differentiation was analyzed on the molecular level by qRT-PCR and protein profiler analyzes of angiogenic markers and flow cytometry of PECAM1. The influence of HEMA on angiogenic phenotypes was analyzed by cell migration and sprouting assays.

RESULTS

Treatment with 0.5 mM HEMA during differentiation can lead to a slight reduction of angiogenic markers on mRNA level. HEMA also seems to slightly reduce the quantity of angiogenic cytokines (not significant). However, these HEMA concentrations have no detectable influence on cell migration, the abundance of PECAM1 and the formation of capillaries. Higher concentrations caused primary cytotoxic effects in angiogenic differentiation experiments conducted for longer periods than 72 h.

SIGNIFICANCE

Non-cytotoxic HEMA concentrations seem to have a minor impact on the expression of angiogenic markers, essentially on the mRNA level, without affecting the angiogenic differentiation process itself on a detectable level.

Physicochemical and osteogenic properties of chairside processed tooth derived bone substitute and bone graft materials

To analyze physicochemical such as surface structures, the crystallinity, chemical composition, calcium phosphate dissolution and osteogenic properties of tooth derived bone substitute (TDBS) processed chair-side and other grafting materials. The number of anaerobic and facultative anaerobic bacteria in the supernatant of processed TDBS was determined. Human osteoblasts were co-cultured with TDBS or allograft in transwell system to examine cell migration. BMP2 released from TDBS was measured by ELISA. TDBS had high crystallinity similar to BoneCeramic while it had a broad pattern to ramus bone, OraGRAFT, and Bio-Oss. TDBS contained carbon, calcium, oxygen, phosphate, sodium and magnesium elements like others. Calcium/phosphorus dissolution of TDBS show closely related to those of mandibular ramus bone and OraGRAFT. In addition, microbial decontamination of TDBS by the chemical processing revealed a hundred percent efficacy. The osteoconductive and osteoinductive properties demonstrated in the TDBS processed chairside suggested the potential of an alternative for bone grafting material.

Effects of salivary pH on coating durability of two different aesthetic archwire coatings under a simulated intraoral environment

Objectives

This study compared the effects of normal salivary pH, and acidic pH found in patients with poor oral hygiene, on the durability of aesthetic archwire coated with epoxy resin and polytetrafluoroethylene (PTFE).

Methods

The posterior parts of the archwires were sectioned into 20 mm segments (N = 102) and divided among six groups. Four groups were treated with different pH levels and two served as controls. The specimens were immersed in individual test tubes containing 10 ml of artificial saliva adjusted to a pH of 6.75 or 3.5. The tubes were sealed and stored in a 37 °C water bath for 28 days. After 28 days, the specimens were ligated to brackets embedded in an acrylic block and subjected to mechanical stress using an electronic toothbrush for 210 s. The specimens were photographed, and images were measured for coating loss using AutoCAD® software. Surface morphology was observed using a scanning electron microscope (SEM).

Results

Significant coating loss (p < 0.001) was found in the epoxy resin groups, regardless of pH value, but not in the PTFE groups. The acidic pH caused epoxy resin layer coating loss by twice as much as normal pH. SEM revealed existing manufacturing defects on the as-received epoxy resin coating, whereas the retrieved epoxy resin demonstrated rupture, roughness, and coating loss in multiple locations.

Significance

Epoxy resin coatings demonstrate poor durability in acidic environments. This condition is worsened by the existing manufacturing defects found on as-received archwires. Hence, archwires coated with epoxy resin are not recommended in patients with poor oral hygiene.

Influence of TEGDMA monomer on MMP-2, MMP-8, and MMP-9 production and collagenase activity in pulp cells

Objectives

Resin-based composites may leach monomers such as triethylene-glycol dimethacrylate (TEGDMA), which could contribute to intrapulpal inflammation. The aim of this investigation was to examine whether various concentrations of TEGDMA are able to influence dentally relevant Matrix metalloproteinase (MMP)-2, MMP-8, and MMP-9 production, total collagenase/gelatinase activity in pulp cells, and suggest possible signaling mechanisms.

Materials and methods

Pulp cells were cultured, followed by a 1-day exposure to sublethal TEGDMA concentrations (0.1, 0.2, and 0.75 mM). Total MMP activity was measured by an EnzCheck total collagenase/gelatinase assay, while the production of specific MMPs and the relative changes of phosphorylated, i.e., activated signaling protein levels of extracellular signal-regulated kinase (ERK)1/2, p38, c-Jun N-terminal kinase (JNK) were identified by western blot. Immunocytochemistry image data was also plotted and analyzed to see whether TEGDMA could possibly alter MMP production.

Results

An increase in activated MMP-2, MMP-8, and MMP-9 production as well as total collagenase activity was seen after a 24-h exposure to the abovementioned TEGDMA concentrations. Increase was most substantial at 0.1 (P = 0.002) and 0.2 mM (P = 0.0381). Concurrent p-ERK, p-p38, and p-JNK elevations were also detected.

Conclusions

Results suggest that monomers such as TEGDMA, leached from resin-based restorative materials, activate and induce the production of dentally relevant MMPs in pulp cells. Activation of ERK1/2, p38, or JNK and MMP increase may play a role in and/or can be part of a broader stress response.

Clinical relevance

Induction of MMP production and activity may further be components in the mechanisms of intrapulpal monomer toxicity.

Effect of high-speed sintering on the flexural strength of hydrothermal and thermo-mechanically aged zirconia materials

OBJECTIVE

To investigate the influence of high-speed and conventional sintering on the flexural strength (FS) of three zirconia materials initial and after artificial aging.

METHODS

Milled zirconia specimens (3Y-TZP: ZI and Zolid; 4Y-TZP: Zolid HT+; Amann Girrbach AG; N = 288, n = 96/group) were sintered in a high-speed sintering protocol (final temperature 1580 °C, n = 48/subgroup) or a conventional sintering protocol (control group, final temperature 1450 °C, n = 48/subgroup). FS was tested initially and after artificial aging (10 h in an autoclave or 1,200,000 chewing cycles; n = 16/subgroup). Univariate ANOVAs, post-hoc Scheffé, partial eta-squared, Kolmogorov-Smirnov-, Kruskal-Wallis- and Mann-Whitney-U-test were performed (p < 0.05).

RESULTS

ZI showed the highest and HT+ the lowest FS, regardless of the sintering protocols and aging regimens (p < 0.001). High-speed sintered HT+ showed higher initial FS than the control group (p < 0.001). ZI (p < 0.001-0.004) and Zolid (p < 0.001-0.007) showed higher FS after thermo-mechanical aging. High-speed sintered HT+ showed higher FS in the initial stage (p < 0.001). The Weibull modulus of the three thermo-mechanically aged materials was negatively influenced by high-speed sintering.

SIGNIFICANCE

As shorter sintering times represent a cost and time efficient alternative, high-speed sintering is a valid alternative to conventional sintering protocols.

Material selection for tooth-supported single crowns-a survey among dentists in Germany

Objectives

This study aimed to survey dentists in Germany to identify their favored materials for the fabrication of tooth-supported single crowns (SCs) depending on the location of the abutment teeth and the preparation margin.

Materials and methods

The survey included questions regarding demographic characteristics of dentists/their dental practice and preferred restorative materials for the fabrication of SCs for abutment teeth 16, 11, 34, and 36 with either supra- or subgingival preparation margins.

Results

Between August 2019 and February 2020, 721 dentists participated in the survey; responses from 33 dentists were excluded from data analysis because the dentists did not work in Germany or provided less than one fixed dental prosthesis/month. Dentists favored ceramic materials independent of the location of the abutment tooth and preparation margin (56.6–92.2%). CAD/CAM resin composites or full metals were preferred by only a few participants. A significantly higher proportion of dentists recommended porcelain fused to metal for subgingival preparation margins than for supragingival margins (p < 0.001). Characteristics of dentists/dental practices influenced a single scenario (11 subgingival) that was dependent on the dentist’s time since graduation. When asked to specify the ceramic materials, numerous participants wrote a free response (5.7–7.8%) or did not answer (0.7–4.8%).

Conclusions

Dentists in Germany selected restorative materials for SCs depending on the clinical scenario. Since numerous dentists did not specify the ceramic materials, postgraduate information and education might help to extend expertise.

Clinical relevance

The results of this survey provide insight into the favored materials of dentists for the fabrication of tooth-supported SCs.

Mineralization-inducing potentials of calcium silicate-based pulp capping materials in human dental pulp cells

Background

This study was performed to provide a long-term bacterial seal through the formation of reparative dentin bridge, calcium silicate-based pulp capping materials have been used at sites of pulpal exposure. The aim of this study was to evaluate the mineralization-inducing potentials of calcium silicate-based pulp capping materials (ProRoot MTA [PR], Biodentine [BD], and TheraCal LC [TC]) in human dental pulp cells (HDPCs).

Methods

Specimens of test materials were placed in deionized water for various incubation times to measure the pH variation and the concentration of calcium released. The morphology of HDPCs cultured on the specimens was examined using a confocal laser scanning microscope (CLSM). Alizarin red S staining and alkaline phosphatase assays were used to evaluate mineralization-inducing potentials of the capping materials.

Results

BD showed the highest calcium release in all test periods, followed by PR and TC. (p<0.05). All experimental groups showed high alkalinity after 1 day, except at 14 days. BD showed the highest cell viability compared with PR and TC after 1 and 3 days, while TC showed the lowest value (p<0.05). The CLSM analysis showed that cells were well adhered and expressed actin filaments for all pulp capping materials. Mineralization by PR and BD groups was higher than that by TC group based on alizarin red S staining. BD showed significantly higher alkaline phosphatase activity than PR and TC, while TC showed the lowest value (p<0.05).

Conclusion

Within the limitations of the in vitro study, BD had higher mineralization-inducing potential than PR and TC.

Fracture force of CAD/CAM resin composite crowns after in vitro aging

OBJECTIVES

The aim of this in vitro study was to investigate the influence of material, preparation, and pre-treatment on the aging and fracture force of CAD/CAM resin composite molar crowns.

MATERIALS AND METHODS

CAD/CAM molar crowns (n = 80) were milled from four resin composites (Block HC, Shofu; Lava Ultimate, 3 M; Grandio Blocs, Voco; and Tetric CAD, Ivoclar Vivadent, with/without sandblasting). Extracted human teeth were prepared with optimal preparation (height 6-8 mm, angle 6-8°) or worst-case preparation (height 3.5-4 mm, angle 10-15°). Both groups were prepared with a 1-mm deep cervical circular shoulder. Crowns were adhesively bonded after corresponding tooth treatment required for the individual adhesive systems (Table 1). Specimens were aged for 90 days in water storage (37 °C) and subsequently subjected to thermal cycling and mechanical loading (TCML 3000 × 5 °C/3000 × 55 °C, 2 min each cycle, H20 distilled; 1.2 × 10⁶ cycles à 50 N, 1.6 Hz). De-bonding and fracture force was determined.

STATISTICS

one-way-ANOVA; post hoc Bonferroni, α = 0.05.

RESULTS

Four crowns of Lava Ultimate with worst-case preparation de-bonded during TCML. Individual crowns without sandblasting treatment (3x Tetric CAD with optimal preparation; 1x Tetric CAD with worst-case preparation) de-bonded during water storage. One crown of Grandio Blocs with optimal preparation showed a small chipping during TCML. All other crowns survived TCML and water storage without failure. Fracture forces differed between 1272 ± 211 N (Lava Ultimate) and 3061 ± 521 N (Tetric CAD). All Grandio Blocs and Tetric CAD crowns revealed significantly (p ≤ 0.023) higher fracture forces than Block HC or Lava Ultimate crowns. No significantly different (p > 0.05) fracture forces were found between optimal or worst-case preparation/fit groups.

CONCLUSIONS

De-bonding during water storage and TCML was dependent on material and crown pre-treatment. Therefore, surface roughening seems strongly required. Fracture forces were not influenced by preparation but by the type of material.

CLINICAL RELEVANCE

Clinical success and de-bonding of CAD/CAM resin composite crowns is strongly influenced by the type of material and its pre-treatment.

Synthesis of chemically modified BisGMA analog with low viscosity and potential physical and biological properties for dental resin composite

OBJECTIVES

The currently available commercial dental resin composites have limitations in use owing to the high viscosity and water sorption of Bisphenol A glycidyl methacrylate (BisGMA). The objective of this study was to obtain a BisGMA analog with reduced viscosity and hydrophilicity for potential use as an alternative to BisGMA in dental resin composites.

METHODS

The targeted chlorinated BisGMA (Cl-BisGMA) monomer was synthesized via the Appel reaction. The structural modification was confirmed via ¹H- and ¹³C nuclear magnetic resonance spectroscopy, Fourier transform infrared spectroscopy, and mass spectrometry. Five resin mixtures (70:30wt.%: F1=BisGMA/TEGDMA; F2=Cl-BisGMA/TEGDMA; F3=Cl-BisGMA only; F4=Cl-BisGMA/BisGMA; F5 contained 15% TEGDMA with equal amounts of BisGMA and Cl-BisGMA) were prepared. The viscosity, degree of double-bond conversion (DC), water sorption (W_SP), and solubility (W_SL) were tested. Cell viability and live/dead assays, as well as cell attachment and morphology assessments, were applied for cytotoxicity evaluation.

RESULTS

Cl-BisGMA was successfully synthesized with the viscosity reduced to 7.22 (Pas) compared to BisGMA (909.93,Pas). Interestingly, the DC of the F2 resin was the highest (70.6%). By the addition of equivalence concentration of Cl-BisGMA instead of BisGMA, the W_SP was decreased from 2.95% (F1) to 0.41% (F2) with no significant change in W_SL. However, the W_SL increased with high Cl-BisGMA content. Biological tests revealed that all the resins were biocompatible during CL1 incubation.

SIGNIFICANCE

The experimental resins based on Cl-BisGMA exhibited improved properties compared with the control samples, e.g., biocompatibility and lower viscosity, indicating that Cl-BisGMA can be considered as a potential monomer for application in dental resin composites.

ZnO nanoparticles inhibit the activity of Porphyromonas gingivalis and Actinomyces naeslundii and promote the mineralization of the cementum

Background

Zinc oxide nanoparticles (ZnONPs) have been widely studied as bactericidal reagents. However, it is still challenging to use ZnONPs as a root canal sealant to eliminate infecting microorganisms in the root canal system. This study aimed at understanding the antibacterial and biofilm effects of ZnONPs in the infected root canal and their effect on cell function.

Methods

This study aimed to develop a better understanding of the antibacterial effects of ZnONPs in the infected root canal and their effect on cell function. Experiments were performed in two stages; the first stage included inhibition zone tests and the minimum inhibitory concentration (MIC) test, which were performed to examine the antibacterial activity of ZnONPs against Porphyromonas gingivalis (P. gingivalis) and Actinomyces Naeslundii (A. naeslundii) bacteria in vitro. ZnONPs were further evaluated for their biocompatibility using normal mouse NIH3T3 and OCCM-30 cells by the cell-based MTT assay. In addition, the influence of ZnONPs on matrix metalloproteinases in NIH3T3 cells and their inhibiting factors (Mmp13 and Timp1) were measured using the real-time PCR technique and western blot method.

Results

The MIC of ZnONPs against P. gingivalis and A. naeslundii were confirmed to be 10 μg/mL and 40 μg/mL, respectively. The MTT assay showed that ZnONPs were nontoxic. The RT-PCR and western blotting results showed that Mmp13 was downregulated and Timp1 expression was increased. Meanwhile, ZnONPs were shown to increase the expression of the OCCM-30 osteogenesis-related factors Bsp and Runx2. Finally, there was no significant change in the morphology of NIH3T3 and OCCM-30 cells after the addition of different concentrations of ZnONPs for different periods of time.

Conclusion

ZnONPs have excellent antibacterial activity against P. gingivalis and A. naeslundii and have low cell cytotoxicity in vitro.

Study on the performance of methyl methacrylate polymerization: Comparison of partially oxidized tri-n-butylborane and benzoyl peroxide with aromatic tertiary amines

In this study, we examined the polymerization performance of methyl methacrylate (MMA) initiated with partially oxidized tri-nbutylborane (TBBO) compared to that initiated with benzoyl peroxide and aromatic tertiary amine (BPO/amine) system. In the bulk polymerization of MMA at 37°C, conversion initiated with TBBO after 3 h was nearly quantitative, whereas the conversion with the BPO/amine system was low (~20%). The number-averaged and weight-averaged molecular weight of the TBBO-initiated polymer was more than twice as high as that of the BPO/amine-initiated polymer. Electron spin resonance (ESR) analysis of MMA polymerization indicated that the TBBO-initiated system maintained its radical intensities for a longer period than the BPO/amine-initiated system. Furthermore, the radical fragments in the TBBO-initiated PMMA after 72 h were still active as a polymerization initiator for MMA. These findings suggest that the polymerization mechanism of MMA initiated by TBBO functions as a living-like polymerization initiator.

Evaluation of the physical properties of a newly developed denture adhesive for patients with dry mouth

PURPOSE

Elderly individuals with dry mouth wearing dentures require an appropriate denture adhesive. The purpose of this study was to evaluate the in vitro properties of a newly developed denture adhesive for patients with dry mouth and compare these with those of a currently available adhesive and oral moisturizing agent.

METHODS

We developed a new gel-type denture adhesive with physical properties suitable for patients with dry mouth (DM). We subsequently performed in vitro comparisons among DM, New Poligrip (NP), and Biotene Oralbalance Gel (BT) with regard to the following properties: retention force, resistance to squeezing, and ease of removal. In accordance with the standards of the International Organization for Standardization (ISO10873:2010), the retention force was measured for dry samples (no water exposure, severe dry mouth model) and for samples exposed to water for 10min (normal model) and 1min (moderate dry mouth model). The resistance to squeezing was evaluated by pushing the samples out of syringes, while the ease of removal was evaluated by measuring the time required to wash the material from a polymethyl methacrylate plate.

RESULTS

In the severe dry mouth model, DM exhibited greater retention force than did NP and BT. Moreover, the resistance to squeezing was significantly lower for DM than for NP. Both BT and DM showed better ease of removal than did NP. NP was the most difficult to wash out with water.

CONCLUSIONS

Our findings suggest that the newly developed denture adhesive DM is suitable for use in patients with dry mouth.

A facile sol-gel synthesis of low-fusing titanium opaque porcelain using borate-silicate system and its bioactivity

The titanium opaque porcelain was synthesized through sol-gel using borate-silicate system. The porcelain was characterized by DSC-TG, X-ray diffraction, N₂ adsorption-desorption isotherms and scanning electron microscope tests. The results of DSC showed that the nitrates could be decomposed completely when the bioglass xerogel precursor was heat-treated at 760 ℃. The XRD results showed that the Na₂Ca₃Si₆O₁₆ was the major phase of the opaque porcelain. The synthesized opaque porcelain powders had an average particle size of about 5-25 µm with nanopores of around 50-70 nm on the surface. The BET average surface area of the porcelain was 12.67 m²/g, while the average pore diameters for adsorption and desorption were 9.73 and 10.16 nm, respectively. The flexure strength significantly increased from 47.4 MPa to 116.2 MPa with the sintering temperature increasing from 575 ℃ to 600 ℃. The XRD, FTIR and EDS results proved that hydroxyapatite had formed on the porcelain surface after incubation in simulated body fluid.

Polymerization shrinkage stress of resin-based dental materials: A systematic review and meta-analyses of composition strategies

PURPOSE

A systematic review was conducted to determine whether there were composition strategies available to reduce and control polymerization shrinkage stress development in resin-based restorative dental materials.

DATA SOURCES

This report was reported in accordance with the PRISMA Statement. Two reviewers performed a literature search up to December 2016, without restriction of the year of publication, in seven databases: PubMed, Web of Science, Scopus, SciELO, LILACS, IBECS, and BBO.

STUDY SELECTION

Only laboratory studies that evaluated polymerization shrinkage stress by direct testing were included. Pilot studies, reviews and in vitro studies that evaluated polymerization shrinkage stress by indirect methods (e.g., microleakage or cuspal deflection measurements), finite elemental analysis, or theoretical and mathematical models were excluded. Of the 6113 eligible articles, 62 studies were included in the qualitative analysis, and the meta-analysis was performed with 58 studies. The composition strategy was subdivided according to the modified part of the material: filler phase, coupling agent, or resin matrix. A global comparison was performed with random-effects models (α = 0.05). The only subgroup that did not show a statistical difference between the alternative strategy and the control was 'the use of alternative photo-initiators' (p = 0.29).

CONCLUSION

Modification of the resin matrix made the largest contribution to minimizing stress development. The technology used for decreasing stress in the formulation of low-shrinkage and bulk-fill materials was shown to be a promising application for reducing and controlling stress development.

Polymerization shrinkage stress of resin-based dental materials: A systematic review and meta-analyses of technique protocol and photo-activation strategies

PURPOSE

A systematic review was conducted to determine whether there were any alternative technique or additional step strategies available to reduce and control polymerization shrinkage stress development in dental resin-based restorative materials.

DATA SOURCES

This report followed the PRISMA Statement. A total of 36 studies were included in this review. Two reviewers performed a literature search up to December 2016, without restriction of the year of publication, in seven databases: PubMed, Web of Science, Scopus, SciELO, LILACS, IBECS, and BBO.

STUDY SELECTION

Only in vitro studies that evaluated polymerization shrinkage stress by direct testing were included. Pilot studies, reviews and in vitro studies that evaluated polymerization shrinkage stress by indirect methods (e.g., microleakage or cuspal deflection measurements), finite elemental analysis or mathematical models were excluded. Of the 6.113 eligible articles, 36 studies were included in the qualitative analysis, and the meta-analysis was performed with 25 studies. A global comparison was performed with random-effects models (α = 0.05). The strategies were subdivided as follows: the use of an alternative technique protocol of placing the material inside the tooth cavity; the modification of the irradiation intensity or total energy delivered to the material; the use of an alternative light-curing source; or the use of an alternative photo-activation mode. All alternative strategies showed statistically significant differences when compared with their respective controls (p < 0.05).

CONCLUSION

The use of alternative light-curing sources contributed more to minimizing stress development than placing the material by means of an alternative technique protocol or by modifying the irradiant intensity or total energy delivered to the material during photo-activation. Moreover, the use of an alternative photo-activation mode (intermittent light, exponential, soft-start or pulse delay modes) was shown to be an effective strategy for reducing and controlling stress development in resin-based dental materials.

Reducing the effect of polymerization shrinkage of temporary fixed dental prostheses by using different materials and fabrication techniques

OBJECTIVE

The aim of this laboratory study was to evaluate the horizontal and vertical effects of the polymerization shrinkage of three-unit temporary fixed dental prostheses (FDPs) on the position of the prepared teeth. In addition, the reduction of these effects by using different fabrication techniques was evaluated.

METHODS

A total of 192 temporary FDPs were fabricated using one methacrylate (MA) and two dimethacrylate (DMA) materials. Each material group (n=64) was divided into two groups according to the fabrication methods (M1: curing on the prepared teeth, M2: curing in a silicone mold). Each fabrication group was divided into four subgroups (n=8) according to the relining method used (B: no relining, S: spacer foil 300μm, DG: grinding-out with 500μm cutting depth, and FG: free grinding). The experimental apparatus consisted of two abutment teeth lowered at right angles into a silicone mold. One prepared tooth was embedded in silicone to simulate the periodontium and permit slight horizontal tooth movement. The dimensional changes were recorded with an optical microscope. The test images were superimposed and measured using image analysis software.

RESULTS

The statistical analysis showed that there were significantly higher horizontal changes for the MA than the DMA resins in M1, while there was none in M2. Regarding the vertical changes, there were significant differences between the baseline group and all relining and fabrication groups in all materials.

SIGNIFICANCE

Relining of directly fabricated temporary FDPs significantly reduces the effect of polymerization shrinkage and thus secures the position of the prepared teeth.

Influence of nanogel additive hydrophilicity on dental adhesive mechanical performance and dentin bonding

OBJECTIVE

To assess the influence of hydrophilicity of reactive nanogels on the mechanical performance of dental adhesives and microtensile bond strength (μTBS) to dentin after 24h or 3 months of aging.

METHODS

A series of three nanogels were synthesized: NG1-IBMA/UDMA; NG2-HEMA/BisGMA; NG3-HEMA/TE-EGDMA. The nanogels were dispersed in solvent, HEMA or BisGMA/HEMA. The degree of conversion (DC) of the materials was measured and the flexural modulus of these polymers was evaluated in dry or wet conditions. For μTBS analysis, a model adhesive was used without nanogel (control) or with the incorporation of nanogels. μTBS was evaluated after storage in distilled water for 24h or 3 months. The analysis of the fracture was performed after μTBS testing. Data were analyzed using ANOVA and Tukey's test (α=0.05).

RESULTS

Water significantly increased the modulus of NG1 and NG2 dispersed in solvent, while significantly decreased the stiffness of NG3. All polymers dispersed in HEMA and BisGMA/HEMA had significantly lower modulus when stored in water. NG2 showed the highest DC in solvent and BisGMA/HEMA. In HEMA, NG1 and NG3 produced the highest DC. After three months, NG2 showed the best μTBS. The μTBS of NG2-containing adhesive resin significantly increased after 3 months, while storage had no effect in the control group, NG1 and NG3.

SIGNIFICANCE

The more hydrophobic IBMA/UDMA nanogel showed higher bulk material mechanical property results, but the best dentin bond strength values, and notably strength values that improved upon storage, were obtained with the amphiphilic nanogel based on BisGMA/HEMA.

Properties evaluation of silorane, low-shrinkage, non-flowable and flowable resin-based composites in dentistry

Purpose. This study tested the null hypothesis that different classes of direct restorative dental materials: silorane-based resin, low-shrinkage and conventional (non-flowable and flowable) resin-based composite (RBC) do not differ from each other with regard to polymerization shrinkage, depth of cure or microhardness.

Methods. 140 RBC samples were fabricated and tested by one calibrated operator. Polymerization shrinkage was measured using a gas pycnometer both before and immediately after curing with 36 J/cm² light energy density. Depth of cure was determined, using a penetrometer and the Knoop microhardness was tested from the top surface to a depth of 5 mm.

Results. Considering polymerization shrinkage, the authors found significant differences (p < 0.05) between different materials: non-flowable RBCs showed lower values compared to flowable RBCs, with the silorane-based resin presenting the smallest shrinkage. The low shrinkage flowable composite performed similarly to non-flowable with significant statistical differences compared to the two other flowable RBCs. Regarding to depth of cure, low-shrinkage flowable RBC, were most effective compared to other groups. Microhardness was generally higher for the non-flowable vs. flowable RBCs (p < 0.05). However, the values for low-shrinkage flowable did not differ significantly from those of non-flowable, but were significantly higher than those of the other flowable RBCs.

Clinical Significance. RBCs have undergone many modifications as they have evolved and represent the most relevant restorative materials in today’s dental practice. This study of low-shrinkage RBCs, conventional RBCs (non-flowable and flowable) and silorane-based composite—by in vitro evaluation of volumetric shrinkage, depth of cure and microhardness—reveals that although filler content is an important determinant of polymerization shrinkage, it is not the only variable that affects properties of materials that were tested in this study.

Polymerization shrinkage, modulus, and shrinkage stress related to tooth-restoration interfacial debonding in bulk-fill composites

OBJECTIVES

The aim of the present study was to measure the polymerization shrinkage, modulus, and shrinkage stress of bulk-fill and conventional composites during polymerization and to investigate the relationship between tooth-composite interfacial debonding and shrinkage stress of the composites.

METHODS

Polymerization shrinkage, dynamic modulus, and shrinkage stress of two high-viscosity bulk-fill (SonicFill (SF)/Tetric N-Ceram Bulk-Fill (TNB)) and two low-viscosity bulk-fill composites (Filtek Bulk-Fill (FB)/SureFil SDR Flow (SDR)) as well as one high-viscosity conventional (Filtek Z250 (Z250)) and one low-viscosity conventional composite (Filtek Z350 XT Flowable (Z350F)) were measured using custom-made instruments. Acoustic emission (AE) analysis was performed to evaluate the tooth-composite interfacial debonding during polymerization of the composites in Class 1 cavities on extracted third molars.

RESULTS

The low-viscosity composites exhibited higher shrinkage and lower modulus than the high-viscosity composites. Polymerization shrinkage at 10 min ranged between 2.05% (SF) and 3.53% (Z350F). Polymerization shrinkage stress values at 10 min ranged between 1.68MPa (SDR) and 3.51MPa (Z350F). The number of AE events was highest in Z350F and lowest in SDR.

CONCLUSIONS

Composites that exhibited greater polymerization shrinkage stress generated more tooth-composite interfacial debonding. In contrast to similar outcomes among the high-viscosity composites (conventional: Z250, bulk-fill: TNB and SF), the low-viscosity bulk-fill composites (FB and SDR) demonstrated better results in terms of polymerization shrinkage stress and tooth-composite interfacial debonding than did the low-viscosity conventional composite (Z350F).

CLINICAL SIGNIFICANCE

Despite the better performance by some of the bulk-fill composites, clinicians should be aware that the bulk-fill composites are not perfect substitutes for conventional composites.

Comparison of fatigue resistance and failure modes between metal-ceramic and all-ceramic crowns by cyclic loading in water

OBJECTIVES

To compare fatigue resistance and fracture mode of metal-ceramic crowns with all-ceramic crowns containing yttria tetragonal zirconia polycrystal (Y-TZP) frameworks under compressive cycling loading in water.

METHODS

Twenty specimens of ivory were randomized and individually prepared to receive anatomically shaped metal-ceramic (n=10) or veneered Y-TZP all-ceramic crowns (n=10). All steps in production were equivalent to clinical situations. Resistance to fatigue fracture was tested under compressive cyclic loading using a universal testing machine, with a loading frequency of 12Hz using a spherical tungsten carbide indenter (6mm diameter) in distilled water. The maximum compressive load was increased as the number of cycles increased (600,000 cycles at 400N, 200,000 cycles at 600 N, 200,000 cycles at 800 N and 200,000 cycles at 1000 N). The specimens were inspected after each loading sequence for initial failures such as infractions. Final failure was considered as any loss of material which automatically ended the test and the number of cycles until final failure was recorded. Fractographic analysis of the fractured specimens was performed with scanning electron microscopy (SEM).

RESULTS

The two types of crowns exhibit similar fatigue resistance (P=0.87) to compressive cycling loading under wet conditions. The failure modes as observed with SEM were similar in the two groups and were found in the veneer ceramic, except that three veneered Y-TZP all-ceramic crowns displayed a complete framework fracture.

CONCLUSIONS

Within the limitation of this study using simulated oral masticatory function, the results revealed that the fatigue resistance was similar for the two crown types.

CLINICAL SIGNIFICANCE

In this study metal-ceramic crowns and veneered Y-TZP all-ceramic crowns showed similar fracture resistance to compressive cycling loading in water. The test conditions were simulating clinical conditions. Thus, the result may predict the long-term clinical performance of these types of crowns.

Outcome of restorative treatment in young patients with amelogenesis imperfecta. a cross-sectional, retrospective study

OBJECTIVES

The longevity of dental restorations in patients with amelogenesis imperfecta (AI) is limited. The aim of this paper is to compare oral health and longevity of dental restorations in a group of young patients with AI compared to a control group.

METHODS

Patients included were 82 patients with AI, 40 boys and 42 girls, 6 to 25 years old (mean age 14.5±4.3 years) and a control group matched in age, gender and residential area. All patients received an examination recording dental caries, gingivitis, previous therapy, replaced restorations, tooth sensitivity, and number of dental visits. Patient dental records, extending from 6 to 10 years before the study, provided data on previous care.

RESULTS

Annual mean number of dental visits in the AI group was 2.9±1.7 compared to 1.9±1.2 in the control group (p<0.001). DMFS was 8.1±15.6 in the AI group compared to 1.0±2.0 in the control group (p<0.001). The longevity of dental restorations was significantly lower in the patients with AI, with 24.7±35.1% of the AI group requiring replacement of fillings during the observation period compared to 9.23±23.7% in the control group (p=0.001). Patients with hypomineralized/hypomaturized AI have restorations of shorter longevity than those with hypoplastic AI (p<0.01). Porcelain crowns had significantly longer survival than composite resin materials in the AI group (p<0.001). Clinical Significance This study shows the need for long-lasting restorative solutions for patients with AI. It also shows the importance of establishing an early permanent therapy plan for these patients to avoid frequent dental visits.

Structural and dynamical studies of acid-mediated conversion in amorphous-calcium-phosphate based dental composites

OBJECTIVE

To investigate the complex structural and dynamical conversion process of the amorphous-calcium-phosphate (ACP)-to-apatite transition in ACP based dental composite materials.

METHODS

Composite disks were prepared using zirconia hybridized ACP fillers (0.4 mass fraction) and photo-activated Bis-GMA/TEGDMA resin (0.6 mass fraction). We performed an investigation of the solution-mediated ACP-to-apatite conversion mechanism in controlled acidic aqueous environment with in situ ultra-small angle X-ray scattering based coherent X-ray photon correlation spectroscopy and ex situ X-ray diffraction, as well as other complementary techniques.

RESULTS

We established that the ACP-to-apatite conversion in ACP composites is a two-step process, owing to the sensitivity to local structural changes provided by coherent X-rays. Initially, ACP undergoes a local microstructural rearrangement without losing its amorphous character. We established the catalytic role of the acid and found the time scale of this rearrangement strongly depends on the pH of the solution, which agrees with previous findings about ACP without the polymer matrix being present. In the second step, ACP is converted to an apatitic form with the crystallinity of the formed crystallites being poor. Separately, we also confirmed that in the regular Zr-modified ACP the rate of ACP conversion to hydroxyapatite is slowed significantly compared to unmodified ACP, which is beneficial for targeted slow release of functional calcium and phosphate ions from dental composite materials.

SIGNIFICANCE

For the first time, we were able to follow the complete solution-mediated transition process from ACP to apatite in this class of dental composites in a controlled aqueous environment. A two-step process, suggested previously, was conclusively identified.

Evaluation of effectiveness of microwave irradiation for disinfection of silicone elastomeric impression material

Use of domestic microwave oven has been suggested as a method of disinfecting a number of dental materials used in dental practice. This study was done to analyse the effect of microwave irradiation on vinyl polysiloxane putty impression material (3M ESPE, Express™ STD) contaminated with test organisms (Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans. 180 square shaped specimens of addition silicon putty material were prepared and divided into 3 groups for three test organisms. The 3 groups were subdivided into 4 subgroups (n = 15) for different exposure parameters (control group 5, 6 and 7 min exposure at 650 W. The specimens were contaminated using standard inoculums of test organism and then were irradiated using domestic microwaves. Broth cultures of the control and test group specimens were plated on selective media culture plates. Colonies formed were counted. Data analyses included Kruskal-Walli's ANOVA and Mann-Whitney's tests. Nil values shows complete elimination of C. albicans and P. aeruginosa after 5, 6 and 7 min exposure. Staphylococcus aureus showed colonies with the mean value of 7.6 × 10(3) ± 2.3 × 10(3), 4.6 × 10(3) ± 2.6 × 10(3) after 5 and 6 min respectively and nil values after 7 min exposure. 5 min exposure caused complete elimination of C. albicans and P. aeruginosa strains, while 7 min exposure eliminated S. aureus completely.