A leptin-loaded poly-ϵ-caprolactone 3D printing scaffold for odontoblastic differentiation in human dental pulp cells.

This study investigated the effects on odontoblast differentiation of a 3D-printed poly-ϵ-caprolactone (PCL) scaffold that incorporated leptin. Material extrusion-type 3D printing with a 43 000-molecular weight PCL material was used to fabricate a PCL scaffold with a 6 mm diameter, 1 mm height, and 270-340 µm pore size. The experimental groups were PCL scaffolds (control group), PCL scaffolds with aminated surfaces (group A), and PCL scaffolds with leptin on the aminated surface (group L). The aminated surface was treated with 1,6-hexanediamine and verified by ninhydrin analysis. Leptin loading was performed using Traut's reagent and 4-(N-Maleimidomethyl)cyclohexane-1-carboxylic acid 3-sulfo-N-hydroxysuccinimide ester sodium salt (Sulfo-SMCC). Groups A and L showed significantly higher surface wettability, pulp cell adhesion, and proliferation than the control group. Group L exhibited increased alkaline phosphatase, calcification deposits, and mRNA and protein expression of dentin sialophosphoprotein and dentin matrix acidic phosphoprotein 1 compared with the control group. In this study, a 3D-printed PCL scaffold containing leptin was enhanced odontoblast differentiation and dental pulp cells adhesion and proliferation.

The Impact of Particle Size and Surface Treatment of Zirconia Suspension for Photocuring Additive Manufacturing.

To prepare a photocurable ceramic suspension for use in commercialized additive manufacturing equipment, the effects of the rheological properties of zirconia particles added to a binder, and the presence or absence of a silane coupling agent on the particles was evaluated. To this end, three experimental groups (ZSs, ZMs, ZLs) and three control groups (ZS, ZM, ZL) were designed depending on the size of the underlying zirconia particles. The test-group zirconia suspensions were prepared through silanization, which was not applied to the control-group suspensions. Depending on the particle size, viscosity differences between the test and control groups were 16,842, 18,623, and 12,303 mPa·s, respectively. Compared to the other groups, the viscosity of the ZLs group suspension decreased by 70.98-88.04%. This confirmed that the viscosity of the suspensions was affected by the particle size and the presence of silane coating. The dispersion stability of the zirconia suspensions was evaluated over 20 days. A sedimentation test confirmed that the sedimentation rate of the ZLs group was slower than those of the other groups. This study aimed to optimize the suspension manufacturing method to effectively be utilized in further commercializing zirconia three-dimensional (3D) printing and could also help to develop various medical applications.

Effects of UV Absorber on Zirconia Fabricated with Digital Light Processing Additive Manufacturing.

This study evaluated the effect of UV absorbers on the dimensional accuracy of zirconia specimens fabricated by additive manufacturing using a digital light process. Zirconia suspension for additive manufacturing was prepared by setting the volume fractions (0, 0.005, 0.05, and 0.1%) of various UV absorbers. The effect of UV absorber content was evaluated through curing thickness, geometric overgrowth model design, linear deviation, and microstructure evaluation before and after sintering. Statistical analysis was performed by Kruskal-Wallis H and post-tested by the Bonferroni correction method. There was no significant difference in the cure depth according to the presence or absence of the UV absorber, the difference in geometric overgrowth was from 2.1 to 12.5%, and the overgrowth significantly decreased as the amount of added UV absorber increased. This result may contribute to improved precision of 3D multilayer ceramic products.

Long-term follow-up implant site development in the submerged mandibular primary second molars: a case report.

Treatment of ankylosed and submerged primary molars without permanent successors is challenging, as normal vertical dentoalveolar growth is compromised. Thus, grafting techniques and distraction osteogenesis are performed for ridge augmentation before implant restoration. However, these techniques are invasive with limited success. Another treatment for implant site development is noninvasive forced eruption. This case report describes long-term follow-up of alveolar ridge augmentation in the submerged mandibular primary second molars using subluxation and orthodontic forced eruption for implant site development. A 19-year old female had Class II molar relationships, upper anterior crowding with large overjet, missing four second premolars and submerged mandibular primary second molars with inadequate vertical development of alveolar bone. For the vertical alveolar bone alterations in the mandible, forced eruption with subluxation of ankylosed lower primary second molars was applied. Treatment outcome was evaluated over 5 years with stable occlusion, healthy periodontal tissues, and successful radiographic results.

Creation of Digital Virtual Patient by Integrating CBCT, Intraoral Scan, 3D Facial Scan: An Approach to Methodology for Integration Accuracy.

ABSTRACT: The purpose of this paper was to introduce a method for creating a digital virtual patient by combining cone-beam computed tomography (CBCT), intraoral scan, and facial scan with a high accuracy of integration. CBCT scan, facial scan, and intraoral scan were obtained from initial visit. The virtual patient was created using the integration of these imaging modalities. Once the virtual patient was generated, digital workflow could be applied to initial patient consultation, diagnosis, treatment planning, virtual tooth setup, virtual treatment simulation, and post-treatment evaluation. integration of digital technology allows clinicians to improve diagnosis and treatment outcome. in addition, it allows for favorable patient communication. This technique eliminates the traditional impression process and complicated laboratory procedures for evaluating patient's occlusion during smile and habitual resting position. Based on this protocol, it is possible to create a digital virtual patient using CBCT, intraoral scan, and facial scan with a high accuracy of integration. it would be helpful for precision diagnosis and accurate treatment as well as favorable communication with patient.

Hybrid porous zirconia scaffolds fabricated using additive manufacturing for bone tissue engineering applications.

For the formation of new bone in critical-sized bone defects, bioactive scaffolds with an interconnected porous network are necessary. Herein, we fabricated three-dimensional (3D) porous hybrid zirconia scaffolds to promote hybrid functionality, i.e., excellent mechanical properties and bioactive performance. Specifically, the 3D printed scaffolds were subjected to Zn-HA/glass composite coating on glass-infiltrated zirconia (ZC). In addition, to pertain the extracellular matrix of bone, biopolymer (alginate/gelatine) was embedded in a developed 3D construct (ZB and ZCB). A zirconia-printed scaffold (Z) group served as a control. The structural and mechanical properties of the constructed scaffolds were studied using essential characterization techniques. Furthermore, the biological performance of the designed scaffolds was tested by a sequence of in vitro cell tests, including the attachment, proliferation, and osteogenic differentiation of dental pulp cells (DPCs). The ZC and ZCB scaffolds exhibited 20% higher compression strength than the zirconia (Z) scaffolds. More importantly, the ZC constructs exhibited superior cell-adhesion, distribution, and osteogenic differentiation ability due to the synergistic effects of the composite coating. In addition, the biopolymer-embedded scaffolds (ZB, ZCB) showed an excellent biological and mechanical performance. Thus, our results suggest that the Zn-HA/glass composite-coated glass-infiltrated zirconia (ZC, ZCB) scaffolds are a dynamic approach to designing bioactive 3D scaffolds for the load-bearing bone regeneration applications.

Effect of Zinc Oxide Nanoparticle Addition to Polycaprolactone Periodontal Membranes on Antibacterial Activity and Cell Viability.

During the design of membranes for guided tissue regeneration (GTR) to treat periodontal diseases, infection of the exposed membranes and postoperative complications can be prevented by increasing bacterial resistance. This study evaluated the antibacterial activity of PCL/ZnO membranes and their effect on cell viability via addition of antibacterial zinc oxide (ZnO) nanoparticles to a biocompatible and biodegradable material such as polycaprolactone (PCL). Neat PCL membranes and PCL/ZnO membranes containing 0.5 wt.% and 5 wt.% ZnO were produced, and divided into PCL (0% ZnO), LZ (0.5 wt.% ZnO), and HZ (5 wt.% ZnO) groups, respectively. The surface characteristics of the membranes including morphological features and changes in composition were analyzed. Adhesion of bacteria, including Streptococcus mutans and Porphyromonas gingi-valis, was analyzed using a crystal violet assay. The proliferation of MC3T3-E1 osteoblasts was evaluated using a WST-8 assay. Significant differences were analyzed using the Kruskal-Wallis test (P < 0.05). The results of groups were compared using the Mann-Whitney test (P < 0.017). ZnO nanoparticles were dispersed in the PCL matrix of PCL/ZnO membranes. Compared with neat PCL membranes, their ability to form crystals decreased and their amorphous structure increased. The adhesion of S. mutans and P. gingivalis in the LZ and HZ groups containing ZnO was significantly decreased compared with that of the neat PCL membranes (P < 0.05). No significant differences were observed in the proliferation of MC3T3-E1 cells between the PCL/ZnO membranes and the neat PCL membranes both on days 2 and 5 of culture (P > 0.05). This study has demonstrated that the PCL membranes carrying the ZnO nanoparticles inhibited bacterial adhesion without affecting the viability of osteoblasts, suggesting the potential application of ZnO in GTR to increase antibacterial activity of membranes.

Fabrication and Characterization of 45S5 Bioactive Glass/Thermoplastic Composite Scaffold by Ceramic Injection Printer.

45S5 bioactive glass (45S5) scaffolds were fabricated using a novel additive-manufacturing (AM) technology. A ceramic injection printer (CIP) was designed by combining injection molding and fused deposition modeling, for the fabrication of three-dimensional constructs of ceramic materials. A high fraction (50 vol%) of 45S5 powder was mixed with the thermoplastic polymer. The synthesized 45S5 composites were subjected to Brunauer-Emmett-Teller (BET) analysis, X-ray diffraction (XRD) analysis, and field-emission scanning electron microscopy (FE-SEM). The BET results of prepared 45S5 powder were confirmed to have a mean pore diameter of 11.402 nm, and specific surface area is 0.966 m²/g. The prepared 45S5/thermoplastic composite powder was subjected to Thermogravimetric/Differential thermal analysis (TG/DTA). The debinding process of polymer occurred at 192.5, 360.8, and 393 °C. The elastic modulus and ultimate stress of these scaffolds were measured to be 312.49±87.36 MPa and 21.83±6.67 MPa, respectively. The XRD results revealed the presence of Na6Ca3Si6O18 phases. The presence of Si, Ca, P, and Na was confirmed via energy-dispersive X-ray spectroscopy (EDS). The printed scaffold exhibited amorphous calcium phosphate (ACP) expression after immersion in simulated body fluid (SBF) and also it was observed that the intensity of the crystalline phase of 45S5 was decreased, as the immersion time increases. Bioactive glass composites with the high volume fraction can be able to construct 3D complex porous scaffolds using CIP.

Wear Behavior of the Human Enamel Antagonist to Different Glazed Zirconia.

In this study, the wear behavior of glazed zirconia was investigated to the antagonist with human enamel after simulated mastication. Twenty Y-TZP specimens were divided into 4 groups: untreated zirconia (Z), glazed zirconia with IPS e.max Ceram (GZE), glazed zirconia with VITA AKZENT® Plus (GZV), and glazed zirconia with glass (GZG). Glazing glass was mainly composed of SiO2, B2O3, Al2O3, Na2O and K2O (nearly 91 wt%). The surface roughness of the specimens was evaluated using roughness profiler. The maxillary premolar teeth were selected as the antagonist. The wear of human enamel against human enamel was used as a control. Five-disc specimens per group were subjected to chewing stimulation CS-4 (SD Mechatronic GmbH, Germany) for 240,000 cycles against human enamel. The wear loss of antagonistic teeth was calculated using a three-dimensional profiling system and the volume loss of the tooth was scanned using a 3D scanner. 3D data obtained before and after testing were overlapped using 3D software (Dentacian Software, EZplant, Korea). The wear loss of glazed zirconia GZE, GZV and GZG groups showed significantly lower than that of human enamel. Whereas, the zirconia (Z) group exhibits significantly lower volume loss than glazed zirconia and enamel. These results show that the wear of the glazing glass is comparable to other commercial glazing materials. Glazing materials are both more susceptible to wear the antagonist relative to zirconia.

Effect of Plasma Surface Treatment on Shear Bond Strength with Denture Base Resin in Co-Cr Alloy, Ti-6Al-4V Alloy, and CP-Ti Alloy.

The purpose of this study was to examine the effect of plasma treatment by treating the surface of Co-Cr alloy, Ti-6Al-4V alloy, and CP-Ti alloy as a material for denture metal frameworks with non-thermal atmospheric pressure plasma (NTAPP) and measuring their shear bond strength (SBS) with a heat-cured resin. 20 specimens were prepared for each of Co-Cr, Ti-6Al-4V, and CP-Ti alloys. Each metal alloy group was divided into the following subgroups depending on NTAPP treatment: C (Co-Cr alloy without plasma), T (CP-Ti without plasma), A (Ti-6Al-4V alloy without plasma), CP (Co-Cr alloy with plasma), TP (CP-Ti with plasma) and AP (Ti-6Al-4V alloy with plasma). Specimens were treated with a metal conditioner and bonded to a denture base resin. SBS was measured using a universal testing machine. All data obtained were statistically analyzed using two-way analysis of variance (ANOVA), Tukey's honestly significant difference (HSD) test, and independent t-test. The mean values (SD) of SBS (MPa) were: 10.31 (1.19) for C group; 12.43 (0.98) for T group; 13.75 (2.02) for A group; 13.53 (1.61) for CP group; 16.87 (1.55) for TP group; 17.46 (1.65) for AP group. The SBS of the AP group was the highest while that of the C group was the lowest. SBS of specimen treated with NTAPP was significantly increased regardless of metal alloy types (p < 0.001). Within the limitations of this study, NTAPP can increases the SBS of Co-Cr alloy, CP-Ti alloy, and Ti-6Al-4V alloy with a denture base resin.

Denture flask fabrication using fused deposition modeling three-dimensional printing.

PURPOSE: This paper describes a method for making a customized denture flask using fused deposition modeling (FDM) by three-dimensional (3D) printing. We have proposed a new digital dental prosthesis using conventional dental base materials and artificial teeth. METHODS: Using the universal development system software, a denture-designed Standard Tessellation Language (STL) file and a denture flask STL file were superimposed, and the denture region was set as an empty space. After setting the offset value to 200µm between the denture base and teeth for artificial tooth positioning, the flask was created by FDM 3D printing. Conventional artificial teeth were inserted into the 3D-printed flask, and resin packing, finishing, and polishing were performed using the conventional method for fabricating the complete denture. CONCLUSIONS: The 3D printing materials used to make digital dental prostheses have not yet been fully validated. Therefore, the production of a 3D-printed denture flask, which can use conventional complete denture materials, presents a new alternative to the digital fabrication of dentures.

Comparison of different impression techniques for edentulous jaws using three-dimensional analysis.

PURPOSE: The purpose of this study was to compare two novel impression methods and a conventional impression method for edentulous jaws using 3-dimensional (3D) analysis software. MATERIALS AND METHODS: Five edentulous patients (four men and one woman; mean age: 62.7 years) were included. Three impression techniques were used: conventional impression method (CI; control), simple modified closed-mouth impression method with a novel tray (SI), and digital impression method using an intraoral scanner (DI). Subsequently, a gypsum model was made, scanned, and superimposed using 3D analysis software. Mean area displacement was measured using CI method to evaluate differences in the impression surfaces as compared to those values obtained using SI and DI methods. The values were confirmed at two to five areas to determine the differences. CI and SI were compared at all areas, while CI and DI were compared at the supporting areas. Kruskal-Wallis test was performed for all data. Statistical significance was considered at P value <.05. RESULTS: In the comparison of the CI and SI methods, the greatest difference was observed in the mandibular vestibule without statistical significance (P>.05); the difference was < 0.14 mm in the maxilla. The difference in the edentulous supporting areas between the CI and DI methods was not significant (P>.05). CONCLUSION: The CI, SI, and DI methods were effective in making impressions of the supporting areas in edentulous patients. The SI method showed clinically applicability.

Evaluation of Cure Depth and Geometrical Overgrowth Depending on Zirconia Volume Fraction Using Digital Light Processing.

The optical properties of zirconia photopolymer suspension for DLP (Digital Light Processing) were evaluated. The light source and intensity were set to 395 nm and 30 mW/cm². Experimental groups were divided into 48, 50, 52, 54, 56 and 58 vol% according to the zirconia volume fraction. The cure depth of all groups was at least 47.35 um when cured for 1 sec, which was higher than layer parameter values of the 3D printer. The geometrical overgrowth showed 28.55% at 48 vol% and 36.94% at 58 vol%. As the volume fraction of zirconia increased, the geometrical overgrowth increased and the cure depth reduced.

Shear Bond Strength of Zirconia to Titanium Implant Using Glass Bonding.

This study evaluated the shear bond strength of zirconia to titanium implant components using silica-based glasses and compared the strength with that of implant components bonded using a commercial resin cement. Forty cylindrical zirconia specimens and forty titanium disks (Grade IV) were divided equally into four groups, depending on the adhesive used: three different types of glasses (group G, group GI, group GIB) and a self-adhesive resin cement (group U200), which was used as a control. The shear bond strength was evaluated using a universal testing machine and failure mode was examined by optical microscope. Data was analyzed using One-way ANOVA with p-value <0.05, which was considered statistically significant. The shear bond strength of the three glass groups was significantly higher than that of group U200 (p<0.05). Failure mode in all groups was a combination of adhesive and cohesive modes. Shear bond strength of zirconia to titanium bonded using glasses was higher than that using self-adhesive resin cement.

Effect of Plasma Treatment and Its Post Process Duration on Shear Bonding Strength and Antibacterial Effect of Dental Zirconia.

We have investigated the effect of non-thermal atmospheric pressure plasma (NTAPP) treatment and the post process time on the bonding strength and surface sterilization of dental zirconia. Presintered zirconia specimens were manufactured as discs, and then subjected to a 30-min argon treatment (Ar, 99.999%; 10 L/min) using an NTAPP device. Five post-treatment durations were evaluated: control (no treatment), P0 (immediate), P1 (24 h), P2 (48 h), and P3 (72 h). The surface characteristics, shear bonding strength (SBS) with two resin cements, and Streptococcus mutans biofilm formation of these plasma-treated dental zirconia were tested. Plasma did not change the roughness, and caused surface element changes and surface energy increase. Due to this increase in surface energy, SBS increased significantly (p < 0.05) within 48 h when RelyXTM U200 was used. However, the increase of surface oxygen significantly decreased (p < 0.05) the SBS of Panavia F 2.0 when using plasma immediately (P0). S. mutans adhesion decreased significantly (p < 0.05) for the P0, P1, and P2 groups compared to the control. The P0 group exhibited lower biofilm thickness than the other experimental groups due to the increased hydrophilicity (p < 0.05). Our study suggests that there is a suitable time window for the post NTAPP treatment regarding bonding strength and antimicrobial growth persist.

Stress distribution in premolars restored with inlays or onlays: 3D finite element analysis.

PURPOSE: To analyze stress distribution in premolars restored with inlays or onlays using various materials. MATERIALS AND METHODS: Three-dimensional maxillary premolar models of abutments were designed to include the following: 1) inlay with O cavity (O group), 2) inlay with MO cavity (MO group), 3) inlay with MOD cavity (MOD group), and 4) onlay (ONLAY group). A restoration of each inlay or onlay cavity was simulated using gold alloy, e.max ceramic, or composite resin for restoration. To simulate masticatory forces, a total of 140 N static axial force was applied onto the tooth at the occlusal contact areas. A finite element analysis was performed to predict the magnitude and pattern of stresses generated by occlusal loading. RESULTS: Maximum von Mises stress values generated in the abutment teeth of the ONLAY group were ranged from 26.1 to 26.8 MPa, which were significantly lower than those of inlay groups (O group: 260.3-260.7 MPa; MO group: 252.1-262.4 MPa; MOD group: 281.4-298.8 MPa). Maximum von Mises stresses generated with ceramic, gold, and composite restorations were 280.1, 269.9, and 286.6 MPa, respectively, in the MOD group. They were 252.2, 248.0, 255.1 MPa, respectively, in the ONLAY group. CONCLUSION: The onlay design (ONLAY group) protected tooth structures more effectively than inlay designs (O, MO, and MOD groups). However, stress magnitudes in restorations with various dental materials exhibited no significant difference among groups (O, MO, MOD, ONLAY).

Novel ß-TCP Coated Titanium Nanofiber Surface for Enhanced Bone Growth.

In this study, we examined the effect of ß-tricalcium phosphate (ß-TCP) coating on alkali-treated CP Grade II titanium surface via RF magnetron sputtering on osteoblast like cell (MC3T3-E1) viability and bone formation in rat tibia. The specimens were divided into three groups; commercially pure titanium (control group), alkali-treated titanium with nanofiber structure (NF group) and ß-TCP coating on alkali-treated titanium with nanofiber structure (TNF group). The surface characteristics of specimens were observed under a field emission scanning electron microscope (FE-SEM), and contact angle was measured. The cell viability was assessed in vitro after 1 day, 3 days and 7 days. Implants of 2.0 mm diameter and 5.0 mm length were inserted into the tibia of rats. After 4 wks, the histomorphometric analysis was performed. Group NF and group TNF showed improved hydrophilicity of Ti. Group TNF showed significantly higher cell viability (P < 0.05) after 7 days. The bone to implant contact (BIC) ratio of the control group, NF group, and TNF group were 32.3%, 35.5%, and 63.9%, respectively. The study results suggested that ß-TCP coated alkali-treated titanium surface via RF magnetron sputtering might be effective in implant dentistry due to enhanced hydrophilicity, improved cell response, and better osseointegration.

Biocompatibility Evaluation of Feldspathic Porcelain with Nano-Sized Silver Ion Particles.

The major failure of dental restorations is caused by dental caries by S. mutans. This study evaluated the effect of nanosized silver ions in feldspathic porcelain on cytotoxicity and antimicrobial activity. The control group was feldspathic porcelain (Noritake EX-3, Kuraray Noritake Dental Inc., Japan) that did not contain Ag (silver). The experimental groups were feldspathic porcelain mixed with colloidal solutions of nanosized silver ions in mixtures of 5% 10%, 20%, 30%. Cell activity assays evaluated with osteoblast hFOB 1.19 cells (human Fetal Osteoblastic cell line, ATCC® CRL- 11372™) and antimicrobial activity test used the streptococcus mutans (S. mutans). According to the observations, the addition of Ag to feldspathic porcelain led to increased cell activity and showed excellent antibacterial performance. Especially, the feldspathic porcelain with 30% nanosized Ag ion appeared to have a significant antimicrobial effect, this allows for the possibility of various clinical applications for such material, including use in dental prosthesis and implants.

Hydroxyapatite Coating on TiO2 Nanotube by Sol-Gel Method for Implant Applications.

The aim of this study was to determine the effect of hydroxyapatite (HA) coating on titanium dioxide (TiO2) nanotube by sol-gel process on viability of osteoblast like cell (MC3T3-E1) and bone formation in rat tibia. Specimens were divided into three groups including commercially pure titanium (control group), TiO2 nanotubes (group N), and HA coated TiO2 nanotubes (group HN). Surface characteristics were determined using field emission scanning electron microscope (FE-SEM; S-4700, Hitachi, Japan) and contact angles were measured. Cell viability was investigated in vitro after 1 day, 3 days, and 7 days of incubation. Implants (2.0 mm in diameter and 5.0 mm in length) were inserted into the tibia of rats. After 4 weeks, histomorphometric analysis was performed. Both N and HN groups showed enhanced hydrophilicity compared to control group. After 7 days of implantation, group HN showed higher cell viability with marginal significance (0.05 < P < 0.1). Bone to implant contact (BIC) ratio in the control group, group N, and group HN were 32.5%, 33.1%, and 43.8%, respectively. Results of this study showed that HA coated TiO2 nanotube using sol-gel process could be used to enhance hydrophilicity and improve osseointegration of dental implant surface.