Effect of Heparan Sulfate on Vasculogenesis and Dentinogenesis of Dental Pulp Stem Cells.

INTRODUCTION: Heparan sulfate (HS) is a major component of dental pulp tissue. We previously reported that inhibiting HS biosynthesis impedes endothelial differentiation of dental pulp stem cells (DPSCs). However, the underlying mechanisms by which exogenous HS induces DPSC differentiation and pulp tissue regeneration remain unknown. This study explores the impact of exogenous HS on vasculogenesis and dentinogenesis of DPSCs both in vitro and in vivo. METHODS: Human-derived DPSCs were cultured in endothelial and odontogenic differentiation media and treated with HS. Endothelial differentiation of DPSCs was investigated by real-time polymerase chain reaction and capillary sprouting assay. Odontogenic differentiation was assessed through real-time polymerase chain reaction and detection of mineralized dentin-like deposition. Additionally, the influence of HS on pulp tissue was assessed with a direct pulp capping model, in which HS was delivered to exposed pulp tissue in rats. Gelatin sponges were loaded with either phosphate-buffered saline or 101-102 µg/mL HS and placed onto the pulp tissue. Following a 28-day period, tissues were investigated by histological analysis and micro-computed tomography imaging. RESULTS: HS treatment markedly increased expression levels of key endothelial and odontogenic genes, enhanced the formation of capillary-like structures, and promoted the deposition of mineralized matrices. Treatment of exposed pulp tissue with HS in the in vivo pulp capping study induced formation of capillaries and reparative dentin. CONCLUSIONS: Exogenous HS effectively promoted vasculogenesis and dentinogenesis of DPSCs in vitro and induced reparative dentin formation in vivo, highlighting its therapeutic potential for pulp capping treatment.

Novel pit and fissure sealant with nano-CaF2 and antibacterial monomer: Fluoride recharge, microleakage, sealing ability and cytotoxicity.

Conventional resin-based sealants release minimal fluoride ions (F) and lack antibacterial activity. The objectives of this study were to: (1) develop a novel bioactive sealant containing calcium fluoride nanoparticles (nCaF2) and antibacterial dimethylaminohexadecyl methacrylate (DMAHDM), and (2) investigate mechanical performance, F recharge and re-release, microleakage, sealing ability and cytotoxicity. Helioseal F served as commercial control. The initial F release from sealant containing 20% nCaF2 was 25-fold that of Helioseal F. After ion exhaustion and recharge, the F re-release from bioactive sealant did not decrease with increasing number of recharge and re-release cycles. Elastic modulus of new bioactive sealant was 44% higher than Helioseal F. The new sealant had excellent sealing, minimal microleakage, and good cytocompatibility. Hence, the nanostructured sealant had substantial and sustained F release and antibacterial activity, good sealing ability and biocompatibility. The novel bioactive nCaF2 sealant is promising to provide long-term F ions for caries prevention.

Development of Antibacterial Resin Composites Incorporating Poly(METAC) Clusters.

This study examined the antibacterial effects and physical properties of a novel resin composite incorporating poly[{2-(methacryloyloxy)ethyl}trimethylammonium chloride] (poly(METAC)), a methacrylate cationic polymer comprising quaternary ammonium compounds (QACs). Resin composites incorporating poly(METAC) were fabricated by adding 6 wt.% METAC aqueous solution to a commercially available resin composite. The FE-SEM/EDS and Raman spec-troscopy analyses showed that METAC was assembled and polymerized in the resin composites after curing. The antibacterial effect was evaluated by inoculating Streptococcus mutans or Strepto-coccus sobrinus suspensions on the surface of cured resin composites, and the experimental resin composites incorporating poly(METAC) clusters exhibited bactericidal effects even after 28 days of ageing. The physical properties of the experimental resin composites were within the ISO-stipulated ranges. Newly fabricated resin composites containing the QAC-based poly(METAC) cluster ex-hibited long-term bactericidal effects against oral bacteria on their surfaces and demonstrated ac-ceptable physical properties for clinical use.

In silico nonlinear dynamic finite-element analysis for biaxial flexural strength testing of CAD/CAM materials.

PURPOSE: The aim of this study was to establish and assess the validity of in silico models of biaxial flexural strength (BFS) tests to reflect in vitro physical properties obtained from two commercially available computer-aided design/computer-aided manufacturing (CAD/CAM) ceramic blocks and one CAD/CAM resin composite block. METHODS: In vitro three-point bending and BFS tests were conducted for three CAD/CAM materials (n = 10): Katana Zirconia ST10 (raw material: super-translucent multilayered zirconia, ST10; Kuraray Noritake Dental, Niigata, Japan), Katana Zirconia HT10 (raw material: highly translucent multilayered zirconia, HT10; Kuraray Noritake Dental), and Katana Avencia N (AN; Kuraray Noritake Dental). Densities, flexural moduli, and fracture strains were obtained from the in vitro three-point bending test and used as an input for an in silico nonlinear finite element analysis. The maximum principal stress (MPS) distribution was obtained from an in silico BFS analysis. RESULTS: The elastic moduli of AN, HT10, and ST10 were 6.513, 40.039, and 32.600 GPa, respectively. The in silico fracture pattern of ST10 observed after the in silico evaluation was similar to the fracture pattern observed after the in vitro testing. The MPS was registered in the center of the tensile surface for all three specimens. The projections of the supporting balls were in the form of a triple asymmetry. CONCLUSIONS: The in silico approach established in this study provided an acceptable reflection of in vitro physical properties, and will be useful to assess biaxial flexural properties of CAD/CAM materials without wastage of materials.

Poly(lactic acid/caprolactone) bilayer membrane achieves bone regeneration through a prolonged barrier function.

Guided bone regeneration (GBR) is a treatment strategy used to recover bone volume. Barrier membranes are a key component of GBR protocols, and their properties can impact treatment outcomes. This study investigated the efficacy of an experimental, slow-degrading, bilayer barrier membrane for application in GBR using in vivo animal models. A synthetic copolymer of poly(lactic acid/caprolactone) (PLCL) was used to prepare a slow-degrading bilayer membrane. The biodegradability of PLCL was evaluated by subcutaneous implantation in a rat model. The barrier function of the PLCL membrane was investigated in a rat calvaria defect model and compared with commercially available membranes composed of type I collagen (Col) and poly(lactic-co-glycolic acid) (PLGA). An alveolar bone defect model in beagle dogs was used to simulate GBR protocols to evaluate the bone regeneration ability of the experimental PLCL membrane. The PLCL membrane showed slow biodegradation, resulting in an efficient and prolonged barrier function compared with commercial materials. In turn, this barrier function enabled the space-making ability of PLCL membrane and facilitated bone regeneration. In the alveolar bone defect model, significantly greater regeneration was achieved by treatment with PLCL membrane compared with Col and PLGA membranes. Additionally, a continuous alveolar ridge contour was observed in PLCL-treated bone defects. In conclusion, the PLCL bilayer membrane is a promising biomaterial for use in GBR given its slow degradation and prolonged barrier function.

CAD-CAM resin composites: Effective components for further development.

OBJECTIVE: This paper summarizes the effective components of computer-aided design and computer-aided manufacturing (CAD-CAM) resin composites that contribute to achieving greater mechanical properties and further development. METHODS: In silico multi-scale analysis, in silico nonlinear dynamic finite element analysis (FEA), and artificial intelligence (AI) were used to explore the effective components of CAD-CAM resin composites. The effects of the filler diameter and silane coupling ratio on the mechanical properties of CAD-CAM resin composites have been clarified through multi-scale analysis. The effects of the filler contents, and filler and monomer compositions have been investigated by AI algorithms. The fracture behavior of CAD-CAM composite crown was analyzed using in silico non-linear dynamic FEA. The longevity of CAD-CAM composite crown was assessed through step-stress accelerating life testing (SSALT). RESULTS: As the filler diameter decreases, there is an increase in elastic moduli and compressive strengths at the macroscale. At the nanoscale, a decrease in the filler diameter results in a decrease in the maximum value of the maximum principal strain. When the silane coupling ratio decreases, there is a decrease in the elastic modulus and compressive strength. According to the exhaustive search and feature importance analysis based on the AI algorithm, the combination of certain components was narrowed down to achieve a flexural strength of 269.5 MPa. The in silico non-linear FEA successfully detected the sign of the initial crack of the CAD-CAM composite molar crown. The SSALT revealed that CAD-CAM resin composite molar crowns containing nanofillers with a high fraction of resin matrix demonstrated great longevity. SIGNIFICANCE: This paper summarized the effective components of CAD-CAM resin composites for their further development. The integration of in vitro and in silico approaches will expedite the advancement of CAD-CAM resin composites, offering benefits such as time efficiency and reduction of material waste for researchers and manufacturers.

Mechanical behavior of endodontically treated teeth: A three-dimensional finite element analysis using displacement vector.

PURPOSE: This study aimed to analyze the effects of core materials, remaining tooth structures, and interfacial bonding on stress distribution in endodontically treated teeth using finite element analysis (FEA). MATERIALS AND METHODS: Three-dimensional FEA was conducted using a reverse engineering technique based on maxillary premolars scanned by micro-computed tomography. Six models were generated with or without ferrules and with one of the following three abutment systems: metal core, resin core, or resin core with fiber posts. In each model, bonding and debonding were assumed in the dentin and surrounding structures: bonded and debonded models. The maximum principal stress values were recorded, and stress distribution of the entire restored teeth and dentin was generated. Furthermore, the distribution of the displacement vector of the debonded models was generated. RESULTS: In comparing the bonded and debonded models, the debonded models showed larger values for tensile stresses than those in bonded models for all abutment models. The models without ferrules rotated around the center of the abutment, whereas those with ferrules did not show remarkable displacement in the analysis. CONCLUSION: FEA assuming fracture of adhesive interface proved to be an effective method to clarify the significance of ferrules. It prevents stress concentration in dentin by reducing the rotation of the abutment, even when the adhesive fails.

Mice Lacking PLAP-1/Asporin Show Alteration of Periodontal Ligament Structures and Acceleration of Bone Loss in Periodontitis.

Periodontal ligament-associated protein 1 (PLAP-1), also known as Asporin, is an extracellular matrix protein expressed in the periodontal ligament and plays a crucial role in periodontal tissue homeostasis. Our previous research demonstrated that PLAP-1 may inhibit TLR2/4-mediated inflammatory responses, thereby exerting a protective function against periodontitis. However, the precise roles of PLAP-1 in the periodontal ligament (PDL) and its relationship to periodontitis have not been fully explored. In this study, we employed PLAP-1 knockout mice to investigate its roles and contributions to PDL tissue and function in a ligature-induced periodontitis model. Mandibular bone samples were collected from 10-week-old male C57BL/6 (WT) and PLAP-1 knockout (KO) mice. These samples were analyzed through micro-computed tomography (µCT) scanning, hematoxylin and eosin (HE) staining, picrosirius red staining, and fluorescence immunostaining using antibodies targeting extracellular matrix proteins. Additionally, the structure of the PDL collagen fibrils was examined using transmission electron microscopy (TEM). We also conducted tooth extraction and ligature-induced periodontitis models using both wild-type and PLAP-1 KO mice. PLAP-1 KO mice did not exhibit any changes in alveolar bone resorption up to the age of 10 weeks, but they did display an enlarged PDL space, as confirmed by µCT and histological analyses. Fluorescence immunostaining revealed increased expression of extracellular matrix proteins, including Col3, BGN, and DCN, in the PDL tissues of PLAP-1 KO mice. TEM analysis demonstrated an increase in collagen diameter within the PDL of PLAP-1 KO mice. In line with these findings, the maximum stress required for tooth extraction was significantly lower in PLAP-1 KO mice in the tooth extraction model compared to WT mice (13.89 N ± 1.34 and 16.51 N ± 1.31, respectively). In the ligature-induced periodontitis model, PLAP-1 knockout resulted in highly severe alveolar bone resorption, with a higher number of collagen fiber bundle tears and significantly more osteoclasts in the periodontium. Our results demonstrate that mice lacking PLAP-1/Asporin show alteration of periodontal ligament structures and acceleration of bone loss in periodontitis. This underscores the significant role of PLAP-1 in maintaining collagen fibrils in the PDL and suggests the potential of PLAP-1 as a therapeutic target for periodontal diseases.

Intracellular stress caused by composite resins: An in vitro study using a bioluminescent antioxidant-responsive element reporter assay.

Context: Elucidating the effects of leachates from composite resins (CRs) on cells by examining the transcription level of detoxification genes and the antioxidant-responsive element (ARE), would be helpful in clinical practice. Aims: The aim of the study is to investigate the cytotoxicity of commercially available CRs, we used a reporter assay system to evaluate intracellular stress based on ARE-mediated transcription. Setting and Design: The study design was an in vitro study. Materials and Methods: Seven kinds of CRs were each placed in four-well plates to which culture medium was added and then light-cured. The prepared samples were used either immediately (sample A) or after incubation at 37°C for 24 h (sample B) in the subsequent ARE-luciferase reporter assay, in which HepG2 cells stably expressing an ARE-regulated luciferase reporter gene (HepG2-AD13 cells) were cultured for 6 h in culture media with the CR eluate (samples A or B) or without (control) (n = 4). In the cell viability assay, cell viability in various solutions with the same incubation time was confirmed by MTT assay (n = 4). Statistical analysis was performed using the paired t-test and one-way analysis of variance. Results: All CR solutions showed an increase in ARE activation rate; a CR with spherical nanofillers showed the highest ARE activation rate of 108.5-fold in sample A. Cell viability was not significantly reduced for any of the CRs in sample A. However, the CR-containing bisphenol A-glycidyl methacrylate (Bis-GMA) caused a significant decrease in cell viability in sample B. Conclusions: The intracellular stress in the viable cells differed among the CRs, depending on the type of monomer used. In particular, Bis-GMA-containing hydroxyl groups showed high cytotoxicity.

Vascularization of a Bone Organoid Using Dental Pulp Stem Cells.

Bone organoids offer a novel path for the reconstruction and repair of bone defects. We previously fabricated scaffold-free bone organoids using cell constructs comprising only bone marrow-derived mesenchymal stem cells (BMSCs). However, the cells in the millimetre-scale constructs were likely to undergo necrosis because of difficult oxygen diffusion and nutrient delivery. Dental pulp stem cells (DPSCs) are capable of differentiating into vascular endothelial lineages and have great vasculogenic potential under endothelial induction. Therefore, we hypothesized that DPSCs can serve as a vascular source to improve the survival of the BMSCs within the bone organoid. In this study, the DPSCs had greater sprouting ability, and the proangiogenic marker expressions were significantly greater than those of BMSCs. DPSCs were incorporated into the BMSC constructs at various ratios (5%-20%), and their internal structures and vasculogenic and osteogenic characteristics were investigated after endothelial differentiation. As a result, the DPSCs are differentiated into the CD31-positive endothelial lineage in the cell constructs. The incorporation of DPSCs significantly suppressed cell necrosis and improved the viability of the cell constructs. In addition, lumen-like structures were visualized by fluorescently labelled nanoparticles in the DPSC-incorporated cell constructs. The vascularized BMSC constructs were successfully fabricated using the vasculogenic ability of the DPSCs. Next, osteogenic induction was initiated in the vascularized BMSC/DPSC constructs. Compared with only BMSCs, constructs with DPSCs had increased mineralized deposition and a hollow structure. Overall, this study demonstrated that vascularized scaffold-free bone organoids were successfully fabricated by incorporating DPSCs into BMSC constructs, and the biomimetic biomaterial is promising for bone regenerative medicine and drug development.

In vitro analysis of durability of S-PRG filler-containing composite crowns for primary molar restoration.

OBJECTIVE: To evaluate the reliability, maximum principal stress, shear stress, and crack initiation of a computer-aided design/computer-aided manufacturing (CAD/CAM) resin composite (RC) incorporating surface pre-reacted glass (S-PRG) filler for primary molar teeth. METHODS: Mandibular primary molar crowns fabricated by experimental (EB) or commercially available CAD/CAM RCs (HC) were prepared and cemented to a resinous abutment tooth using an adhesive resin cement (Cem) or a conventional glass-ionomer cement (CX). These specimens were subjected to a single compressive test (n = 5/each) and the step-stress accelerated life testing (SSALT) (n = 12/each). Data was evaluated using Weibull analyses and reliability was calculated. Afterwards, the maximum principal stress and crack initiation point of each crown was analyzed by finite element analysis. To evaluate bonding of EB and HC to dentin, microtensile bond strength (µTBS) testing was conducted using primary molar teeth (n = 10/each). RESULTS: There was no significant difference between the fracture loads of EB and HC for either cement (p > 0.05). The fracture loads of EB-CX and HC-CX were significantly lower than EB-Cem and HC-Cem (p < 0.05). The reliability at 600 N for EB-Cem was greater than that for EB-CX, HC-Cem, and HC-CX. The maximum principal stress concentrated on EB was lower than that on HC. The shear stress concentrated in the cement layer for EB-CX was higher than that for HC-CX. There was no significant difference among the µTBSs of EB-Cem, EB-CX, HC-Cem, and HC-CX (p > 0.05). SIGNIFICANCE: The crowns fabricated with the experimental CAD/CAM RC incorporating S-PRG filler yielded greater fracture loads and reliability than the crowns manufactured with commercially available CAD/CAM RC regardless of the luting materials. These findings suggest that the experimental CAD/CAM RC crown may be clinically useful for the restoration of primary molars.

Multiple-Ion Releasing Bioactive Surface Pre-Reacted Glass-Ionomer (S-PRG) Filler: Innovative Technology for Dental Treatment and Care.

Surface Pre-Reacted Glass-ionomer (S-PRG) filler, which releases strontium (Sr2+), borate (BO33-), fluoride (F-), sodium (Na+), silicate (SiO32-), and aluminum (Al3+) ions at high concentrations, is a unique glass filler that are utilized in dentistry. Because of its multiple-ion releasing characteristics, S-PRG filler exhibits several bioactivities such as tooth strengthening, acid neutralization, promotion of mineralization, inhibition of bacteria and fungi, inhibition of matrix metalloproteinases, and enhancement of cell activity. Therefore, S-PRG filler per se and S-PRG filler-containing materials have the potential to be beneficial for various dental treatments and care. Those include restorative treatment, caries prevention/management, vital pulp therapy, endodontic treatment, prevention/treatment of periodontal disease, prevention of denture stomatitis, and perforation repair/root end filling. This review summarizes bioactive functions exhibited by S-PRG filler and its possible contribution to oral health.

Intercellular crosstalk in adult dental pulp is mediated by heparin-binding growth factors Pleiotrophin and Midkine.

BACKGROUND: In-depth knowledge of the cellular and molecular composition of dental pulp (DP) and the crosstalk between DP cells that drive tissue homeostasis are not well understood. To address these questions, we performed a comparative analysis of publicly available single-cell transcriptomes of healthy adult human DP to 5 other reference tissues: peripheral blood mononuclear cells, bone marrow, adipose tissue, lung, and skin. RESULTS: Our analysis revealed that DP resident cells have a unique gene expression profile when compared to the reference tissues, and that DP fibroblasts are the main cell type contributing to this expression profile. Genes coding for pleiotrophin (PTN) and midkine (MDK), homologous heparin-binding growth-factors, possessed the highest differential expression levels in DP fibroblasts. In addition, we identified extensive crosstalk between DP fibroblasts and several other DP resident cells, including Schwann cells, mesenchymal stem cells and odontoblasts, mediated by PTN and MDK. CONCLUSIONS: DP fibroblasts emerge as unappreciated players in DP homeostasis, mainly through their crosstalk with glial cells. These findings suggest that fibroblast-derived growth factors possess major regulatory functions and thus have a potential role as dental therapeutic targets.

Kinetics of Phenotype Modification Therapy with VISTA: A Retrospective Case Series Using 3D Digital Analysis

Phenotype modification therapy has emerged as one of the main treatment objectives of periodontal plastic surgery. However, long-term data on the stability of gingival thickness gains are not available. This study examined the kinetics of mucosal thickness gain as a measure of phenotype modification therapy following treatment of multiple gingival recession defects with vestibular incision subperiosteal tunnel access (VISTA). Six patients with 14 recession type (RT) II teeth were treated using VISTA and subepithelial connective tissue grafts (SCTG). Scanned images of study casts at pre- and postoperative periods (6 to 66 months) were digitally superimposed for quantitative evaluation of soft tissue dimensional changes. Mucosal thickness gains ranged from 1.0 ± 0.7 mm (1 mm apical to cement-enamel junction [CEJ]) to 1.4 ± 0.4 mm (5 mm apical to CEJ). The gingival thickness gains remained relatively stable, with thickness gains at 66 months of 0.5 ± 0.8, 0.9 ± 0.6, 1.1 ± 0.6, 1.0 ± 0.4, and 1.2 ± 0.6 mm at 1, 2, 3, 4 and 5 mm apical to the CEJ, respectively. Treatment of multiple gingival recession defects with VISTA and SCTG led to stable gingival thickness gains and shows promise as a strategy for phenotype modification therapy.

The inhibitory effects of various ions released from S-PRG fillers on dentin protease activity.

This study investigates the effect of ions released from S-PRG fillers on host-derived enzymatic degradation of dentin collagen matrices. Dentin beams (n=80) were demineralized and distributed to eight groups following baseline dry mass and total MMP activity assessments. Each group treated with boron, fluoride, sodium, silicone, strontium, aluminium, or S-PRG eluate solutions for 5 min. Untreated beams served as control. After pre-treatment, MMP activity was reassessed, beams were incubated in complete medium for 1 week, dry mass was reassessed. Incubation media were analyzed for MMP and cathepsin-K-mediated degradation fragments. Data were analyzed with ANOVA and Tukey's test. All pretreatment groups showed significant reduction in total MMP activity (p<0.05) that was sustainable after incubation in all groups except for boron and silicone groups (p<0.05). Cathepsin-K activity did not differ between control or treatment groups. The results indicated that ions released from S-PRG fillers have the potential to partly inhibit MMP-mediated endogenous enzymatic activity.

Osteogenic capacity of octacalcium phosphate involving macrophage polarization.

Previous research has found that octacalcium phosphate (OCP) increases macrophage accumulation and alters the initial inflammatory response. However, the role of the immune response induced by OCP in osteogenesis remains unknown. This study investigated the behavior of macrophages and bone regeneration capacity during the early inflammatory stage of OCP-mediated osteogenesis. To assess the change in macrophage polarization and osteogenic capacity, we used a standardized rat defect model filled with OCP or calcium-deficient hydroxyapatite (CDHA)-a material obtained through the hydrolysis of the original OCP. OCP or CDHA granules were incubated with RAW264 cells for 5 days to investigate the effect of physicochemical characteristics on macrophage cytokine/chemokine expression in vitro. Our in vivo results show that due to the OCP implantation, macrophages in the rat tibial defect area tend to polarize to the M2 phenotype (anti-inflammatory) and inhibit the formation of the M1 phenotype (pro-inflammatory). In comparison to CDHA, OCP exhibited superior bone regeneration potential due to its rapid promotion of cortical bone healing and stimulation of macrophage-related growth factors. Furthermore, our in vitro results have shown that OCP regulates the expression of macrophage chemokines over time. Compared to incubation with CDHA, incubation with OCP caused changes in the ionic microenvironment. These findings suggest that the OCP-mediated macrophage polarization and secretion profile not only regulate immune function but also positively affect osteogenesis.

Quantitative evaluation of the degradation amount of the silane coupling layer of CAD/CAM resin composites by water absorption.

PURPOSE: Degradation of silane coupling layers by water ingress in computer-aided design/computer-aided manufacturing (CAD/CAM) of resin composites has been reported qualitatively. In this study, we quantitatively evaluated how water absorption of CAD/CAM resin composites affects the silane coupling layer by in vitro and in silico methods. METHODS: A Katana Avencia block (KAB) and an experimental matrix block composed of only a matrix resin were used to evaluate the effect of water immersion for seven days on the elastic modulus. X-ray photoelectron spectroscopy (XPS) with fluorine-labeling of the KAB was performed to evaluate the atomic percentage of F1s, which represents the hydrolysis amount by water immersion. In silico analysis of the three-dimensional model of the KAB was performed to determine the coupling ratios before and after water immersion. RESULTS: The elastic modulus of the KAB was 8.2 GPa before and 6.9 GPa after immersion in water. The atomic percentages of F1s in the after- and before-immersion groups were 14.31% and 11.52%, respectively, suggesting that hydrolysis of the silane coupling layer occurred during water immersion. From in silico analysis of the three-dimensional model of the KAB, the coupling ratio was predicted to be 78.2% before water immersion. After water immersion, the coupling ratio was predicted to be 68.4%. CONCLUSIONS: The in vitro and in silico approaches established in this study were able to predict the silane coupling ratios of CAD/CAM resin composites, and they showed that the silane coupling ratio decreased by water absorption.

In Silico Finite Element Analysis of Implant-Supported CAD-CAM Resin Composite Crowns.

PURPOSE: The aim of this study was to evaluate the mechanical behavior of an implant-supported crown made using computer-aided design and computer-aided manufacturing (CAD-CAM) resin composite (RC) blocks in the posterior region. MATERIAL AND METHODS: Four commercially available CAD-CAM RC blocks were used in this study: Cerasmart 300 (CS300; GC, Tokyo, Japan), Katana Avencia P Block (KAP; Kuraray Noritake Dental, Niigata, Japan); KZR HR3 Gamma Theta (HR3; Yamakin, Osaka, Japan), and Estelite P block (ESP; Tokuyama Dental, Tokyo, Japan). Katana Zirconia STML (ST; Kuraray Noritake Dental) was used as the control group. The elastic moduli of each material were determined by a three-point bending test. After the CAD models were designed, two different loading scenarios (oblique, vertical) were created. 3D finite element analysis was conducted with the prepared models. RESULTS: The elastic modulus of the material utilized for the implant restorations did not cause any change in the stresses transmitted to the implant or peripheral bone. An important difference was detected in the abutment-crown junction area. The minimum von Mises value at the abutment-crown interface was obtained in ST, which has the closest elastic modulus to the titanium abutment. CONCLUSIONS: The 3D finite element model designed in this study was used to demonstrate that implant-supported crowns fabricated with four different CAD-CAM RCs showed no critical stress concentrations in the bone or implant under all loading conditions. These results suggest that CAD-CAM RC blocks could be used as an alternative material for implant-supported restorations in the posterior region in terms of stress distribution.

Development of artificial intelligence model for supporting implant drilling protocol decision making.

Purpose This study aimed to develop an artificial intelligence (AI) model to support the determination of an appropriate implant drilling protocol using cone-beam computed tomography (CBCT) images.Methods Anonymized CBCT images were obtained from 60 patients. For each case, after implant placement, images of the bone regions at the implant site were extracted from 20 slices of CBCT images. Based on the actual drilling protocol, the images were classified into three categories: protocols A, B, and C. A total of 1,200 images were divided into training and validation datasets (n = 960, 80%) and a test dataset (n = 240, 20%). Another 240 images (80 images for each type) were extracted from the 60 cases as test data. An AI model based on LeNet-5 was developed using these data sets. The accuracy, sensitivity, precision, F-value, area under the curve (AUC) value, and receiver operating curve were calculated.Results The accuracy of the trained model is 93.8%. The sensitivity results for drilling protocols A, B, and C were 97.5%, 95.0%, and 85.0%, respectively, while those for protocols A, B, and C were 86.7%, 92.7%, and 100%, respectively, and the F values for protocols A, B, and C were 91.8%, 93.8%, and 91.9%, respectively. The AUC values for protocols A, B, and C are 98.6%, 98.6%, and 99.4%, respectively.Conclusions The AI model established in this study was effective in predicting drilling protocols from CBCT images before surgery, suggesting the possibility of developing a decision-making support system to promote primary stability.

Metal-doped silicate and phosphate glasses for antibacterial dental biomaterials.

Owing to the development of glass 45S5 (Bioglass®) comprising 45 mol% SiO2, 24.5 mol% Na2O, 24.5 mol% CaO, and 6 mol% P2O5, different compositions of silicate glasses have been developed. When these silicate glasses contact an aqueous environment, such as body fluids, they induce apatite layer formation on their surfaces owing to ion exchange. In addition to promoting hard tissue formation, researchers have sought to enhance the antibacterial properties of these glasses, thereby resulting in the development of metal-doped silicate glasses. The addition of antibacterial metals (silver, copper, zinc, and gallium) to silicate glass offers a promising avenue for combating oral pathogens. In recent years, there has been growing interest in metal-doped phosphate glasses. The release of metal ions can be regulated by modifying the dissolution rate of the phosphate glasses. This review summarizes the metal-doped silicate and phosphate glasses that confer antibacterial activity. Future strategies for the development of dental biomaterials that incorporate metal-doped glass and exhibit antibacterial effects are discussed.