Polymer-Induced Liquid Precursor (PILP) remineralization of artificial and natural dentin carious lesions evaluated by nanoindentation and microcomputed tomography.

OBJECTIVES: The study evaluates the efficacy to remineralize artificial and natural dentin lesions through restorative dental procedures that include the Polymer-Induced Liquid Precursor (PILP) method comprising polyaspartic acid (pAsp). METHODS: Novel ionomeric cement compositions based on bioglass 45S5 and pAsp mixtures, as well as conditioning solutions (conditioner) containing 5 mg/mL pAsp, were developed and tested on demineralized dentin blocks (3-4 mm thick) on shallow and deep lesions with the thickness of 140 µm ± 50 and 700 µm ± 50, respectively. In the first treatment group, 20 µL of conditioner was applied to demineralized shallow (n = 3) and deep (n = 3) lesion specimens for 20 s before restoration with glass ionomer cement (RMGIC). For the PILP cement treatment group, cement was applied onto the wet surface of the demineralized specimen for both shallow (n = 3) and deep (n = 3) artificial lesions after the application of the conditioner and before the final restoration. Sample groups were compared to RMGIC restoration, for both shallow and deep lesions (n = 3 each) and treatments in PILP-solution (n = 3 for deep lesions) without restoration for 4 weeks. All of the restored specimens were immersed in simulated body fluid (SBF) solution for 2 weeks and 4 weeks for shallow and deep lesions respectively to allow for remineralization. The artificial lesion specimens were evaluated for changes in the nanomechanical profile (E-modulus and hardness) using nanoindentation. Shallow lesions were analyzed by SEM under vacuum for changes in morphology caused by PILP treatments. Also, a pilot study on human third molars with moderate lesions in dentin (n = 3) was initiated to test the efficacy of treatments in natural lesions based on mineral densities using microcomputed tomography (µCT) at 0, 1, and 3 months. RESULTS: This study showed that functional remineralization of artificial lesions using PILP-releasing restoratives occurred, indicated by an increase of the elastic modulus in shallow lesions and in the middle zone of deep artificial lesions. The mechanical improvement was significant when compared to RMGIC restoration without pAsp (P < 0.05). Nonetheless, recovery across artificial lesions was most significant when specimens were immersed into PILP-solution with restorative (P < 0.01). Furthermore, natural lesions increased in mineral volume content to a higher degree when the restorative treatment included the PILP-method (P < 0.05). However, none of the natural lesions recovered to full mineral degree regardless of the treatments. CLINICAL SIGNIFICANCE/CONCLUSION: These findings indicate the benefit of PILP applications in the functional repair of dentin caries and illustrate the challenge to integrate the PILP-method into a restorative approach in minimally invasive dental procedures.

Fabrication Aspects of Porous Biomaterials in Orthopedic Applications: A Review.

Porous biomaterials have been widely used in a variety of orthopedic applications. Porous scaffolds stimulate the cellular responses and accelerate osteogenesis. The porous structure of scaffolds, as well as their compositions, dictate cellular responses such as their adhesion, penetration, differentiation, nutrition diffusion, and bone in-growth. During the last two decades, tremendous efforts have been devoted by researchers on innovative processing technologies of porous ceramics, metals, polymers, and glasses, resulting in a wide variety of porous architectures with substantial improvements in properties. Design and fabrication of porous scaffolds are complex issues that can jeopardize scaffolds' biological, mechanical, and physiochemical properties. This paper intends to comprehensively review the processing techniques used in fabricating porous biomaterials including ceramics, polymers, metals, and glasses along with correlating with their biological and mechanical performances. From a macroscopic perspective, pore size distribution, interconnectivity, pore morphology, and porosity play critical roles in bone formation in vivo. From a microscopic viewpoint, the adhesion-retention of proteins, which eventually affect some cellular fates, and absorption-delivery of therapeutic agents can be tailored by microtextured surfaces. Various processing techniques such as partial sintering, sacrificial fugitives, foaming, freeze casting, metal injection molding, rapid prototyping, etc., and their associated parameters in designing of porous biomaterials are reviewed, with specific examples of their applications. The remainder of the paper is organized as follows. First, the paper describes correlations of porosity characteristics with biological properties. Subsequently, mechanical properties of porous scaffolds are discussed. Finally, a summary of this review and future directions are presented.

Microwave-assisted magnesium phosphate coating on the AZ31 magnesium alloy.

Due to the combination of many unique properties, magnesium alloys have been widely recognized as suitable metallic materials for fabricating degradable biomedical implants. However, the extremely high degradation kinetics of magnesium alloys in the physiological environment have hindered their clinical applications. This paper reports for the first time the use of a novel microwave-assisted coating process to deposit magnesium phosphate (MgP) coatings on the Mg alloy AZ31 and improve its in vitro corrosion resistance. Newberyite and trimagnesium phosphate hydrate (TMP) layers with distinct features were fabricated at various processing times and temperatures. Subsequently, the corrosion resistance, degradation behavior, bioactivity and cytocompatibility of the MgP coated AZ31 samples were investigated. The potentiodynamic polarization tests reveal that the corrosion current density of the AZ31 magnesium alloy in simulated body fluid (SBF) is significantly suppressed by the deposited MgP coatings. Additionally, it is seen that MgP coatings remarkably reduced the mass loss of the AZ31 alloy after immersion in SBF for two weeks and promoted precipitation of apatite particles. The high viability of preosteoblast cells cultured with extracts of coated samples indicates that the MgP coatings can improve the cytocompatibility of the AZ31 alloy. These attractive results suggest that MgP coatings, serving as the protective and bioactive layer, can enhance the corrosion resistance and biological response of magnesium alloys.

A new method to produce macroporous Mg-phosphate bone growth substitutes.

This paper is a sequel to our previous effort in developing Mg-phosphate orthopedic cements using amorphous Mg-phosphate (AMP) as the precursor. In this paper, we report a new real-time in situ technique to create macroporous bone growth substitute (BGS). The method uses biodegradable Mg-particles as the porogen. As opposed to the conventional wisdom of providing corrosion protection layers to biodegradable Mg-alloys, the present method uses the fast corrosion kinetics of Mg to create macropores in real time during the setting of the cement. An aqueous solution of PVA was used as the setting solution. Using this technique, a macroporous cement containing up to 91% porosity is obtained, as determined by pycnometry. Due to formation of H2 gas bubbles from corrosion of Mg, the cement becomes macroporous. The pore sizes as big as 760µm were observed. The results of SBF soaking indicated change in crystallinity as confirmed via scanning electron microscopy (SEM) and X-ray diffraction (XRD). Our in vitro cytocompatibility evaluation also revealed that the macroporous bone growth substitute composed of bobierrite is cytocompatible and can improve gene expression.

Evaluation of amorphous magnesium phosphate (AMP) based non-exothermic orthopedic cements.

This paper reports for the first time the development of a biodegradable, non-exothermic, self-setting orthopedic cement composition based on amorphous magnesium phosphate (AMP). The occurrence of undesirable exothermic reactions was avoided through using AMP as the solid precursor. The phenomenon of self-setting with optimum rheology is achieved by incorporating a water soluble biocompatible/biodegradable polymer, polyvinyl alcohol (PVA). Additionally, PVA enables a controlled growth of the final phase via a biomimetic process. The AMP powder was synthesized using a precipitation method. The powder, when in contact with the aqueous PVA solution, forms a putty resulting in a nanocrystalline magnesium phosphate phase of cattiite. The as-prepared cement compositions were evaluated for setting times, exothermicity, compressive strength, biodegradation, and microstructural features before and after soaking in SBF, and in vitro cytocompatibility. Since cattiite is relatively unexplored in the literature, a first time evaluation reveals that it is cytocompatible, just like the other phases in the MgO-P2O5 (Mg-P) system. The cement composition prepared with 15% PVA in an aqueous medium achieved clinically relevant setting times, mechanical properties, and biodegradation. Simulated body fluid (SBF) soaking resulted in coating of bobierrite onto the cement particle surfaces.

Influence of ethanol content in the precipitation medium on the composition, structure and reactivity of magnesium-calcium phosphate.

Biocompatible amorphous magnesium calcium phosphate (AMCP) particles were synthesized using ethanol in precipitation medium from moderately supersaturated solution at pH10. Some synthesis parameters such as, (Mg+Ca):P, Mg:Ca ratio and different drying methods on the structure and stability of as-produced powder was studied and characterized using SEM, XRD and cell cytocompatibility. The results showed that depending on the Mg(2+) concentration, nano crystalline Struvite (MgNH4PO4·6H2O) can also be alternatively formed. However, the as-formed AMCP preserved its amorphous structure after 7 days of incubation in SBF for tested phosphate concentration, and equally ionic concentration of magnesium and calcium.