Poly(N-isopropylacrylamide) based smart nanofibrous scaffolds for use as on-demand delivery systems for oral and dental tissue regeneration.

Stimuli-responsive domains capable of releasing loaded molecules, "on-demand," have garnered increasing attention due to their enhanced delivery, precision targeting, and decreased adverse effects. The development of an on-demand delivery system that can be easily triggered by dental clinicians might have major roles in dental and oral tissue engineering. A series of random graft poly(NIPAm-co-HEMA-Lactate) copolymers were synthesized using 95:5, 85:5, 60:40, and 40:60 ratios of thermosensitive NIPAm and HEMA-poly lactate respectively then electrospun to produce nanofibrous scaffolds loaded with bovine serum albumin (BSA). Cumulative BSA release was assessed at 25C and 37°C. To appraise the use of scaffolds as on-demand delivery systems, they were subjected to thermal changes in the form cooling and warming cycles during which BSA release was monitored. To confirm the triggered releasing ability of the synthesized scaffolds, the copolymer made with 60% NIPAm was selected, based on the results of the release tests, and loaded with bone morphogenetic protein-2 (BMP-2). The loaded scaffolds were placed with mesenchymal-like stem cells (iMSCs) derived from induced pluripotent stem cells (iPSCs), and subjected to temperature alterations. Then, the osteogenic differentiation of iMSCs, which might have resulted from the released protein, was evaluated after 10 days by analyzing runt-related transcription factor 2 (RUNX-2) osteogenic gene expression by the cells using real-time quantitative polymerase chain reaction (qRT-PCR). BSA release profiles showed a burst release at the beginning followed by a more linear pattern at 25°C, and a much slower release at 37°C. The release also decreased when the PNIPAm content decreased in the scaffolds. Thermal triggering led to a step-like release pattern in which the highest release was reported 30 min through the warming cycles. The iMSCs cultivated with scaffolds loaded with BMP-2 and exposed to temperature alteration showed significantly higher RUNX-2 gene expression than cells in the other experimental groups. The synthesized scaffolds are thermo-responsive and could be triggered to deliver biological biomolecules to be used in oral and dental tissue engineering. Thermal stimuli could be simulated by dental clinicians using simple means of cold therapy, for example, cold packs in intraoral accessible sites for specified times.

New biodegradable nanoparticles-in-nanofibers based membranes for guided periodontal tissue and bone regeneration with enhanced antibacterial activity.

INTRODUCTION: Guided tissue regeneration (GTR) and guided bone regeneration (GBR) are commonly used surgical procedures for the repair of damaged periodontal tissues. These procedures include the use of a membrane as barrier to prevent soft tissue ingrowth and to create space for slowly regenerating periodontium and bone. Recent approaches involve the use of membranes/scaffolds based on resorbable materials. These materials provide the advantage of dissolving by time without the need of surgical intervention to remove the scaffolds. OBJECTIVES: This study aimed at preparing a new series of nanofibrous scaffolds for GTR/GBR applications with enhanced mechanical properties, cell adhesion, biocompatibility and antibacterial properties. METHODS: Electrospun nanofibrous scaffolds based on polylactic acid/cellulose acetate (PLA/CA) or poly(caprolactone) (PCL) polymers were prepared and characterized. Different concentrations of green-synthesized silver nanoparticles, AgNPs (1-2% w/v) and hydroxyapatite nanoparticles, HANPs (10-20% w/v) were incorporated into the scaffolds to enhance the antibacterial and bone regeneration activity. RESULTS: In-vitro studies showed that addition of HANPs improved the cell viability by around 50% for both types of nanofibrous scaffolds. The tensile properties were also improved through addition of 10% HANPs but deteriorated upon increasing the concentration to 20%. AgNPs significantly improved the antibacterial activity with 40 mm inhibition zone after 32 days. Additionally, the nanofibrous scaffolds showed a desirable degradation profile with losing around 40-70% of its mass in 8 weeks. CONCLUSIONS: The obtained results show that the developed nanofibrous membranes are promising scaffolds for both GTR and GBR applications.

In vitro and in vivo biofilm adhesion to esthetic coated arch wires and its correlation with surface roughness.

OBJECTIVE: To evaluate the in vitro ability of esthetic coated rectangular arch wires to retain oral biofilms and in vivo biofilm formation on these wires after 4 and 8 weeks of clinical use and to correlate the findings with the surface roughness of these wires. MATERIALS AND METHODS: Three brands of esthetic coated nickel-titanium (NiTi) arch wires were selected. Arch wires retrieved after 4 and 8 weeks of intraoral use were obtained from 30 orthodontic patients. Surface roughness (SR) was assessed with an atomic force microscope. In vitro adhesion assays were performed using Streptococcus mutans (MS), Staphylococcus aureus, and Candida albicans. The amount of bacterial adhesion was quantified using the colony-count method. Paired t-test, analysis of variance, post hoc Tukey's test, and Pearson's correlation coefficient test were used for statistical analysis at the .05 level of significance. RESULTS: In vitro bacterial adhesion showed significant differences between wires in terms of MS adhesion (P  =  .01). All wires showed significant increases in SR (P  =  .001 after 4 weeks and .007 after 8 weeks) and biofilm adhesion (P  =  .0001 after 4 weeks and .045 after 8 weeks) after intraoral exposure. A significant positive correlation (P  =  .001 after 4 weeks and .05 after 8 weeks) was observed between these two variables in vivo, but the correlation was not significant for in vitro bacterial adhesion. CONCLUSIONS: SR and biofilm adhesion increased after intraoral use at all time intervals. There was a positive correlation between SR and biofilm adhesion in vivo only.

Effect of different sterilization modes on the surface morphology, ion release, and bone reaction of retrieved micro-implants.

OBJECTIVE: To compare as-received and sterilized micro-implants in order to assess the prospects of reusing them. MATERIALS AND METHODS: Forty micro-implants from a single manufacturing lot were used in the study. Thirty were retrieved from patients after successful service in their mouth and with no signs of failure. The retrieved micro-implants were divided into three groups, according to method of sterilization: autoclave, gamma radiation, or ultraviolet radiation. All groups were subjected to scanning electron microscope analysis for surface morphology assessment. The specimens were immersed in a standard simulated body-fluid solution kept at 37°C in an incubator; the solution was then withdrawn at 24 hours and 30 days to evaluate aluminum and vanadium ion release by atomic absorption spectrophotometer in parts per billion. The micro-implants were then surgically implanted into the tibia of rabbits for a 1-month healing period, and the bone-implant blocks were processed for routine histologic examination. RESULTS: This study revealed that sterilized micro-implants had altered surface topography, different ion release values, and different histologic cell reactions than the as-received micro-implants. CONCLUSIONS: Within the limitations of this study, it can be concluded that retrieved self-drilling micro-implants have tip sharpness variations that require correction before insertion by bone drilling. The autoclave-sterilized micro-implants showed better histologic results than micro-implants sterilized by gamma or ultraviolet rays.

Translucency of monolithic and core zirconia after hydrothermal aging.

Objective: To evaluate the hydrothermal aging effect on the translucency of partially stabilized tetragonal zirconia with yttria (Y-TZP) used as monolithic or fully milled zirconia and of core type. Methods: Twenty disc-shaped specimens (1 and 10 mm) for each type of monolithic and core Y-TZP materials were milled and sintered according to the manufacturer's instruction. The final specimens were divided into two groups according to the type of Y-TZP used. Translucency parameter (TP) was measured over white and black backgrounds with the diffuse reflectance method; X-ray diffraction (XRD) and scanning electron microscope (SEM) were used to analyze the microstructure of both Y-TZP types before and after aging. Data for TP values was statistically analyzed using Student's t-test. Results: Monolithic Y-TZP showed the highest TP mean value (16.4 ± 0.316) before aging while core Y-TZP showed the lowest TP mean value (7.05 ± 0.261) after aging. There was a significant difference between the two Y-TZP types before and after hydrothermal aging. XRD analysis showed increases in monoclinic content in both Y-TZP surfaces after aging. Conclusion: Monolithic Y-TZP has a higher chance to low-temperature degradation than core type, which may significantly affect the esthetic appearance and translucency hence durability of translucent Y-TZP.

Effect of non-ionizing radio frequency signals of magnetic resonance imaging on physical properties of dental alloys and metal-ceramic adhesion.

PURPOSE: To assess the influence of non-ionizing radio frequency signals of magnetic resonance imaging (MRI) on physical properties of dental alloys and metal-ceramic adhesion. MATERIALS AND METHODS: A total of 120 disk-shaped wax patterns (10 mm x 10 mm x 1 mm) were cast in a base metal alloy (Ni-Cr alloy) and commercially pure titanium (Ti) following the manufacturing recommendation. After casting, air abrasion and ultrasonic cleaning, feldspathic ceramic was applied and fired according to manufacturer's instructions using a standard mold. The specimens were subjected to 3000 thermocycles in distilled water between 5°C and 55°C, then veneered alloy specimens were randomly assigned to three groups according to MRI exposure time: a) 15 min of MRI exposure, b) 30 min of MRI exposure and c) no MRI exposure (control group). The specimens were subjected to shear loading until failure. A separate set of Ni-Cr and Ti specimens were prepared, and after exposure to MRI for 15 and 30 min, x-ray diffraction (XRD) analysis, surface roughness, and Vicker's hardness were measured. RESULTS: Both the alloy type (p < 0.005) and exposure duration (p < 0.005) had a significant effect on the bond results. While the control group presented the highest bond strength for Ni-Cr and Ti (36.9 ± 1.4 and 21.5 ± 1.6 MPa, respectively), 30 min MRI exposure significantly decreased the bond strength for both alloys (29.4 ± 1.5 and 12.8 ± 1.5 MPa, respectively) (p < 0.05). XRD analysis indicated formation of the crystalline phase as well as change in crystal size and position for Ni-Cr and Ti after MRI. Compared to the control group where alloys were not exposed to MRI (Ni-Cr: 0.40 µm; Ti: 0.17 µm), surface roughness increased (Ni-Cr: 0.54 µm; Ti: 1.1 µm). Vicker's hardness of both alloys decreased after 30 min MRI (Ni-Cr: 329.5; Ti: 216.1) compared to the control group c (Ni-Cr: 356.1; Ti: 662.1), being more significant for Ti (p < 0.005). CONCLUSION: Ni-Cr alloy is recommended over Ti for the fabrication of metal-ceramic restorations for patients with a history of frequent exposure to MRI.

Clinical survival of anterior metal-ceramic and all-ceramic cantilever resin-bonded fixed dental prostheses over a period of 60 months.

PURPOSE: To evaluate the survival of maxillary anterior cantilever resin-bonded metalceramic (MC) and all-ceramic (AC) fixed dental prostheses (RBFDPs). MATERIALS AND METHODS: Between August 2007 and December 2009, 40 patients received 40 RBFDPs made of either cobalt-chromium-ceramic (n = 20) or glass-infiltrated alumina (In-Ceram, Vident; n = 20) and were followed up until December 2012. Restorations were adhesively cemented (Panavia 21, Kuraray). RESULTS: Two fractures were observed with AC. No debondings were observed with MC (n = 0) but were observed with AC (n = 3). The difference in survival rates of MC and AC was not significant (MC: 100%; AC: 90%; P = .15) (Kaplan-Meier method, confidence interval = 95%). CONCLUSIONS: Cantilever AC RBFDPs could be a promising alternative to MC RBFDPs for replacement of missing anterior incisors, provided that no mechanical complications were experienced with the latter.

A new modification for improving shear bond strength and other mechanical properties of conventional glass-ionomer restorative materials.

PURPOSE: To study the effect of addition of poly(acrylamide-co-sodium acrylate) copolymer and/or TiO2 nanoparticles on the mechanochemical properties of conventional glass ionomer (GIC)-based restorative materials. MATERIALS AND METHODS: The copolymer was prepared, characterized and then added, either separately or in combination with different proportions of TiO2 nanoparticles to the conventional GIC powder. The developed composites were characterized using FTIR spectrometry, x-ray diffraction, and scanning electron microscopy. The mechanical properties of the obtained series of modified GIC formulations were investigated in comparison with other formulations containing only TiO2 nanoparticles through testing their compressive strength, flexural strength, and dentin shear bond strength. RESULTS: The preliminary data of the study showed a significant increase in the compressive strength of the conventional GIC after addition of 3% and 5% TiO2 nanoparticles by weight, but 7% decreased it. Upon addition of copolymer, the compressive strength was lower than that of the conventional GIC. The highest average compressive strength value was obtained upon incorporation of 7% 1:1 combination of copolymer-TiO2 nanoparticles. The results also demonstrated a significant increase in the flexural strength values after addition of both copolymer and TiO2 nanoparticles to the GIC powder. In addition, the results revealed a significant increase in values of dentin shear bond strength after copolymer addition with the highest value noted upon addition of 7% by weight of copolymer. CONCLUSION: The new series of modified glass ionomers developed here can be tailored to act as restorative materials with high quality performance in high stress-bearing areas.

Influence of pulpotomy medicaments on the ultrastructure and shear bond strength of a self-etch adhesive to primary tooth dentin.

OBJECTIVE: To compare the effect of the pulpotomy medicaments glutaraldehyde, ferric sulfate, and formocresol on the structure and shear bond strength of a self-etch adhesive to the dentin of primary teeth. METHOD AND MATERIALS: Forty human primary molars were sectioned mesiodistally and divided into four groups: group I (control group), dentin specimens were soaked in distilled water for 48 hours; group II, dentin specimens were soaked in 2% glutaraldehyde; group III, dentin specimens were soaked in formocresol; and group IV, dentin specimens were soaked in 15.5% ferric sulfate. All specimens were rinsed with tap water and dried with air. AdheSE One (a self-etch adhesive) and Valux Plus composite resin were applied to the dentin surfaces. The molecular structure of the adhesive itself and adhesive with composite resin were tested using an FTIR spectrometer. Shear bond strength was tested with a universal testing machine. Failure modes analyses were performed with a scanning electron microscope (SEM). RESULTS: Glutaraldehyde showed little changes in the molecular structure of the adhesive itself and adhesive with composite. However, ferric sulfate and formocresol affected the molecular structure of the adhesive alone and the adhesive with composite. The highest mean value of shear bond strength was for the glutaraldehyde group (11.17 ± 4.87 MPa). Ferric sulfate and formocresol significantly reduced shear bond strength after the application of pulpotomy medicaments (7.45 ± 3.73 and 5.31 ± 3.30 MPa, respectively). SEM analysis revealed that most of the specimens failed in cohesive and mixed modes. CONCLUSION: This study revealed that formocresol and ferric sulfate adversely affect the shear bond strength and molecular structure of the adhesive system to primary dentin.