Utility of intraoral scanner imaging for dental plaque detection.

Purpose: Oral hygiene, maintained through plaque control, helps prevent periodontal disease and dental caries. This study was conducted to examine the accuracy of plaque detection with an intraoral scanner (IOS) compared to images captured with an optical camera. Materials and Methods: To examine the effect of color tone, artificial tooth resin samples were stained red, blue, and green, after which images were acquired with a digital single-lens reflex (DSLR) camera and an IOS device. Stained surface ratios were then determined and compared. Additionally, the deviation rate of the IOS relative to the DSLR camera was computed for each color. In the clinical study, following plaque staining with red disclosing solution, the staining was captured by the DSLR and IOS devices, and the stained area on each image was measured. Results: The stained surface ratios did not differ significantly between DSLR and IOS images for any color group. Additionally, the deviation rate did not vary significantly across colors. In the clinical test, the stained plaque appeared slightly lighter in color, and the delineation of the stained areas less distinct, on the IOS compared to the DSLR images. However, the stained surface ratio was significantly higher in the IOS than in the DSLR group. Conclusion: When employing IOS with dental plaque staining, the impact of color was minimal, suggesting that the traditional red stain remains suitable for plaque detection. IOS images appeared relatively blurred and enlarged relative to the true state of the teeth, due to inferior sharpness compared to camera images.

Comparison of plaque control record measurements obtained using intraoral scanner and direct visualization.

OBJECTIVE: Intraoral scanner (IOS) can acquire three-dimensional color images of teeth. Thus, the detection of areas with plaque adhesion stained by plaque-disclosing solutions using an IOS could be a potential oral hygiene evaluation method. This study aimed to verify the usefulness of obtaining O'Leary's plaque control record (PCR) measurements using an IOS in clinical practice. METHODS: Twenty patients with >20% PCR measurements who underwent oral prophylaxis were enrolled in this study. A plaque-disclosing gel was applied to stain the areas with plaque adhesion, and the dentition was scanned using the IOS. The PCR values obtained via the direct method and those obtained using the digital image were compared for the entire dentition, maxillary total area, the labial and palatal aspects of the maxillary anterior teeth, the buccal and palatal aspects of the maxillary posterior teeth, mandibular total area, the labial and lingual aspects of the mandibular anterior teeth, and the buccal and lingual aspects of the mandibular posterior teeth. RESULTS: The IOS group tended to have higher values than the direct observation group. The labial and palatal aspect of the maxillary anterior teeth, the labial and lingual aspects of the mandibular anterior teeth did not differ significantly between the groups. CONCLUSION: Plaque adhesion was visualized easily and conclusively using an IOS. As the large tip size often hinders its use, it is necessary to develop a smaller IOS tip in the future.

Osseointegration Aspects of Implants at the Bone Reconstruction Site by a Novel Porous Titanium Scaffold.

OBJECTIVES: Porous titanium is used for the reconstruction of large bone defects due to its excellent mechanical strength. The quality of osseointegration of implants placed in bone reconstructed with porous titanium is unknown. The purpose of this in vivo study was to evaluate the osseointegration of implants at sites reconstructed using porous titanium. MATERIAL AND METHODS: Hollow porous titanium (Ti) (outer-diameter 6 mm, inner-diameter 2 mm, length 4 mm, 85% porosity) and similar-sized porous hydroxyapatite (porous HA: 75% porosity) samples were prepared and implanted in 6 New Zealand white rabbit femurs. Four weeks later, an implant bed was created to receive a Ti implant (diameter 2 mm, length 4 mm). An implant placed at a pristine bone site served as the control. Four weeks later, histological and histomorphometric evaluations of the test and control sites were conducted. RESULTS: Osseointegration was observed in all groups. There was no significant difference in the bone formation ratio and bone-implant contact (BIC) ratio across all groups for the whole area. At the cancellous bone area of the bone defect, superior bone formation ratio and BIC ratio were observed with porous Ti and porous HA compared to the control (bone formation ratio: control 1.8 [SD 3]%, HA 23 [SD 3]%, Ti 23.6 [SD 5]%; BIC ratio: control 5.4 [SD 5.3]%, HA 28.9 [SD 10.7]%, Ti 41.6 [SD 14]%). Porous Ti demonstrated good osteoconduction and osseointegration abilities, similar to porous HA. CONCLUSIONS: To our knowledge, this is the first report of implant treatment after preliminary bone reconstruction using a titanium biomaterial. Porous titanium is a suitable material for bone reconstruction before implant treatment in load-bearing areas that allow subsequent prosthetic treatment.

Comparative Study of Surface Modification Treatment for Porous Titanium.

OBJECTIVES: This study was to investigate suitable surface treatment methods for porous titanium by ex vivo study of material properties and calcium phosphate deposition in simulated body fluid. MATERIAL AND METHODS: Porous titanium with acid (H2SO4 and HCl mixed acid) or alkali (NaOH) treatment was prepared. The surfaces were observed, and the weight change ratio (after and before surface treatment) and compression strength were measured. To investigate the apatite formation ability, each sample was immersed in simulated body fluid (SBF). Surface observations were performed, and the weight change ratio (before/after immersing SBF) and calcification (by alizarin red staining) were measured. RESULTS: The acid group showed a martensitic micro-scale rough structure and the weight and mechanical strength greatly decreased compared to the other groups. The alkali group exhibited a nano-scale roughness structure with similar weight and mechanical strength. Following immersion in SBF, an apatite-like crystal layer in the alkali group was observed. The weight of all samples increased. The change in weight of the samples in the alkali, acid, and control groups were significantly different, showing the following trend: alkali group (1.6%) > acid group (1.2%) > control group (0.8%). Calcium precipitation values were higher in the samples from alkali group than in those from the acid and control groups. CONCLUSIONS: Alkali treatment was found to be a suitable surface modification method for porous titanium, resulting in good mechanical strength and apatite formation ability in simulated body fluid.

Development of a novel bioactive titanium membrane with alkali treatment for bone regeneration.

This study evaluates a bioactive titanium membrane with alkali treatment for stimulating apatite formation and promoting bone regeneration. The titanium thin membranes were either treated with NaOH (alkali-group) or untreated (control). Each sample were incubated in simulated body fluid. Subsequently, the composition of the surface calcium deposition, its weight increase ratio, and optical absorbance were evaluated. Then, the bone defect was trephined on the rats calvaria and covered with each sample membrane or no membrane, and the bone tissue area ratio (BTA) and bone membrane contact ratio (BMC) were evaluated. The spherical crystalline precipitates formed in both groups. In the alkali-group after 21 days, the precipitates matured, forming apatite-like precipitates. The alkali-group showed higher Ca and P contents and weight increase ratios than the control. The alkali-group exhibited a higher BMC than the control in the central area. Thus, this novel membrane has high apatite-forming and bone regeneration abilities.

The development of novel bioactive porous titanium as a bone reconstruction material.

Porous titanium fabricated by the resin-impregnated titanium substitute technique has good mechanical strength and osteoconduction. The alkali treatment of the titanium surface creates a bioactive surface. Alkali-treated porous titanium is expected to accelerate bone formation. The purpose of this study was to evaluate the bone reconstruction ability of alkali-treated porous titanium. Porous titanium (85% porosity) was treated with an alkali solution (5 N NaOH, 24 h). To assess material properties, we analyzed the surface structure by scanning electron microscopy (SEM) and mechanical strength testing. To assess bioactivity, each sample was soaked in a simulated body fluid (Hank's solution) for 7 days. Surface observations, weight change ratio measurement (after/before being soaked in Hank's solution) and surface elemental analysis were performed. We also designed an in vivo study with rabbit femurs. After 2 and 3 weeks of implantation, histological observations and histomorphometric bone formation ratio analysis were performed. All data were statistically analyzed using a Student's t-test (P < 0.05) (this study was approved by the Hiroshima University animal experiment ethics committee: A11-5-5). Non-treated porous titanium (control) appeared to have a smooth surface and the alkali-treated porous titanium (ATPT) had a nano-sized needle-like rough surface. ATPT had similar mechanical strength to that of the control. After soaking into the Hank's solution, we observed apatite-like crystals in the SEM image, weight gain, and high Ca and P contents in ATPT. There was significant bone formation at an early stage in ATPT compared with that in control. It was suggested that the alkali-treated porous titanium had a bioactive surface and induced bone reconstruction effectively. This novel bioactive porous titanium can be expected to be a good bone reconstruction material.

Novel fabrication of porous titanium by a resin-impregnated titanium substitution technique for bone reconstruction.

The purpose of this study was to develop a novel porous titanium material with superior mechanical strength and osteoconduction for bone reconstruction. Porous titanium samples were fabricated by titanium-slurry impregnate to prepare urethane forms with several porosities (high-porosity; 92%, middle-porosity; 85% and low-porosity; 65%). Porous HA (mean porosity; 75.3%) was used as a control. To evaluate the characteristics of these materials, we performed porosity measurements, scanning electron microscopy (SEM), three-point bending testing, and cell proliferation assays. To evaluate the osteoconduction ability, porous titanium was placed into the femurs of rabbits and histological and histomorphometric evaluations were performed after 3 weeks. In SEM images, porous three-dimensional structures were observed in all samples. The bending strength significantly increased as porosity increased (Ti-65 > Ti-85 > porous HA > Ti-92, P < 0.05; respectively). Ti-65, Ti-85, and porous HA showed good cell proliferation. Newly formed bone was observed in the central portion of Ti-65, Ti-85, and porous HA. Ti-92 was mainly detected in the bone marrow tissue. The bone formation areas of Ti-65, Ti-85, and porous HA were significantly higher than that of Ti-92 (P < 0.05). It was suggested that novel developed porous titanium composed of Ti-65 and Ti-85 showed superior mechanical strength and osteoconduction.

Ameloblastin induces tumor suppressive phenotype and enhances chemosensitivity to doxorubicin via Src-Stat3 inactivation in osteosarcoma.

Ameloblastin (AMBN), the most abundant non-amelogenin enamel matrix protein, plays a role in ameloblast differentiation. Previously, we found that AMBN promoted osteogenic differentiation via the interaction between CD63 and integrin ß1, leading to the inactivation of Src; however, how AMBN affects the malignant behavior of osteosarcoma is still unclear. Osteosarcoma affects the bone and is associated with poor prognosis because of the high rate of pulmonary metastases and drug resistance. Here we demonstrated that stable overexpression of AMBN induced apoptosis and suppressed colony formation and cell migration via the inactivation of Src-Stat3 pathway in human osteosarcoma cells. Moreover, AMBN induced chemosensitivity to doxorubicin. Thus, AMBN induced a tumor suppressive phenotype and chemosensitivity to doxorubicin via the AMBN-Src-Stat3 axis in osteosarcoma. Indeed, immunohistochemical expression of AMBN was significantly correlated with better outcome of osteosarcoma patients. Our findings suggest that AMBN can be a new prognostic marker and therapeutic target for osteosarcoma combined with conventional doxorubicin treatment.