Flexural strength, biocompatibility, and antimicrobial activity of a polymethyl methacrylate denture resin enhanced with graphene and silver nanoparticles.

OBJECTIVE: The study evaluates the effect of adding graphene-Ag nanoparticles (G-AgNp) to a PMMA auto-polymerizing resin, with focus on antibacterial activity, cytotoxicity, monomer release, and mechanical properties. MATERIALS AND METHODS: Auto-polymerizing acrylic resin (M) was loaded with 1 wt% G-AgNp (P1) and 2 wt% G-AgNp (P2). Methyl methacrylate monomer release (MMA) was measured after immersion of the samples in chloroform and cell medium respectively. Cell viability was assessed on dysplastic oral keratinocytes (DOK) and dental pulp stem cells. Oxidative stress and inflammatory response following exposure of dysplastic oral keratinocytes to the experimental resins was evaluated. Antibacterial activity against Staphylococcus aureus, Streptococcus mutans and Escherichia coli and also flexural strength of the resins were assessed. RESULTS: Residual monomer: For samples immersed in chloroform, MMA concentration reached high levels, 10.27 µg/g for sample P1; MMA increased at higher G-AgNp loading; 0.63 µg/g MMA was found in medium for P1, and less for sample P2. Cell viability: Both cell lines displayed a viability decrease, but remained above 75%, compared to controls, when exposed to undiluted samples. Inflammation: proinflammatory molecule TNF-α decreased when DOK cultures were exposed to G-AgNp samples. MDA levels indicated increased oxidative stress damage in cells treated with PMMA, confirmed by the antioxidant mechanism activation, while samples containing G-AgNp induced an antioxidant effect. All tested samples showed antibacterial properties against Gram-positive bacteria. Samples containing G-AgNp also exhibited bactericide action on E. coli. Mechanical properties: both samples containing G-AgNp improved flexural strength compared to the sample resin, measured through elastic strength parameters. CONCLUSIONS: PMMA resin loaded with G-AgNp presents promising antibacterial activity associated with minimal toxicity to human cells, in vitro, as well as improved flexural properties. CLINICAL RELEVANCE: These encouraging results obtained in vitro support further in vivo investigation, to thoroughly check whether the PMMA loaded with graphene-silver nanoparticles constitute an improvement over current denture materials.

SEM Evaluation of Marginal Adaptation E-Max Crowns Manufactured by Printing-Pressed and Milling.

Dental crown marginal adaptation is a matter of the success of dental restoration treatment. Nowadays, there are many technological ways for crown manufacturing, such as tridimensional printing of an exactly desired shape through CAD-assisted systems and the appropriate shape milling of a predesigned bulk crown. Both methods are developed for patient benefits. The current research aims to investigate the marginal adaptation of E-Max crowns manufactured by printing-pressed and milling methods. The in vitro cementation procedures were effectuated on healthy teeth extracted for orthodontic purposes according to the standard procedures and the marginal adaptation was investigated with SEM microscopy. The restoration overview was inspected at a magnification of 100× and the microstructural details at 400×. The integrity of marginal adaptation was properly inspected in identical samples on segments of 2 mm from each buccal, palatal, distal and mesial side. The obtained results reveal a good marginal adaptation for all samples, with some particularities. The statistical analysis shows that the best values of the marginal adaptation were obtained for vestibular/buccal and palatal sides of the teeth being situated around 90-95%, while the values obtained for distal and mesial sides are slightly lower such as 80-90%. Furthermore, it was observed that the milled crowns presents better marginal adaptations than the printed-pressed ones, sustained by the statistical p < 0.05. This indicates that the milling process allows a better fit of the crown to the tooth surface and preserves the integrity of the bonding cement layer.

Comparative Assessment of the Functional Parameters for Metal-Ceramic and All-Ceramic Teeth Restorations in Prosthetic Dentistry-A Literature Review.

The metal-ceramic fixed partial prosthesis is the golden standard for posterior tooth restorations. Following the demands of patients and clinicians for metal-free restorations, all-ceramic materials were developed as they offer an adequate alternative with better optical qualities and good mechanical properties. This study aims to carry out a bibliographic review to assess the survival rate and the biological and technical complications of all-ceramic and metal-ceramic fixed partial dentures. An electronic search for articles in the English language literature was performed using PubMed (MEDLINE). This literature review focused on research studies between 2010 and 2020 that performed clinical studies on tooth-supported fixed partial dentures with a mean follow-up of at least 3 years. All the studies, which analyzed the survival and complications of tooth-supported fixed partial dentures, were included. Thus, 14 studies reporting on 756 all-ceramic and 160 metal-ceramic fixed partial dentures met the inclusion criteria. A comparative analysis was carried out based on all the data existing in the studies included in this review. The metal-ceramic fixed partial dentures showed survival rates of 95% to 100% at 3-, 5-, and 10-year follow-up periods. Zirconia fixed partial dentures were reported to have survival rates of 81% to 100% at 3-, 5-, 9-, 10-year follow-up evaluations. The reinforced glass-ceramic fixed partial dentures showed survival rates of 70% to 93.35% at 5 years, while the alumina FPDs showed a survival rate of 68% at 3 years follow-up. The incidence of caries and loss of vitality were reported as higher for all-ceramic prostheses as compared to the metal-ceramic ones. A significant framework fracture was reported for glass-infiltrated alumina fixed partial dentures in comparison to metal-ceramic fixed partial dentures. All-ceramic and metal-ceramic restorations showed similar survival rates after 3 years, although all-ceramic restorations have problems with technical complications such as chipping, which can lead to framework fractures over time.

In Vitro Evaluation of Biological Activities of Canes and Pomace Extracts from Several Varieties of Vitis vinifera L. for Inclusion in Freeze-Drying Mouthwashes.

In this study, the biological activities of four extracts from Vitis vinifera by-products: two pomace extracts, white (WPE) and red (RPE), a canes extract (CE), and their combination (CoE), were evaluated, to be included in freeze-drying mouthwashes formulations. The cytocompatibility and anticancerous potential of the four extracts were tested on three cancerous cell lines, as well as the cytoprotective activity against nicotine-induced cytotoxicity and the antioxidant potential determined on a human gingival fibroblasts (HGF) cell line. Additionally, the anti-inflammatory activity and the antimicrobial activity against several microorganisms from the oral microbiome were tested. Freeze-dried mouthwashes with CoE were prepared and characterized, both as lyophilizates and after reconstitution. The four tested extracts showed the highest cytotoxicity on MDA-kb2 cell line. The antioxidant potential was demonstrated for WPE, RPE, CE, and CoE, both in non-stimulated and H2O2 stimulated conditions. The four extracts reduced the levels of proinflammatory cytokines (IL-6, IL-8, and IL-1ß) in a dose-dependent manner, confirming their anti-inflammatory activity. The antimicrobial activity of tested extracts was shown against pathogenic bacteria from the oral microbiome. Mouthwashes of CoE with poloxamer-407, xylitol, and different ratios of mannitol were prepared by freeze-drying leading to porous formulations with interesting mechanical properties and reconstitution times.

Oral Microbiome: Getting to Know and Befriend Neighbors, a Biological Approach.

The oral microbiome, forming a biofilm that covers the oral structures, contains a high number of microorganisms. Biofilm formation starts from the salivary pellicle that allows bacterial adhesion-colonization-proliferation, co-aggregation and biofilm maturation in a complex microbial community. There is a constant bidirectional crosstalk between human host and its oral microbiome. The paper presents the fundamentals regarding the oral microbiome and its relationship to modulator factors, oral and systemic health. The modern studies of oral microorganisms and relationships with the host benefits are based on genomics, transcriptomics, proteomics and metabolomics. Pharmaceuticals such as antimicrobials, prebiotics, probiotics, surface active or abrasive agents and plant-derived ingredients may influence the oral microbiome. Many studies found associations between oral dysbiosis and systemic disorders, including autoimmune diseases, cardiovascular, diabetes, cancers and neurodegenerative disorders. We outline the general and individual factors influencing the host-microbial balance and the possibility to use the analysis of the oral microbiome in prevention, diagnosis and treatment in personalized medicine. Future therapies should take in account the restoration of the normal symbiotic relation with the oral microbiome.

Oral Hygiene Habits of Complete Denture Wearers in Central Transylvania, Romania.

PURPOSE: To identify the oral hygiene habits and denture hygiene status (e.g. sociodemographic characteristics, general health status) of complete denture wearers in Central Transylvania, Romania. MATERIALS AND METHODS: This descriptive cross-sectional study was based on an original self-administered questionnaire. It included 162 patients who experienced complete tooth loss in one or both jaws and wore polymethylmethacrylate acrylic (PMMA) complete dentures. The exclusion criteria were partial dentures, dentures fabricated from materials other than PMMA, and the patient being unable to provide all the required information. The questionnaire solicited information regarding sociodemographic status, general health and oral hygiene-related habits. The dentures were clinically evaluated in order to assess denture hygiene. RESULTS: Most respondents were completely edentulous (38.0% wore maxillary dentures, 10.6% mandibular dentures, while 51.6% had both), with an average age above 60, all wearing dentures. The clinical evaluation of the dentures revealed that 12.3% exhibited optimal hygiene status, 40.1% good, 32.7% unsatisfactory and 14.8% bad, with more women than men having well-cleaned dentures. Cleaning frequency was found to be 2-3 times per day for 54.3% of the patients, with 93.2% of the subjects using a toothbrush and 76.5% using toothpaste. Most of the participants felt at ease with the cleaning procedures. Only 30.9% of the respondents reported denture removal overnight. The results showed that the hygiene of the patients' dentures was not correlated with their answers regarding oral hygiene habits. CONCLUSIONS: Competent oral health and denture hygiene promotion should be established, especially regarding nocturnal denture removal, denture hygiene methods, instruments and cleaning frequency.

Association of Graphene Silver Polymethyl Methacrylate (PMMA) with Photodynamic Therapy for Inactivation of Halitosis Responsible Bacteria in Denture Wearers.

(1) Background: Poor hygiene and denture presence in the oral cavity are factors that favor bacterial accumulation, the cause of halitosis and of various oral and general diseases. Aim: This study aimed to evaluate the possibility of inactivating bacteria associated with halitosis in acrylic denture wearers using polymethyl methacrylate resin enhanced with graphene silver nanoparticles and the effect of the resin association with extra oral photodynamic therapy. (2) Methods: Graphene silver nanoparticles in 1 and 2 wt% were added to a commercial acrylic resin powder. Three study groups containing samples from the three different materials were established. The first group was not exposed to the light treatment, and the other two were exposed to red light (laser and light emitting diode) after photosensitizer placement on the disk's surface. Samples were incubated with Porphyromonas gingivalis and Enterococcus faecalis. (3) Results: For both bacterial strains, inhibition zones were obtained, showing significant differences for the light-treated samples. (4) Conclusions: Denture resins with antibacterial properties associated with extra oral photodynamic therapy exhibited enhanced antibacterial effects. The procedure could be used as a safer and more efficient alternative technique against halitosis and oral infections in denture wearers.

The Influence of Graphene in Improvement of Physico-Mechanical Properties in PMMA Denture Base Resins.

The clinical performances of dental materials depend on their mechanical profiles, determining their long-term deformation and wear resistance. This paper describes a study on the mechanical properties, water absorption and morphological properties of a polymethyl methacrylate (PMMA) resin enriched with graphene-silver nanoparticles (Gr-Ag). Two different concentrations-1 and 2 wt.%-of Gr-Ag were loaded into the PMMA material. For the mechanical characterization, the compression behavior, flexural strength and tensile strength were evaluated. Optical microscopy in polarized light and scanning electron microscopy were used for filler analysis. The filler addition led to an improvement in all mechanical properties, with slight changes being derived from the filler content variation. Gr-Ag use led to an increase in the applied maximum loads. Moreover, 1 wt.% Gr-Ag determined an increase of 174% in the modulus of rupture, which indicates high flexibility.