Cathepsin-K inhibition enhances anti-cancerous activity within oral squamous cell carcinoma cells: Uncloaking the potency of new K21 formulation.

BACKGROUND: The ability of cancer cells to be invasive and metastasize depend on several factors, of which the action of protease activity takes center stage in disease progression. PURPOSE/OBJECTIVE: To analyze function of new K21 molecule in the invasive process of oral squamous cell carcinoma (OSCC) cell line. MATERIALS & METHODS: The Fusobacterium (ATCC 23726) streaks were made, and pellets were resuspended in Cal27 (ATCC CRL-2095) OSCC cell line spheroid cell microplate. Cells were seeded and Lysotracker staining performed for CathepsinK red channel. Cell and morphology were evaluated using Transmission Electron microscopy. Thiobarbituric acid assay was performed. OSCC was analyzed for Mic60. Raman spectra were collected from the cancer cell line. L929 dermal fibroblast cells were used for Scratch Assay. ELISA muti arrays were used for cytokines and matrix molecules. Internalization ability of fibroblast cells were also analyzed. Structure of K21 as a surfactant molecule with best docked poses were presented. RESULTS: Decrease in lysosomal staining was observed after 15 and 30 min of 0.1% treatment. Tumor clusters were associated with cell membrane destruction in K21 primed cells. There was functional silencing of Mic60 via K21, especially with 1% concentration with reduced cell migration and invasiveness. Raman intensity differences were seen at 700 cm-1, 1200 cm-1 and 1600 cm-1 regions. EVs were detected within presence of fibroblast cells amongst K21 groups. Wound area and wound closure showed the progress of wound healing. CONCLUSION: Over expression of CatK can be reduced by a newly developed targeted K21 based drug delivery system leading to reduced migration and adhesion of oral squamous cell carcinoma cells. The K21 drug formulation can have great potential for cancer therapies due to targeting and cytotoxicity effects.

Effect of peroxide-free and peroxide-based in-office bleaching on the surface and mechanical properties of CAD/CAM esthetic restorative materials.

The study aimed to investigate the influence of H2O2-based and H2O2-free in-office bleaching on the surface and mechanical attributes of CAD/CAM composite blocks. CAD/CAM composite blocks from five different composite materials (CC1, CC2, CC3, CC4, and CC5) were randomly divided into two groups according to bleaching application (H2O2-based and H2O2-free). The surface topography, morphology, nanohardness, elastic modulus, flexural strength, and fracture toughness were measured. A paired and unpaired sample t-tests gauged the effect of pre- and post-bleaching on the substrates. The estimated mean differences (before-after bleaching) suggested an increase in surface roughness for two materials CC2 and CC4, and a significant decrease in nanohardness for material CC4 and in elastic modulus for materials CC2 and CC4 with H2O2-based bleaching, whereas H2O2-free bleaching resulted in changes compatible with no change in these properties. Flexural strength and fracture toughness showed no evidence of changes, irrespective of the bleaching gel used. Scanning electron microscopic analysis revealed erosive effects and micropore formation due to H2O2-based bleaching. H2O2-based bleaching deteriorates the surface of CAD/CAM composite materials while H2O2-free bleaching gel had an insignificant effect on both surface and bulk properties. The clinician should carefully evaluate the potential effects of H2O2-based bleaching on the surface properties of CAD/CAM composites.

A Novel Coated Suture Displays Antimicrobial Activity Without Compromising Structural Properties.

BACKGROUND: Treated or coated sutures promise to prevent contamination of wounds. PURPOSE: The purpose of the study was to coat surgical sutures with a new quaternary ammonium silane (QAS) antimicrobial compound at two different application temperatures and then to evaluate the resulting structural, physical, mechanical, and biological properties. STUDY DESIGN, SETTING, SAMPLE: In vitro and in vivo studies were conducted using male albino Wistar rats approved by the Joint Ethical Committee of IMU and Postgraduate Medical Institute, Lahore. Only suture samples, coated uniformly with verified presence of the compound and of adequate length were used. Samples which were not coated uniformly and with inadequate length or damaged were excluded. PREDICTOR VARIABLE: Predictor variables were sutures with and without QAS coatings and different temperatures. Sutures were coated with QAS at 0.5 and 1.0% wt/vol using the dip coating technique and sutures with and without QAS coating were tested at 25 and 40 °C temperatures. MAIN OUTCOME VARIABLE(S): Outcome variables of structural and physico-mechanical properties of QAS-coated and non-coated sutures were measured using Fourier transform infrared spectroscopy (for structural changes), confocal laser and scanning electron (for diameter changes), and tensile strength/modulus (for mechanical testing). Biologic outcome variables were tested (bacterial viability); macrophage cultures from Wistar rats were tested (M1/M2 polarization detecting IL-6 and IL-10). Macrophage cells were analyzed with CD80+ (M1) and CD163+ (M2). Chemotaxis index was calculated as a ratio of quantitative fluorescence of cells. COVARIATES: Not applicable. ANALYSES: Ordinal data among groups were compared using the Wilcoxon Mann-Whitney U test along with the comparison of histological analysis using the Wilcoxon Sign-rank test (P < .05). RESULTS: Fourier transform infrared spectroscopy peak at 1490 cm-1 confirmed the presence of QAS on suture's surfaces with a significant increase (P < .05) in diameter (0.99 ± 0.5-mm) and weight (0.77 ± 0.02-mg) observed for 1% QAS groups treated at 40 °C. Non-coated samples heated at 25 °C had significantly (P < .05) less diameters (0.22 ± 0.03-mm) and weights (0.26 ± 0.06-mg). Highest tensile strength/modulus was observed for 0.5% QAS-coated samples which also had significantly higher antibacterial characteristics than other sutures (P < .05). QAS-coated sutures significantly increased M1 and M2 markers. CONCLUSION AND RELEVANCE: QAS coating conferred antibacterial action properties without compromising the physical and mechanical properties of the suture.

The influence of the resin-based cement layer on ceramic-dentin bond strength.

The purpose of the study was to measure the cement thickness obtained when ceramic rods were luted to dentin and to analyze the relation between cement thickness and the previously published tensile bond strength of similar test specimens. In addition, the ISO standard 4049:2019 method was used to determine the film thickness of the used cements. Zirconia (n = 100) and lithium disilicate (n = 50) rods were cemented to bovine dentin using one of five different resin-based cements. The ceramic-dentin test specimens were cut into two slices and the cement thickness was measured using a scanning electron microscope and compared to the bond strength values of similar specimens already published. The mean cement thickness recorded for ceramic rods cemented to dentin was in the range 20-40 µm, which was larger than the cement film thickness found by the ISO method. The cement film thickness determined according to ISO standard methods did not concur with the results obtained when cementing ceramic rods to dentin. For cementing ceramic restorations, a cement thickness in the range 25-35 µm seems to be favorable for the bond strength.

The Influence of Surface Roughening and Polishing on Microbial Biofilm Development on Different Ceramic Materials.

PURPOSE: To test the hypothesis that surface roughening and polishing of ceramics have no effect on their surface roughness and biofilm adhesion. MATERIALS AND METHODS: Feldspathic ceramic Vitablocks™ TriLuxe forte (VTF), lithium disilicate glass IPS e.max Press™ (IPS) and zirconia reinforced lithium silicate Vita Suprinity™ (VS) ceramic blocks (n = 27 per group) were prepared from sintered CAD blocks using a water-cooled saw. They were further subdivided into 3 subgroups according to the surface treatment protocols (n = 9): as prepared, roughened and polished. The surface roughness of the ceramic blocks was measured using an electro-mechanical profilometer. The ceramic sections were inoculated with Streptococcus mutans and incubated for 48 hours to form a biofilm. The ceramic surfaces with the biofilms were analyzed using Confocal Laser Scanning Microscopy to calculate the percentage of live bacteria and substratum coverage by the biofilm, and further visualized using scanning electron microscopy. Statistical analysis was done with SPSS software using two-way ANOVA, followed by post hoc Bonferroni test to identify significant differences between the groups. The level of significance was set at p = 0.05. RESULTS: As prepared VTF showed significantly higher mean surface roughness values than as prepared IPS and VS. The mean percentage of live bacteria and biofilm coverage of the substrate were significantly higher in the roughened ceramic blocks than the as prepared and polished blocks for all three ceramic types (p < 0.05). Polished specimens of VS significantly lower percentage of biofilm coverage than the other groups (p < 0.05). CONCLUSIONS: This study sheds new light that adjustments of ceramic restorations prior to cementation increases the likelihood for formation and adhesion of microbial biofilms on the surface. Polished zirconia reinforced lithium disilicate ceramics demonstrated the lowest bacterial adhesion among the evaluated ceramics.

Effect of fiber post length and abutment height on fracture resistance of endodontically treated premolars prepared for zirconia crowns.

The purpose of this study was to compare the fracture resistance, mode of fracture, and stress distribution of endodontically treated teeth prepared with three different fiber post lengths and two different abutment heights, using both experimental and finite element (FE) approaches. Forty-eight human maxillary premolars with two roots were selected and endodontically treated. The teeth were randomly distributed into six equally sized groups (n = 8) with different combinations of post lengths (7.5, 11, and 15 mm) and abutment heights (3 and 5 mm). All the teeth restored with glass fiber post (Rely X Fiber Post, 3M ESPE, USA) and a full zirconia crown. All the specimens were thermocycled and then loaded to failure at an oblique angle of 135°. Statistical analysis was performed for the effects of post length and abutment height on failure loads using ANOVA and Tukey's honestly significant difference test. In addition, corresponding FE models of a premolar restored with a glass fiber post were developed to examine mechanical responses. The factor of post length (P < 0.01) had a significant effect on failure load. The abutment height (P > 0.05) did not have a significant effect on failure load. The highest mean fracture resistance was recorded for the 15 mm post length and 5 mm abutment height test group, which was significantly more resistant to fracture than the 7.5 mm post and 5 mm abutment height group (P < 0.05). The FE analysis showed the peak compression and tension stress values of 7.5 mm post length were higher than that of 11 and 15 mm post length. The stress value of remaining tooth decreased as the post length was increased. Within the limitations of this experimental and FE analysis study, increasing the post length inside the root of endodontically treated premolar teeth restored with glass-fiber posts increase the fracture resistance to non-axial forces. Failure mode is more favorable with reduced abutment heights.

EPA-coated titanium implants promote osteoconduction in white New Zealand rabbits.

OBJECTIVES: To investigate the effect of eicosapentaenoic acid (EPA)-coated Ti implants on osteoconduction in white New Zealand rabbit mandibles. MATERIAL AND METHODS: Sandblasted and cleansed planar titanium specimens with a size of 5 × 5 × 1 mm were coated on one side with 0.25 vol% eicosapentaenoic acid (EPA). The other side of the specimens was kept highly polished (the control side). These specimens were inserted in rabbit mandibles. Twelve rabbits were randomly assigned into three study groups (n = 4). The rabbits were sacrificed at 4, 8, and 12 weeks. The harvested specimens with the implants were assessed for new bone formation on both sides of the implant using CBCT, conventional radiographs, and the biaxial pullout test. The results were statistically analyzed by a nonparametric Kruskal-Wallis test and Friedman's test as multiple comparisons and by Brunner-Langer nonparametric mixed model approach (R Software). RESULTS: A significant osteoconductive bone formation was found on the EPA-coated Ti implant surface (P < 0.05) at 8 weeks when compared to the polished surface (control). Biaxial pullout test results showed a significant difference (P < 0.05) after 8 and 12 weeks with a maximum force of 243.8 N, compared to 143.25 N after 4 week. CONCLUSION: EPA implant coating promoted osteoconduction on the Ti implant surfaces, enhancing the anchorage of the implant to the surrounding bone in white New Zealand rabbits.

The evaluation of prepared microgroove pattern by femtosecond laser on alumina-zirconia nano-composite for endosseous dental implant application.

Ceramic dental materials, especially alumina (20 %vol)-yttrium stabilized tetragonal zirconia poly crystal (A-Y-TZP20), have been considered as alternatives to metals for endosseous dental implant application. For increasing the bone-to-implant contact as well as the speed of bone formation, a new surface modification can be effective. The aim of this study was to design microgroove patterns by femtosecond laser on A-Y-TZP20 nano-composite disks for endosseous dental implant application. The phase composition and the morphology of the A-Y-TZP20 nano-composite samples were characterized using X-ray diffraction and Scanning electron microscopy equipped with energy dispersive X-ray spectroscopy techniques. Statistical analysis was submitted to Kolmogorov-Smirnov test and Student's t test for independent variables, with a 5 % significance level. EDAX analysis revealed a significant decrease in the relative content of contaminants like carbon (p < 0.05) in laser surface-treated group as compared to non surface-treated group. X-ray diffraction did not show any change in the crystalline structure induced by laser processing. It was concluded that the femtosecond laser is a clean and safe method for surface modification of A-Y-TZP20.

The Effect of Hydrofluoric Acid Etching Duration on the Surface Micromorphology, Roughness, and Wettability of Dental Ceramics.

The current laboratory study is evaluating the effect of hydrofluoric acid etching duration on the surface characteristics of five silica-based glass ceramics. Changes in the pore pattern, crystal structure, roughness, and wettability were compared and evaluated. Seventy-five rectangularly shaped specimens were cut from each material (IPS e-max™, Dentsply Celtra™, Vita Suprinity™, Vita mark II™, and Vita Suprinity FC™); the sectioned samples were finished, polished, and ultrasonically cleaned. Specimens were randomly assigned into study groups: control (no etching) and four experimental groups (20, 40, 80 and 160 s of etching). The etched surfaces' microstructure including crystal structure, pore pattern, pore depth, and pore width was studied under a scanning electron microscope, and the surface roughness and wettability were analyzed using a non-contact surface profilometer and a contact angle measuring device, respectively. The results were statistically analyzed using one-way analysis of variance (ANOVA) and the post hoc Tukey's test. The results showed a significant change in the pore number, pore pattern, crystal structure, surface roughness, and wettability with increased etching duration. Etching for a short time resulted in small pores, and etching for longer times resulted in wider, irregular grooves. A significant increase in the surface roughness and wettability was observed with an increase in the etching duration. The findings also suggested a strong association between the surface roughness and wettability.

Modifications in Glass Ionomer Cements: Nano-Sized Fillers and Bioactive Nanoceramics.

Glass ionomer cements (GICs) are being used for a wide range of applications in dentistry. In order to overcome the poor mechanical properties of glass ionomers, several modifications have been introduced to the conventional GICs. Nanotechnology involves the use of systems, modifications or materials the size of which is in the range of 1-100 nm. Nano-modification of conventional GICs and resin modified GICs (RMGICs) can be achieved by incorporation of nano-sized fillers to RMGICs, reducing the size of the glass particles, and introducing nano-sized bioceramics to the glass powder. Studies suggest that the commercially available nano-filled RMGIC does not hold any significant advantage over conventional RMGICs as far as the mechanical and bonding properties are concerned. Conversely, incorporation of nano-sized apatite crystals not only increases the mechanical properties of conventional GICs, but also can enhance fluoride release and bioactivity. By increasing the crystallinity of the set matrix, apatites can make the set cement chemically more stable, insoluble, and improve the bond strength with tooth structure. Increased fluoride release can also reduce and arrest secondary caries. However, due to a lack of long-term clinical studies, the use of nano-modified glass ionomers is still limited in daily clinical dentistry. In addition to the in vitro and in vivo studies, more randomized clinical trials are required to justify the use of these promising materials. The aim of this paper is to review the modification performed in GIC-based materials to improve their physicochemical properties.

Candida albicans aspects of novel silane system-coated titanium and zirconia implant surfaces.

OBJECTIVES: The aim of the present study was to evaluate the effect of novel silane system coatings on zirconia and titanium implant surfaces and the attachment of the fungal pathogen Candida albicans. MATERIALS AND METHODS: Titanium and zirconia specimens were silica-coated and silanized either with a commercial silane primer (RelyX Ceramic Primer™, 3M ESPE) or a novel silane system primer. The novel silane system primer was a blend of 1.0 vol% 3-acryloxypropyltrimethoxysilane and 0.3 vol% bis-1,2-(triethoxysilyl)ethane diluted in acidified ethanol-water solvent. The surface roughness (Ra ), the surface free energy and the chemical composition of substrate surfaces after treatments were evaluated. C. albcans biofilms were developed on silica-coated + silanized surfaces during 48 h of incubation time. Colony forming units (CFU) and real-time PCR (RT-PCR) quantified the cells on the material surfaces. Statistical analyses were carried out by 1-way ANOVA, Tukey post hoc and Games Howell post hoc test at 5% significance level (p). RESULTS: On zirconia and titanium surfaces, the Ra and the chemical composition of the specimens were equal (P < 0.05). The surface free energy was decreased on titanium specimens and increased on zirconia specimen after silanization. CFU of C. albicans was significantly lower on zirconia coated with RelyX Ceramic Primer™, (P < 0.001) and on titanium coated with both silanes (P = 0.002). RT-PCR revealed no differences between the mean quantities of C. albicans (P ≥ 0.067). CONCLUSION: Silica-coating and silanization had modified the titanium and zirconia surfaces significantly. Both the control and experimental silane primers might inhibit the biofilm formation of C. albicans.

Effect of Adhesive Resin Type for Bonding to Zirconia Using Two Surface Pretreatments.

PURPOSE: This laboratory study evaluated the short-term adhesive properties of one 10-MDP-containing and two MDP-free resin composite cements, using two types of zirconia surface pretreatments. MATERIALS AND METHODS: Eighteen sintered zirconia disks (Procera, Nobel Biocare) were randomly divided into three study groups according to their surface treatment: (a) polished surface (control group); (b) airborne-particle abraded (grit blasted) with 50-µm aluminum trioxide (APA); and (c) selective infiltration etching (SIE). The zirconia disks were then bonded to 180 pre-aged composite resin disks (0.9 mm×0.7 mm) using three different resin composite cements (Panavia F2.0, Esthetic, and Aegis). Resin-zirconia adhesion strength was evaluated using the microshear bond strength test (µSBS) after 24 h (baseline) and 2 weeks of storage in deionized water at 37°C. Three-way ANOVA, one-way ANOVA, and Scheffé's post-hoc tests were used to analyze the data (p=0.05). RESULTS: Surface treatments significantly influenced the µSBS (p<0.001). The highest mean µSBS values were recorded with the MDP-containing resin composite cement (Panavia F2.0) in both SIE (32.4±5.3 MPa) and APA (28.6±8.8 MPa) groups. Water storage significantly reduced the bond strength obtained with the MDP-free cements (Esthetic and Aegis) and in the control group, while the bond strength in SIE and APA groups using the 10- MDP-containing resin composite cement exhibited relatively unchanged values. CONCLUSION: SIE and APA in combination with the 10-MDP-containing resin composite cement established a strong, durable bond to zirconia substrates under short-term aging conditions. The cement containing amorphous calcium phosphate (Aegis) did not bond to zirconia surfaces. During the observation period, µSBS decreased significantly due to hydrolytic degradation, except when the 10-MDP-containing resin composite cement (Panavia F2.0) was used in the SIE and APA groups.

Effect of Solvents on Dentin Collagen Cross-linking Potential of Carbodiimide.

PURPOSE: This study compared the dentin collagen cross-linking potential of carbodiimide (EDC) prepared in three most commonly used solvents in dental adhesive systems: water, ethanol, and acetone. MATERIALS AND METHODS: Thirty-eight extracted caries-free human permanent molars were used in this study. Demineralized dentin beams were prepared and cross linked by 0.3 M EDC in water, acetone, or ethanol. The modulus of elasticity of demineralized dentin, the resistance of dentin matrix to enzymatic degradation, the swelling ratio, and the mass change of demineralized dentin matrix were examined to compare the cross-linking efficacy of EDC in their respective solvents. RESULTS: The modulus of elasticity of demineralized dentin cross linked by EDC in acetone was significantly higher (p < 0.05) than demineralized dentin cross linked by EDC in ethanol and EDC in water. Furthermore, the ultimate tensile strength of demineralized dentin cross linked by EDC in water and ethanol dropped significantly following enzymatic degradation, while the ultimate tensile strength of demineralized dentin cross linked by EDC in acetone was preserved. The swelling ratio of demineralized dentin cross linked by EDC in acetone and ethanol was significantly lower (p < 0.05) than that of demineralized dentin cross linked by EDC in water. Conversely, the mass change of demineralized dentin cross linked by EDC in acetone was significantly higher (p < 0.05) than demineralized dentin cross linked by EDC in water and EDC in ethanol. CONCLUSION: The dentin collagen cross-linking potential of EDC could be enhanced by using acetone as a solvent.

Structural stability of posterior retainer design for resin-bonded prostheses: a 3D finite element study.

The purpose of this in vitro study was to compare the stress distribution and natural frequency of different shape and thickness retainer designs for maxillary posterior resin-bonded prostheses using finite element (FE) method. A 3D FE model of a three unit posterior resin-bonded prosthesis analysis model was generated. Three different shaped retainer designs, viz. C-shaped (three axial surface wraparounds), D-shaped (three axial surface wraparounds with central groove) and O-shaped (360° wraparounds), and three different thicknesses, viz., 0.4, 0.8, and 1.2 mm, resin-bonded prostheses were used in this study. The resin-bonded prosthesis analysis model was imported into an FE analysis software (ANSYS 10.0, ANSYS, USA) and attribution of material properties. The nodes at the bottom surface of the roots were assigned fixed zero displacement in the three spatial dimensions. A simulated angle of 45° loading of a 100 N force was applied to the node of the pontic lingual cusp surface. The stress distributions and corresponding natural frequencies were analyzed and resolved. The C-shaped retainer for 0.4 mm thickness recorded the greatest von Mises stresses of 71.4 MPa for all three groups. C-shaped, D-shaped and O-shaped retainer presented natural frequencies 3,988, 7,754, and 10,494 Hz, respectively. D-shaped retainer and O-shaped retainer increased natural frequencies and structural rigidity over the traditional C-shaped retainer. The maximum von Mises stresses values of the remaining tooth and prosthesis decreased with greater retainer thickness. D-shaped retainer and O-shaped retainer increased natural frequencies and structural rigidity over the traditional C-shaped retainer.

Comparison of mechanical properties of three machinable ceramics with an experimental fluorophlogopite glass ceramic.

STATEMENT OF PROBLEM: Fluorophlogopite glass ceramic (FGC) is a biocompatible, etchable, and millable ceramic with fluoride releasing property. However, its mechanical properties and reliability compared with other machinable ceramics remain undetermined. PURPOSE: The purpose of this in vitro study was to compare the mechanical properties of 3 commercially available millable ceramic materials, IPS e.max CAD, Vitablocs Mark II, and Vita Enamic, with an experimental FGC. MATERIAL AND METHODS: Each type of ceramic block was sectioned into beams (n=15) of standard dimensions of 2×2×15 mm. Before mechanical testing, specimens of the IPS e.max CAD group were further fired for final crystallization. Flexural strength was determined by the 3-point bend test with a universal loading machine at a cross head speed of 1 mm/min. Hardness was determined with a hardness tester with 5 Vickers hardness indentations (n=5) using a 1.96 N load and a dwell time of 15 seconds. Selected surfaces were examined by scanning electron microscopy and energy-dispersive x-ray spectroscopy. Data were analyzed by the 1-way ANOVA test and Weibull analysis (α=.05). Weibull parameters, including the Weibull modulus (m) as well as the characteristic strength at 63.2% (η) and 10.0% (B10), were obtained. RESULTS: A significant difference in flexural strength (P<.001) was found among groups, with IPS e.max CAD (341.88 ±40.25 MPa)>Vita Enamic (145.95 ±12.65 MPa)>Vitablocs Mark II (106.67 ±18.50 MPa), and FGC (117.61 ±7.62 MPa). The Weibull modulus ranged from 6.93 to 18.34, with FGC showing the highest Weibull modulus among the 4 materials. The Weibull plot revealed that IPS e.max CAD>Vita Enamic>FGC>Vitablocs Mark II for the characteristic strength at both 63.2% (η) and 10.0% (B10). Significant difference in Vickers hardness among groups (P<.001) was found with IPS e.max CAD (731.63 ±30.64 H(V))>Vitablocs Mark II (594.74 ±25.22 H(V))>Vita Enamic (372.29 ±51.23 H(V))>FGC (153.74 ±23.62 H(V)). CONCLUSIONS: The flexural strength and Vickers hardness of IPS e.max CAD were significantly higher than those of the 3 materials tested. The FGC's flexural strength was comparable with Vitablocs Mark II. The FGC's Weibull modulus was the highest, while its Vickers hardness was the lowest among the materials tested.

Penetration depth of monomer systems into acrylic resin denture teeth used as pontics.

STATEMENT OF PROBLEM: The ways of softening and dissolving the surface of acrylic resin denture teeth need to be specified to obtain more durable prosthetic treatments that include resin denture teeth. PURPOSE: The purpose of this study was to analyze the penetration depth of 4 monomer systems applied during different exposure times on the acrylic resin denture teeth used as pontics of directly fabricated fiber-reinforced composite fixed dental prostheses. The penetration depth contributes to the adhesion of the tooth to the adhesive resin. MATERIAL AND METHODS: Ninety-six specimens were divided into 3 groups according to the acrylic resin denture tooth used: Artic 8 (Heraeus Kultzer), experimental tooth (GC), and Vitapan (Vita). Each group was divided into 4 subgroups according to the monomer system used: methylmethacrylate (99%), composite primer, a flowable composite resin, and a photopolymerizing dimethacrylate resin. The 4 monomer systems were labeled with rhodamine B to determine their penetration depth into the acrylic resin denture teeth. After exposure times of 1, 5, 15, and 60 minutes, the monomers were photopolymerized for 5 minutes, with the exception of methylmethacrylate. The specimens were cut orthogonally from gingival to occlusal in 4 slices (n=8/subgroup). The penetration depths of monomers were measured by a confocal scanning type microscope. Differences in the penetration depths were evaluated with ANOVA. RESULTS: ANOVA (R(2)=.699) revealed significant differences in the penetration depths according to the exposure times (P<.001), monomers (P<.001), brands used (P=.047), and their mutual interaction (P<.001). CONCLUSIONS: The ability of monomers to penetrate the surface of acrylic resin denture teeth was influenced by the monomer systems, which might improve the bond between the pontics and the fiber-reinforced composite frameworks of fixed dental prostheses.

Effect of surface treatments of zirconia ceramics on the bond strength to resin cement.

PURPOSE: The purpose of this in vitro study was to evaluate the bond strength of a resin luting cement to zirconia surfaces that had received two novel surface pretreatment methods: etching of a pre-fired overglaze or paste liner on the zirconia substrate. MATERIALS AND METHODS: Fully sintered zirconia disks were assigned to 6 groups according to the surface pretreatment: firing of 2 layers of paste liner which was then etched with hydrofluoric acid and treated with silane (Liner group); firing of 2 layers of overglaze which were then etched with hydrofluoric acid and treated with silane (glaze group); Rocatec treatment and silane application (Rocatec group); Rocatec treatment followed by ultrasonic cleaning and silanization (ultrasonic-Rocatec group); sandblasted with alumina (alumina group); as-sintered with no pretreatment (control group). Twenty composite resin cylinders were bonded to each group with Panavia F 2.0. Each group was further divided into 2 subgroups (n = 10) for 2 different storage conditions: 24 h water storage or 3 weeks water storage plus 6000 thermocycles between 5°C and 55°C. The shear bond strength was then determined. Statistical analyses with two-way ANOVA were conducted; the level of significance was set at p < 0.05. RESULTS: At 24 h, the shear bond strength values of all groups except the control showed no statistically significant difference. After artificial aging, the mean bond strength of all groups dropped, but the decrease in the glaze group was not statistically significant. The glaze group showed the highest shear bond strength. However, that was not statistically different from the liner or the Rocatec group without ultrasonic cleaning (p < 0.05). All the control specimens debonded spontaneously after aging. Ultrasonic cleaning after Rocatec treatment caused a reduction in shear bond strength, but the difference was not statistically significant. CONCLUSION: Both the fired paste liner and overglazed ceramic treated zirconia surfaces provided a strong and durable bond to resin cement under the conditions tested.

Fiber-reinforced composite fixed dental prostheses with various pontics.

PURPOSE: To evaluate the load-bearing capacities of fiber-reinforced composite (FRC) fixed dental prostheses (FDP) with pontics of various materials and thicknesses. MATERIALS AND METHODS: Inlay preparations for retaining FDPs were made in a polymer phantom model. Seventy-two FDPs with frameworks made of continuous unidirectional glass fibers (everStick C&B) were fabricated. Three different pontic materials were used: glass ceramics, polymer denture teeth, and composite resin. The FDPs were divided into 3 categories based on the occlusal thicknesses of the pontics (2.5 mm, 3.2 mm, and 4.0 mm). The framework's vertical positioning varied respectively. Each pontic material category contained 3 groups (n = 8/group). In group 1, pontics were fabricated conventionally with composite resin (G-ӕnial, GC) with one additional transversal fiber reinforcement. In group 2, the pontics were polymer denture teeth (Heraeus- Kulzer). Group 3 had an IPS-Empress CAD pontic (Ivoclar Vivadent) milled using a Cerec CAD/CAM unit. Groups 1 and 2 served as controls. Each FDP was statically loaded from the pontic until initial fracture (IF) and final fracture (FF). Initial-fracture data were collected from the load-deflection graph. RESULTS: ANOVA indicated statistically significant differences between the materials and occlusal thicknesses (p < 0.001). Quadratic analysis demonstrated the highest correlation between the thickness of the pontic and IF and FF values with ceramic pontics (IF: p < 0.001; R2 = 0.880; FF: p < 0.001; R2 = 0.953). CONCLUSION: By increasing the occlusal thickness of the pontic, the load-bearing capacity of the FRC FDPs may be increased. The highest load-bearing capacity was obtained with 4.0 mm thickness in the ceramic pontic. However, with thinner pontics, polymer denture teeth and composite pontics resulted in higher load-bearing values.

Comprehensive properties of a novel fiber reinforced composite with a UEDMA-based resin matrix.

The traditional fiber reinforced composite (FRC) contains bisphenol A glycidyl methacrylate (bis-GMA) in the resin matrix, which is thought to have some disadvantages. This research aimed at replacing bis-GMA with another monomer-urethane dimethacrylate (UEDMA), with the desired properties for dental use still retained. Four groups were prepared with light-curing (n = 30), one Control group with a bis-GMA-based resin matrix and three experimental groups with UEDMA-based matrices (Exper 1, Exper 2 and Exper 3 with a varying UEDMA weight percentage). Specimens were stored in dry conditions for 24 h or in deionized water for 1, 3, 6 or 12 months prior to the tests. Water sorption (n = 6), Vicker's hardness (n = 6) and flexural properties (n = 6) after each storage time were investigated. Scanning electron microscopy (SEM) images were taken at the fracture sites after 3-point bending. All the results were statistically analyzed (α = 0.05). The Exper 1 group exhibited the lowest weight increase after water storage among the experimental groups. As for dry conditions, 1- and 6-month storage, different resin matrix compositions made no significant difference to hardness, while for 3- and 12-month storage, "Control" possessed the highest hardness. The Control group's strength and modulus, Exper 1 and Exper 2's modulus were stable during water storage. Compared to other experimental groups, Exper 1 had the highest strength and modulus values with most of the storage times. SEM images showed relatively good adhesion between the fiber and the matrix. With all the tested properties considered, the Exper 1 group had superior performance among all the three experimental groups.

Acid etching of human enamel in clinical applications: a systematic review.

STATEMENT OF PROBLEM: The laboratory-based enamel acid-etching doctrine with 30% to 50% phosphoric acid for 60 seconds to generate the maximum amount of Type 1 and/or Type 2 etch pattern has been established for more than 30 years. However, this recommendation may not be clinically relevant. PURPOSE: The purpose of this systematic review was to compare clinically accepted protocols of enamel acid etching with the laboratory protocol. MATERIAL AND METHODS: Studies were identified by searching 4 electronic databases: Medline, CINAHL Plus, Embase, and Cochrane Library. The final search was run on November 8, 2012. All clinical studies published in English that investigated enamel acid pretreatment methods on human permanent teeth were included. Additional publications were obtained from the reference lists of the included studies. The clinical evidence of all included studies was tabulated. RESULTS: Initially, 4543 publications were retrieved from the databases. A total of 4508 articles were excluded, including 2285 duplicates, 1805 publications according to exclusion criteria by their titles and abstracts, 368 laboratory articles, 49 reviews, and 1 pilot study. Only 1 study was added from reference lists of the included studies. Finally, 36 clinical publications were included. The included clinical studies provided different levels of clinical evidence on the efficacy of acid-etching protocols to enable successful enamel adhesion. CONCLUSIONS: Clinical protocols of enamel acid etching differ from the laboratory-generated doctrine, which may imply that maximization of the Type 1 and/or Type 2 etch pattern is not important in the clinical acid etching of human enamel.