Comparison of fracture strength, surface hardness, and color stain of conventionally fabricated, 3D printed, and CAD-CAM milled interim prosthodontic materials after thermocycling.

PURPOSE: The purpose of this in vitro study was to investigate the fracture resistance, surface hardness, and color stain of 3D printed, CAD-CAM milled, and conventional interim materials. MATERIALS AND METHODS: A total of 80 specimens were fabricated from auto polymerizing polymethyl methacrylate (PMMA), bis-acryl composite resin, CAD-CAM polymethyl methacrylate resin (milled), and 3D printed composite resin (printed) (n = 20). Forty of them were crown-shaped, on which fracture strength test was performed (n = 10). The others were disc-shaped specimens (10 mm × 2 mm) and divided into two groups for surface hardness and color stainability tests before and after thermal cycling in coffee solution (n = 10). Color parameters were measured with a spectrophotometer before and after each storage period, and color differences (CIEDE2000 [DE00]) were calculated. The distribution of variables was measured with the Kolmogorov Smirnov test, and one-way analysis of variance (ANOVA), Tukey HSD, Kruskal-Wallis, Mann-Whitney U tests were used in the analysis of quantitative independent data. Paired sample t-test was used in the analysis of dependent quantitative data (P < .05). RESULTS: The highest crown fracture resistance values were determined for the 3D printed composite resin (P < .05), and the lowest were observed in the bis-acryl composite resin (P < .05). Before and after thermal cycling, increase in mean hardness values were observed only in 3D printed composite resin (P < .05) and the highest ΔE00 value were observed in PMMA resin for all materials (P < .05). CONCLUSION: 3D printing and CAD-CAM milled interim materials showed better fracture strength. After the coffee thermal cycle, the highest surface hardness value was again found in 3D printing and CAD-CAM milled interim samples and the color change of the bis-acryl resin-based samples and the additive production technique was higher than the PMMA resin and CAD-CAM milled resin samples.

Salivary opiorphin levels in denture-related traumatic ulcers.

OBJECTIVE: Opiorphin is a pentapeptide secreted in saliva and has a strong analgesic effect. Salivary opiorphin has been shown to increase in orofacial pain and may act as a pain reliever in pain caused by denture-related ulcers. The current study aimed to evaluate the salivary opiorphin levels in traumatic ulcers caused by ill-fitting dentures and demonstrate whether there is any correlation between trauma-related pain levels and salivary opiorphin levels. MATERIALS AND METHODS: Twenty-two individuals with new full dentures and a complaint of pain due to ill-fitting were included in this study. Patients were asked to rate their level of pain on a visual analog scale (VAS). Then, saliva specimens were collected at the first visit with the complaint of pain and 7 days following the denture adjustment. RESULTS: The average saliva opiorphin level before and after denture adjustment were 19.29 ± 5.44 and 15.78 ± 3.95 ng/mL, respectively. A dependent (paired) t-test determined that the mean salivary opiorphin level differed statistically significantly before and after the adjustment of the dentures. CONCLUSIONS: The findings show that salivary opiorphin levels increase in pain associated with denture-related traumatic ulcers. Adjusting the dentures resulted in pain relief and a statistically significant reduction in opiorphin levels.

Finite Element Analysis of Stress Distribution in Root Canals When Using a Variety of Post Systems Instrumented with Different Rotary Systems.

It is very important for clinicians to provide restorative treatments that provide durability for endodontically treated teeth. Trauma, occlusal premature contact, and features of teeth are some of the issues that can cause vertical root fractures (VRFs) in root canal-treated teeth. The aim of this 3-D study was to compare stress distribution on mandibular premolar teeth when using a variety of post designs instrumented with different rotary systems. Six mandibular premolar teeth were instrumented with the following tools: ProTaper Next, WaveOne (WO), Reciproc (R), ReciprocBlue (RB), F6-Skytaper, and TF-Adaptive. Teeth were scanned using cone beam computed tomography (CBCT) and the images were transferred to the Catia V5R25 software. Data were recorded in a stereolithography (STL) format. Four different post systems were used, fabricated from metal, fiber, zirconia, and titanium, respectively. Dentin, gutta, post, core, and crown models were added to the solid model. ANSYS V17.2 finite element analysis (FEA) software was used to determine stress distribution on each assembly. Finite analysis models were created that allowed for the calculation of stress distribution of 250-N loading at a 45° angle and vertical in relation to the roots. The maximum principal stress and von Mises values were higher under oblique loading on the roots. The F6-Skytaper and WO systems showed lower stress than other systems. The TF-Adaptive instrument showed higher stress distribution than the other models. Fiber and titanium posts showed lower stress than others. The F6-Skytaper, R, and RB instruments were found to be most effective in terms of displacement of the crown, resulting in the lowest stress values. Fiber and titanium posts showed better results than other post systems, while root canals instrumented with the F6-Skytaper and WO instruments were less likely to result in root fractures.

Shear bond strength of a self-adhesive resin cement to dentin surface treated with Nd:YAG and femtosecond lasers.

This study aims to evaluate the effect of Nd:YAG and femtosecond lasers irradiation on the shear bond strength (SBS) of a self-adhesive resin cement to the human dentin surface. One hundred extracted third molar teeth were randomly divided into 10 experimental groups according to dentin surface treatments; with and without the bonding agent, Nd:YAG 302 J/cm2 and 440 J/cm2, femtosecond 4 J/cm2 and 7 J/cm2, and control groups were prepared. After surface treatments, a self-adhesive resin cement was luted by using a bonding jig (Ultradent Products Inc.). The specimens were then subjected to shear test at a crosshead speed of 0.5 mm/min, and failure loads were recorded as megapascal (MPa). Two-way analysis of variance and Tukey HSD tests were performed (p Ë‚ 0.05). Representative specimens from each experimental subgroup were examined by means of SEM. The highest SBS values were obtained in Group 302 J/cm2 Nd:YAG with bonding agent, and there is no statistical difference between Group 440 J/cm2 Nd:YAG with bonding and Group 7 J/cm2 femtosecond with bonding (p > 0.05). The lowest SBS values were observed in Group control without bonding agent. Nd:YAG and femtosecond laser treatments improved the adhesion between the dentin surface and the self-adhesive resin cement.

Silicon nitride ceramic for all-ceramic dental restorations.

Silicon nitride (Si3N4) is one of the promising ceramics for dental restoration due to providing significant benefits during the application. This study aimed to investigate the potential use of Si3N4 for all-ceramic dental restorations by characterizing some critical properties as color shade, mechanical resistance, shear-bond strength and radiolucency. For our study, porous Si3N4 ceramic was produced by partial sintering process with limited amounts of sintering additives and low temperature. A commercial ZrO2 ceramic was prepared according to manufacturer's instructions and results were compared with Si3N4. Si3N4 is an attractive ceramic for dental applications with good mechanical properties even in porous form, it has additional advantages over the conventional ceramics used as restorative material, such as, inherent antibacterial/anti-infective activity, radiolucency, and lower hardness. It is expected that Si3N4 will become popular in dental applications as well.

Accelerated Calcium Phosphate Mineralization by Peptides with Adjacent Oppositely Charged Residues.

Calcium phosphate mineralizing peptides are of special importance for dental and orthopedic applications, such as caries remineralization and improved osteointegration. Uncovering the mechanism of action for such peptides is an ongoing challenge with the aim of a better fundamental understanding of biomineralization processes and developing optimized peptides for clinical use. It has recently been reported that "adjacent oppositely charged residue" motifs are found abundantly in cation binding, inorganic surface binding, or biomineralization-related proteins and may play a key role in the biomineralization events. Despite their medical importance, the role of these motifs has not yet been investigated on calcium phosphate mineral systems. To investigate this, we have designed peptides with different structural properties and different numbers of adjacent oppositely charged residues. We have evaluated their effects on in vitro calcium phosphate mineralization kinetics and mineral properties. The kinetics of the mineralization increased proportionally with an increasing number of adjacent oppositely charged residues. Two peptides with relatively high structural stability and two adjacent oppositely charged residues resulted in faster mineralization and more crystalline mineral compared to a peptide with a higher structural degree of freedom that contained only acidic residues. The fastest mineralization and the highest mineral crystallinity were obtained with a peptide containing the highest number of adjacent oppositely charged residues and highest structural degree of freedom. Our findings and observations from previously identified natural or designed peptides indicate that, in addition to structural instability, adjacent oppositely charged residues play a role in the cation binding, inorganic surface binding, and biomineralization of peptides and require further investigation. Lastly, the peptide identified in this study is an agent with potential medical applications involving the treatment of mineralized tissues.

Evaluation of Stress Distribution on Mandibular Implant-Supported Overdentures With Different Bone Heights and Attachment Types: A 3D Finite Element Analysis.

The biomechanical behavior of the edentulous mandible with bone irregularities that has been rehabilitated with implant-supported overdentures has become an important factor for treatment planning. Restorative options, including dental implants with various attachments, affect the stress distribution. The purpose of this study was to evaluate the stress distribution of cortical bone around the implant neck and implant structures in overdentures with two different attachment types at the edentulous mandible and with different bone heights using three-dimensional finite element analysis. Five three-dimensional models of an edentulous mandible were designed and implemented. Ten models were constructed with ball and locator attachments. Static bilateral and unilateral vertical and oblique occlusal loads with magnitudes of 100 N were applied to the overdentures. The principal stresses were higher in the presence of oblique loads compared to vertical loads in all the analyzed models. Maximum principal stresses were observed around the mesial side of the contralateral implant, and the minimum principal stresses were noted around the distal side of ipsilateral implant during unilateral vertical loading. These patterns were reversed during oblique loadings. The ball attachment models yielded lower von Mises stress values than the locator models at all the loading conditions, while the stress distributions were similar in the models with the same and different bone levels. Correspondingly, bone corrections due to irregularities may not be necessary in terms of biomechanics. The results of this study may provide clinicians a better understanding for the mandibular overdenture design in the cases at which different bone heights exist.

Salivary opiorphin in dental pain: A potential biomarker for dental disease.

OBJECTIVES: Opiorphin is a recently discovered peptide shown to inhibit the enkephalin-degrading enzymes and prolong the effects of enkephalins. Although opiorphin is found in high concentrations in saliva, the relationship between salivary opiorphin and orofacial pains is not yet fully understood. We aimed to determine salivary opiorphin concentrations in dental pain related to symptomatic irreversible pulpitis (SIP), and symptomatic apical periodontitis (SAP). DESIGN: 39 patients participated in this study. The participants were categorized into SIP and SAP based on their diagnosis. All the patients were treated with root canal treatment. Saliva specimens were collected, and pain levels were recorded at pre-treatment, 7 days post-treatment and 30 days post-treatment. Saliva opiorphin levels were measured using a commercially available ELISA kit. Pre-treatment and post-treatment opiorphin levels were evaluated using repeated measures ANOVA. Correlations between VAS scores, opiorphin levels and age were evaluated using Spearman's Rank Correlation. RESULTS: The average saliva opiorphin level pre-treatment, 7 days post-treatment and 30 days post-treatment were 31.28 ± 7.10 ng/ml, 20.41 ± 2.67 ng/ml and 18.61 ± 2.05 ng/ml respectively. Significantly higher pre-treatment opiorphin levels were observed in the SIP group compared to the SAP group. A strong correlation was observed between the pre-treatment pain levels and the saliva opiorphin concentrations. CONCLUSIONS: Our findings indicate that saliva opiorphin levels increase in inflammation related dental pain. The level of salivary opiorphin is strongly correlated with the reported level of pain. The extent of the inflammation (pulpal vs. periodontal) also affects the opiorphin level.