Three-Dimensional Printed Teeth in Endodontics: A New Protocol for Microcomputed Tomography Studies.

This study aimed to describe a support material removal protocol (SMRP) from inside the root canals of three-dimensional printed teeth (3DPT) obtained by the microcomputed tomography (microCT) of a natural tooth (NT), evaluate its effectiveness by comparing the 3DPT to NT in terms of internal anatomy and behaviour toward endodontic preparation, and evaluate if 3DPT are adequate to assess the differences between two preparation systems. After the SMRP, twenty 3DPT printed by PolyJet™ were microCT scanned before preparation and thereafter randomly assigned into two groups (n = 10). One group and NT were prepared using ProTaper Gold® (PTG), and the other group with Endogal® (ENDG). MicroCT scans were carried out after preparation, and the volume increase, volume of dentin removed, centroids, transportation, and unprepared areas were compared. For the parameters evaluated, no significant differences were found between the 3DPT and NT before and after preparation (p > 0.05), and no significant differences were found between the 3DPT PTG group and the 3DPT ENDG group (p > 0.05). It can be concluded that the SMRP described is effective in removing the support material SUP706B™. PolyJet™ is adequate for printing 3DPT. Furthermore, 3DPT printed with high-temperature RGD525™ have similar behaviour during endodontic preparation with PTG as the NT, and 3DPT can be used to compare two preparation systems.

Comparison between digital superimposition and microcomputed tomography methods of fit assessment of removable partial denture frameworks.

STATEMENT OF PROBLEM: The fit of removable partial denture frameworks should be assessed to optimize clinical adaptation. Potential discrepancies between framework and supporting structures are typically precisely measured with negative subtracts and high-resolution equipment. The growth of computer-aided engineering technology allows the development of new methods for the direct evaluation of discrepancies. However, how the methods compare is unclear. PURPOSE: The purpose of this in vitro study was to compare 2 digital methods of fit assessment based on direct digital superimposition and microcomputed tomography indirect analysis. MATERIAL AND METHODS: Twelve cobalt chromium removable partial denture frameworks were fabricated by conventional lost-wax casting or additive manufacturing techniques. The thickness of the gap between occlusal rests and respective definitive cast rest seats (n=34) was evaluated by using 2 different digital methods. Silicone elastomer impressions of the gaps were obtained, and microcomputed tomography measurements were used as controls for validation purposes. Digitization of the framework, the respective definitive cast, and the combination was followed by digital superimposition and direct measurements with the Geomagic Control X software program. Because normality and homogeneity of variance were not verified (Shapiro-Wilk and Levene tests, P<.05), the data were analyzed with Wilcoxon signed rank and Spearman correlation tests (α=.05). RESULTS: The thicknesses measured by microcomputed tomography (median=242 µm) and digital superimposition (median=236 µm) did not reveal statistically significant differences (P=.180). A positive correlation (ρ=0.612) was detected between the 2 methods of assessing fit. CONCLUSIONS: The frameworks presented median gap thicknesses under the limit of clinical acceptability without differences between the proposed methods. The digital superimposition method was determined to be as acceptable as the high-resolution microcomputed tomography method for assessing removable partial denture framework fit.

A 3D-Printed Ceramics Innovative Firing Technique: A Numerical and Experimental Study.

Additive manufacturing (AM), also known as three-dimensional (3D) printing, allows the fabrication of complex parts, which are impossible or very expensive to produce using traditional processes. That is the case for dinnerware and artworks (stoneware, porcelain and clay-based products). After the piece is formed, the greenware is fired at high temperatures so that these pieces gain its mechanical strength and aesthetics. The conventional (gas or resistive heating elements) firing usually requires long heating cycles, presently requiring around 10 h to reach temperatures as high as 1200 °C. Searching for faster processes, 3D-printed stoneware were fired using microwave (MW) radiation. The pieces were fired within 10% of the conventional processing time. The temperature were controlled using a pyrometer and monitored using Process Temperature Control Rings (PTCRs). An error of 1.25% was calculated between the PTCR (1207 ± 15 °C) and the pyrometer (1200 °C). Microwave-fast-fired pieces show similar mechanical strength to the references and to the electrically fast-fired pieces (41, 46 and 34 (N/mm2), respectively), presenting aesthetic features closer to the reference. Total porosities of ~4%, ~5% and ~9% were determined for microwave, electrically fast-fired and reference samples. Numerical studies have shown to be essential to better understand and improve the firing process using microwave radiation. In summary, microwave heating can be employed as an alternative to stoneware conventional firing methods, not compromising the quality and features of the processed pieces, and with gains in the heating time.

Development of a chlorhexidine delivery system based on dental reline acrylic resins.

The high recurrence rate of common denture stomatitis after antifungal treatment is still concerning. This condition is caused by low patient compliance and incomplete local elimination of the main etiological factor - Candida albicans, often associated with other microorganisms, such as Streptococcus species. Impregnating denture materials with antimicrobials for local delivery is a strategy that can overcome the side effects and improve the efficacy of conventional treatments (topical and/or systemic). In this work, we describe the development of three hard autopolymerizing reline acrylic resins (Kooliner, Ufi Gel Hard, and Probase Cold) loaded with different percentages of chlorhexidine (CHX). The novel formulations were characterized based on their antimicrobial activity, mechanical, morphological and surface properties, in-vitro drug release profiles, and cytotoxicity. The addition of CHX in all resins did not change their chemical and mechanical structure. Among all the tested formulations, Probase Cold loaded with 5 wt% CHX showed the most promising results in terms of antimicrobial activity and lack of serious detrimental mechanical, morphological, surface, and biological properties.

Assessment of 3D-Printed Polycaprolactone, Hydroxyapatite Nanoparticles and Diacrylate Poly(ethylene glycol) Scaffolds for Bone Regeneration.

Notwithstanding the advances achieved in the last decades in the field of synthetic bone substitutes, the development of biodegradable 3D-printed scaffolds with ideal mechanical and biological properties remains an unattained challenge. In the present work, a new approach to produce synthetic bone grafts that mimic complex bone structure is explored. For the first time, three scaffolds of various composition, namely polycaprolactone (PCL), PCL/hydroxyapatite nanoparticles (HANp) and PCL/HANp/diacrylate poly(ethylene glycol) (PEGDA), were manufactured by extrusion. Following the production and characterisation of the scaffolds, an in vitro evaluation was carried out using human dental pulp stem/stromal cells (hDPSCs). Through the findings, it was possible to conclude that, in all groups, the scaffolds were successfully produced presenting networks of interconnected channels, adequate porosity for migration and proliferation of osteoblasts (approximately 50%). Furthermore, according to the in vitro analysis, all groups were considered non-cytotoxic in contact with the cells. Nevertheless, the group with PEGDA revealed hydrophilic properties (15.15° ± 4.06) and adequate mechanical performance (10.41 MPa ± 0.934) and demonstrated significantly higher cell viability than the other groups analysed. The scaffolds with PEGDA suggested an increase in cell adhesion and proliferation, thus are more appropriate for bone regeneration. To conclude, findings in this study demonstrated that PCL, HANp and PEGDA scaffolds may have promising effects on bone regeneration and might open new insights for 3D tissue substitutes.

3D-Printed Teeth in Endodontics: Why, How, Problems and Future-A Narrative Review.

Three-dimensional printing offers possibilities for the development of new models in endodontics. Numerous studies have used 3D-printed teeth; however, protocols for the standardization of studies still need to be developed. Another problem with 3D-printed teeth is the different areas of literature requested to understand the processes. This review aims to gather evidence about 3D-printed teeth on the following aspects: (1) why they are advantageous; (2) how they are manufactured; (3) problems they present; and (4) future research topics. Natural teeth are still the standard practice in ex vivo studies and pre-clinical courses, but they have several drawbacks. Printed teeth may overcome all limitations of natural teeth. Printing technology relies on 3D data and post-processing tools to form a 3D model, ultimately generating a prototype using 3D printers. The major concerns with 3D-printed teeth are the resin hardness and printing accuracy of the canal anatomy. Guidance is presented for future studies to solve the problems of 3D-printed teeth and develop well-established protocols, for the standardization of methods to be achieved. In the future, 3D-printed teeth have the possibility to become the gold standard in ex vivo studies and endodontic training.

3D-printed multisampling holder for microcomputed tomography applied to life and materials science research.

The aim of this work was to design, fabricate, test and validate a 3D-printed multisampling holder for multi-analysis by microcomputed tomography. Different raw materials were scanned by microcomputed tomography. The raw material chosen was used to fabricate the holder by 3D printing. To validate the multisampling holder, five teeth were filled with a high density-material and scanned in two ways: a single and a multisampling scan mode. For each tooth, the root canal filling volume, porosity volume, closed pore volume, and open pore volume were calculated and compared when the same tooth was scanned in the two sampling scan mode. ABSplus P430™ allowed a high transmission value (84.3 %), and then it was the polymeric material selected to fabricate the holder. In a single sampling scan mode, the scan duration for scanning five teeth was 87.42 min, contrasting with 21.51 min for a multisampling scan mode, which scanned five teeth at the same time. The scan duration time and the cost using a multisampling holder represented a reduction of 75 % and the data volume generated represented a reduction of 60 %. Comparing the two scan modes, the results also showed that the difference of root canal filling volume, porosity volume, closed pore volume, and open pore volume was not statistically significant (p > .05). The multisampling holder was validated to do multi-analysis by microcomputed tomography without significant loss of quantitative accuracy data, allowing a reduction in scan duration time, imaging cost, and data storage.

Recuperação física da lesão músculo-esquelética do atleta de futebol: Vivências e intervenções / Physical recovery from musculoskeletal injury in soccer athletes: Experiences and interventions

A lesão músculo-esquelética é uma situação limitadora das atividades de vida diárias do atleta de futebol, exigindo mudança e adaptação nos vários sistemas humanos. Desta forma, a adesão do atleta à recuperação, restabelecendo a sua funcionalidade, possui um elevado interesse para a enfermagem e em particular para a enfermagem de reabilitação. O presente estudo tem como objetivo identificar as vivências do atleta de futebol em recuperação da lesão músculo-esquelética. É de natureza qualitativa, com abordagem fenomenológica descritiva. A colheita de informação foi realizada através de entrevista semiestruturada a dez atletas de futebol que reuniam os critérios de inclusão. Para a análise e interpretação das informações recorreu-se ao método de Colaizzi. Através das declarações dos participantes emergiram seis temas: ocorrência de lesão, paragem de competição, procura de ajuda da equipa de saúde, recuperação, limitações e sugestões. As vivências do atleta com lesão músculo-esquelética com paragem da competição abrangem diversas dimensões. Os participantes referiram que a lesão foi devida a si, vivenciando-a como um obstáculo à concretização dos seus objetivos e expetativas desportivas, e ?impedimento? da sua afirmação desportiva, conduzindo à expressão de sentimentos de insatisfação e desvalorização pessoal, com consequente perda da autoconfiança e de motivação. No final considera-se a necessidade de implementar intervenções promotoras da adesão do atleta ao processo de recuperação, sendo indicadas várias intervenções integrando uma visão holística do atleta, atendendo às suas vivências e respostas emocionais, para uma melhor recuperação.

Fabrication of Poly(ε-caprolactone) Scaffolds Reinforced with Cellulose Nanofibers, with and without the Addition of Hydroxyapatite Nanoparticles.

Biomaterial properties and controlled architecture of scaffolds are essential features to provide an adequate biological and mechanical support for tissue regeneration, mimicking the ingrowth tissues. In this study, a bioextrusion system was used to produce 3D biodegradable scaffolds with controlled architecture, comprising three types of constructs: (i) poly(ε-caprolactone) (PCL) matrix as reference; (ii) PCL-based matrix reinforced with cellulose nanofibers (CNF); and (iii) PCL-based matrix reinforced with CNF and hydroxyapatite nanoparticles (HANP). The effect of the addition and/or combination of CNF and HANP into the polymeric matrix of PCL was investigated, with the effects of the biomaterial composition on the constructs (morphological, thermal, and mechanical performances) being analysed. Scaffolds were produced using a single lay-down pattern of 0/90°, with the same processing parameters among all constructs being assured. The performed morphological analyses showed a satisfactory distribution of CNF within the polymer matrix and high reliability was obtained among the produced scaffolds. Significant effects on surface wettability and thermal properties were observed, among scaffolds. Regarding the mechanical properties, higher scaffold stiffness in the reinforced scaffolds was obtained. Results from the cytotoxicity assay suggest that all the composite scaffolds presented good biocompatibility. The results of this first study on cellulose and hydroxyapatite reinforced constructs with controlled architecture clearly demonstrate the potential of these 3D composite constructs for cell cultivation with enhanced mechanical properties.

Spreading of HIV-1 subtype G and envB/gagG recombinant strains among injecting drug users in Lisbon, Portugal.

We have evaluated the genetic diversity of HIV-1 strains infecting injecting drug users (IDUs) in Lisbon, Portugal. Heteroduplex mobility assay and/or phylogenetic analysis revealed that env (C2V3C3 or gp41) subtype B is present in 63.7% of the 135 viral samples studied, followed by subtypes G (23.7%), A (6.7%), F (5.2%), and D (0.7%). Similar analysis of gag (p24/p7) performed on 91 of the specimens demonstrated that 49.5% of the infections were caused by subtype G viruses; other gag subtypes identified were B (39.5%), F (3.3%), A and D (1.1.% each), and the recombinant circulating form CRF02_AG (5.5%). Discordant env/gag sub-types were detected in 34.1% of the strains and may reflect the presence of dual infections and/or recombinant viruses. The presumptive B/G recombinant form was highly predominant (21 of 31). The genetic pattern of HIV-1 subtype B and G strains is suggestive of multiple introductions and recombination episodes and of a longstanding presence of both subtypes in the country. C2V3C3 amino acid sequences from IDU-derived subtype G viruses presented highly significant signatures, which distinguish the variants from this transmission group. The unusually high prevalence of subtype G sequences (34.1%), independent of the geographic origin of the infected individuals, makes this IDU HIV-1 epidemic unique.

Molecular epidemiology of HIV type 1 infection in Portugal: high prevalence of non-B subtypes.

In this study, we have investigated the diversity of current HIV-1 strains circulating in the metropolitan area of Lisbon, Portugal. A total of 217 HIV-1-positive blood samples, collected between October 1998 and December 2000, was genetically characterized in the gp120 C2V3C3 region (n = 205) or part of the gp41 N-terminal segment (n = 12) by heteroduplex mobility assay (HMA) and/or DNA sequencing. The HMA subtyping efficiency (number of samples unambiguously subtyped by HMA divided by the total number of samples subtyped) was 65.9% (143 of 217), with indeterminate migration patterns of subtype A and G strains contributing significantly to this value. On the overall, subtype B was the most prevalent (50.2%), followed by subtypes G (21.7%), A (17.5%), and F (5.5%), whereas subtypes C, D, H, and J accounted altogether for 5.1% of the infections. Non-B subtypes were responsible for 77.4 and 33.1% of the infections among African immigrants and Portuguese subjects, respectively. Angolan individuals (n = 25) were the only ones infected with all the HIV-1 subtypes documented, probably reflecting a high degree of viral genetic diversification in their country of origin. Phylogenetic analysis showed a predominance of IbNG-like viruses among subtype A sequences and two new major subclusters within subtype G (G(P) and G(P)'). The majority of the Portuguese G sequences described formed a well-defined subcluster (G(P)), supported by bootstrap values >90%, phylogenetically distant from clade G sequences in databases. gag (p24/p7) sequence analysis of these variants confirmed the maintenance of the subtype G subclusters. The multiple subclustering observed for the major clades A, B, D, and G, as well as the variety of subtypes found, indicate a high diversity of HIV-1 variants circulating in Portugal and suggest a need for continuous epidemiologic surveillance.