Effect of incisal preparation design on the fracture strength of monolithic zirconia-reinforced lithium silicate laminate veneers.

PURPOSE: This study aimed to assess the fracture resistance of monolithic zirconia-reinforced lithium silicate laminate veneers (LVs) fabricated on various incisal preparation designs. MATERIALS AND METHODS: Sixty maxillary central incisors with various preparation designs were 3D-printed, 15 each, including preparation for: (1) LV with feathered-edge design; (2) LV with butt-joint design; (3) LV with palatal chamfer; and (4) full-coverage crown. Restorations were then designed and manufactured from zirconia-reinforced lithium silicate (ZLS) following the contour of a pre-operation scan. Restorations were bonded to the assigned preparation using resin cement and following the manufacturer's instructions. Specimens were then subjected to 10,000 thermocycles at 5 to 55°C with a dwell time of 30 s. The fracture strength of specimens was then assessed using a universal testing machine at a crosshead speed of 1.0 mm/min. One-way ANOVA and Bonferroni correction multiple comparisons were used to assess the fracture strength differences between the test groups (α = 0.001). Descriptive fractographic analysis of specimens was carried out with scanning electron microscopy images. RESULTS: Complete coverage crown and LV with palatal chamfer design had the highest fracture resistance values (781.4 ± 151.4 and 618.2 ± 112.6 N, respectively). Single crown and LV with palatal chamfer had no significant difference in fracture strength (p > 05). LV with feathered-edge and butt-joint designs provided significantly (p < 05) lower fracture resistance than complete coverage crown and LV with palatal chamfer design. CONCLUSION: The fracture resistance of chairside milled ZLS veneers was significantly influenced by the incisal preparation designs tested. Within the limitation of this study, when excessive occlusal forces are expected, LV with palatal chamfer display is the most conservative method of fabricating an indirect restoration.

An in vitro study using confocal laser scanning microscopy to evaluate the marginal misfits of different implant-supported frameworks.

PURPOSE: This study aimed to develop and evaluate a simple, non-destructive method for assessing the misfit and passivity of implant-retained prostheses frameworks. MATERIALS AND METHODS: To simulate the rehabilitation of a mandible posterior partially edentulous area using 3-unit screw-retained frameworks supported by two implants were fabricated and divided into the following five groups (n = 10 in each group): OP = one-piece framework cast in Co-Cr with the conventional method (control-group); Co-Cr frameworks sectioned and welded by laser (=LAS) or tungsten inert gas (=TIG); Co-Cr CAD-CAM = milled Co-Cr framework; Zir CAD-CAM = milled zirconia framework. The horizontal |X| and vertical |Y| misfits were measured using confocal laser scanning microscopy with one or both screws tightened. Data were analyzed by a two-way ANOVA with repeated measures and Bonferroni correction (α = 0.05). RESULTS: The greatest |X| misfit was observed in the OP group with both screws tightened (290 µm) and one screw tightened (388 and 340 µm). The conventional casting groups sectioned and welded by laser or TIG had lower mean values (235.35 µm, both screws tightened; and 275 µm, one screw tightened) than the OP framework. However, these values still exceeded those of the milled Co-Cr and zirconia frameworks (190 and 216 µm with both screws tightened). Across all reading conditions, every framework subjected to testing consistently maintained vertical |Y| misfit levels below the threshold of 53 µm; however, the milled frameworks exhibited higher vertical misfits than the frameworks obtained by the conventional cast method. CONCLUSIONS: The frameworks, whether cast and sectioned with laser welding or milled from Co-Cr, exhibit improved marginal misfit and enhanced passive fit when compared to other fabrication methods. Additionally, the use of confocal laser scanning microscopy is highly effective for passivity and misfit analysis.

Traditional versus conservative endodontic access impact on fracture resistance of chairside CAD-CAM lithium disilicate anterior crowns: An in vitro study.

PURPOSE: To evaluate the effect of traditional and conservative endodontic access hole preparation on fracture resistance of chairside computer-aided design and computer-aided manufacturing (CAD-CAM) lithium disilicate maxillary right central incisor crowns. MATERIALS AND METHODS: Fifty-seven milled lithium disilicate maxillary right central incisor crowns were designed and fabricated with a chairside CAD-CAM system (Planmeca Romexis, Planmeca). The abutment preparation had a 1.0 mm incisal reduction and 1.0 mm chamfer finish. The restorations were bonded with resin cement to printed resin dies (n = 19 per group) and were treated and divided into three groups, (1) no endodontic access, (2) traditional triangular endodontic access, and (3) conservative ovoidal endodontic access. The endodontic access of the crowns was sealed with flowable resin composite. Restorations were subjected to 10,000 cycles of thermal cycling between 5° and 55°C. Then, restorations were loaded and exposed to compressive loading force, and the crack initiation (CI) and complete fracture (CF) were recorded. SEM micrographs of broken specimens on the printed dies were captured. ANOVA test and Bonferroni's correction were used for statistical comparison. RESULTS: The fracture resistance among the three groups varied. Crowns with no endodontic access displayed significantly (p < 0.001) higher resistance [CI: 1025 (121) N; CF 1134 (127) N], followed by crowns with conservative ovoidal endodontic access [CI: 924 (60) N; CF: 1000 (72) N. Crowns with traditional triangular endodontic access showed the significantly (p < 0.001) lowest fracture resistance [CI: 635 (82) N; CF: 709 (75) N]. CONCLUSION: The fracture resistance of chairside CAD-CAM lithium disilicate maxillary anterior crowns is influenced by the type of endodontic access provided. Conservative ovoidal endodontic access provides crowns with higher fracture resistance than traditional triangular endodontic access. Crowns with no endodontic access provided the highest resistance than other types of endodontic access.

Ceramic versus Composite Resin Polishing Systems on the Surface Roughness of Milled Leucite-Reinforced Ceramics.

Background and Objective: This study aimed to compare the surface finish of milled leucite-reinforced ceramics polished with ceramic and composite polishing systems based on the manufacturers' recommendations. Materials and Methods: Sixty subtractive computer-aided manufactured (s-CAM) leucite-reinforced glass-ceramic specimens (IPS-Empress-CAD) were assigned into six groups: no polishing, a ceramic polishing kit, and four composite kit groups. The roughness average (Ra) was evaluated in microns using a profilometer, and scanning electron micrographs were obtained for qualitative analysis. A Tukey HSD posthoc test (α = 0.05) was used to determine significant intergroup differences. Results: After surface evaluation of the ceramics, the Ra values of the polishing systems ranked OptraFine (0.41 ± 0.26) < Enhance (1.60 ± 0.54) < Shofu (2.14 ± 0.44) < Astropol (4.05 ± 0.72) < DiaComp (5.66 ± 0.62) < No Polishing (5.66 ± 0.74). Discussion: Composite polishing systems did not provide as smooth surfaces as the ceramic polishing kit for CAD-CAM leucite-reinforced ceramics. Thus, using ceramic polishing systems, polishing leucite ceramics is recommended, whereas composite polishing systems should not be considered as an alternative for use in minimally invasive dentistry.

Influence of light irradiation for in-office tooth whitening: A randomized clinical study.

PURPOSE: To evaluate the influence of light irradiation on the clinical efficiency of an in-office whitening agent. METHODS: The in-office whitening agent (Opalescence Boost 35%) was used in this study. Two whitening regimens were evaluated on maxillary anterior teeth: (1) with light irradiation; and (2) without light irradiation. The ΔE*, changes of L*, a*, b*, and the best shade match on the central incisor before, immediately after, and 6 months after whitening procedures were evaluated using a dental spectrophotometer. RESULTS: The ΔE and shade had no significant differences with or without light irradiation. In addition, the ΔE, changes of L*, a*, b*, and shade did not change over 6 months after bleaching at a level detectable to the naked eye. The results suggested that the in-office whitening agent using 35% hydrogen peroxide without photocatalysts can improve tooth color with or without light irradiation for 6 months after whitening. CLINICAL SIGNIFICANCE: In office whitening using 35% hydrogen peroxide without photocatalysts should be considered as a good treatment option for vital teeth whitening.

Dual Oral Tissue Adhesive Nanofiber Membranes for pH-Responsive Delivery of Antimicrobial Peptides.

Bioadhesive membranes with controllable and reversible underwater adhesion are desirable for several biomedical applications ranging from biosensing, drug/therapeutic delivery, and tissue regeneration. Here, we present dual soft mucosal and hard bone/enamel tissue adhesive nanofiber membranes composed of chitosan and pectin derivatives for pH-controlled delivery of antimicrobial peptides (AMPs) in the oral cavity. Ex vivo testing with porcine esophagus (soft mucosal mimic) indicated a 2-fold increase in the mucoadhesion of chitosan membranes with 0.05 wt % oxidized pectin coating, while the uncoated membranes exhibited 3-4-fold stronger adhesion to hydroxyapatite discs (enamel/hard bone mimic) compared to the coated membranes. The former is attributed to a synergistic interaction of surface nanofiber topography, intermolecular hydrogen bonding, and aldehyde-amine chemistry between surface polar groups and mucosal proteins, while the latter may arise from electrostatic interactions between cationic amines (-NH3+) in chitosan and anionic phosphates (-PO43-) in hydroxyapatite. Further, the dual hard-soft oral tissue adhesive nanofiber membranes loaded with cationic amphipathic AMPs (D-GL13K and IDR-1018) elicited pH-responsive AMP delivery and antimicrobial action comparable to chlorhexidine (CHX) against oral streptococci. Concurrently, the AMP loaded membranes were cytocompatible to both soft epithelial tissue-derived human oral keratinocytes and hard calvarial murine pre-osteoblast cells. We envision these membranes to function as adhesive gingival grafts and guided bone regeneration (GBR) membranes at the hard-soft tissue interface while simultaneously protecting against oral infections.

Influence of 38% silver diamine fluoride application on bond stability to enamel and dentin using universal adhesives in self-etch mode.

In order to evaluate the influence of 38% silver diamine fluoride (SDF) application on enamel and dentin bond stability of universal adhesives in self-etch mode, a 38% SDF and three universal adhesives were used in this study. Initial shear bond strength (ISBS), fatigue bond strength (FBS), and shear bond strength of survivors (SBSS) to enamel and dentin of universal adhesives in self-etch mode, with and without SDF application, were determined. SDF was applied to the polished enamel or dentin surface for 1 min, water-rinsed and air-dried for comparison with controls. The universal adhesives were applied to the prepared samples and composite resin was bonded using a mold-enclosed method. Enamel bond stability of universal adhesives with SDF (ISBS: 14.7-20.4 MPa; FBS: 5.5-7.4 MPa and SBSS: 14.4-21.5 MPa) was significantly weaker than those without SDF (ISBS: 28.0-29.2 MPa; FBS: 12.1-15.6 MPa and SBSS: 28.4-34.4 MPa). Dentin bond stability with SDF (ISBS: 14.8-20.9 MPa; FBS: 7.1-8.2 MPa and SBSS: 17.3-21.8 MPa) was also significantly weaker than without SDF (ISBS: 19.3-36.1 MPa; FBS: 11.0-13.7 MPa and SBSS: 22.2-34.6 MPa). The results suggest that SDF application on enamel and dentin reduces the bond stability of universal adhesives in self-etch mode.

Ultrasonic measurement of remaining dentin thickness using a pencil-type transducer.

PURPOSE: To evaluate the ability of a pencil-type transducer connected to a pulser-receiver to measure remaining dentin thickness (RDT). METHODS: A total of 24 freshly extracted bovine incisors were used to prepare dentin disks with certain thicknesses (0.5, 1.0, 1.5 and 2.0 mm). The thicknesses of the specimens were measured with an ultrasonic technique using a pencil-type transducer, and the data obtained were compared with the direct measurement obtained using a micrometer. The Bland-Altman comparison method and paired t-test were performed at a 0.05 significance level. RESULTS: The agreement between different measurement methods was analyzed to evaluate the inter-methodology variation. The Bland-Altman comparison method revealed a mean difference of 0.0098 ± 0.724 mm between the ultrasonic technique and the direct measurement, with the 95% Bland-Altman limits of agreement ranging from 0.1322 to 0.1517 mm. CLINICAL SIGNIFICANCE: Ultrasonic measurement using the pencil-type transducer may be a promising method to evaluate remaining dentin thickness.

Implant therapy with ultratranslucent monolithic zirconia restorations in the esthetic zone: a case report.

Esthetic problems in maxillary central incisors are often difficult to treat with dental implants. It is necessary to preserve the interdental papillae, or regenerate them if they are absent, and minimize the risk of loss of hard or soft tissue. This task may be made easier by the recent introduction of ultratranslucent zirconia, which can be used with custom zirconia abutments to mutually enhance the effectiveness of both materials. This case report describes implant therapy with ultratranslucent monolithic zirconia restorations in the esthetic zone. In this approach, adequate pink esthetics can be achieved by delayed titanium implant placement in conjunction with guided bone regeneration. Ultratranslucent monolithic zirconia restorations with custom zirconia abutments provide predictable esthetic results.

Conservative Ultrathin Veneer Restorations with Minimal Reduction: A 5-year Follow-up Report.

AIM AND OBJECTIVE: This case report shows how a feldspathic veneer with diagnostic wax-ups, subsequent mock-up, and reduction guides can lead to good patient esthetics and reports a 5-year follow-up. BACKGROUND: Conservative tooth preparation is important for the long-term success of adhesive dentistry as it has been shown that bonding to enamel is more predictable in obtaining better long-term success than dentin. To preserve enamel for optimal bonding, diagnostic wax-ups and the subsequent mock-up are the first tools in a restorative dentist's arsenal to find and address differences between current and ideal tooth proportions and also help toward an overall conservative approach. Reduction guides are recommended in order to provide adequate tooth reduction and prevent over-reduction. CASE DESCRIPTION: This case report shows a 5-year follow-up of feldspathic veneer restorations for a patient with excessive space among teeth, defective composite restorations on facial and incisal surfaces, and worn teeth. Veneers were delivered with conservative tooth preparation combining different tooth reduction guides. CONCLUSION: This case report highlights the added benefits of tooth reduction guides and diagnostic wax-ups and the subsequent mock-up for long-term patient satisfaction. CLINICAL SIGNIFICANCE: Conservative tooth preparation, reduction guides, and wax-ups may increase the life span of veneer restorations and demonstrate good esthetics at 5 years.

Surface moisture influence on etch-and-rinse universal adhesive bonding.

PURPOSE: To evaluate whether surface moisture would influence the bonding effectiveness of universal adhesives in etch-and-rinse mode. METHODS: All-Bond Universal (AB), G-Premio Bond (GP) Prime&Bond Active (PB) and Scotchbond Universal Adhesive (SU) were evaluated. Shear bond strengths after 24 hours and 10,000 thermal cycles of universal adhesives to moist and dry enamel and dentin in etch-and-rinse mode were determined. Scanning electron microscopy observations of the adhesive interfaces were conducted. RESULTS: The bond durability of universal adhesive to dentin in etch-and-rinse mode was influenced by the surface moisture, unlike bond durability to enamel. The bond durability of AB and GP, but not PB and SU, to dentin in etch-and-rinse mode was different depending on the surface moisture. Surface moisture did not influence the thicknesses of the adhesive or hybrid layer of resin-dentin interfaces, but the length of resin tags in the moist group was longer than in the dry group. CLINICAL SIGNIFICANCE: Some universal adhesives, with the addition of specific components and optimization of water content, can achieve stable bonds regardless of surface moisture, but the surface moisture of dentin, although not enamel, is still a significant factor for universal adhesive bonding in etch-and rinse mode.

Shear fatigue strength of resin composite bonded to dentin at physiological frequency.

The purpose of this study was to examine the shear fatigue strengths of a resin composite bonded to dentin. Three adhesive systems - a two-step self-etch adhesive (OptiBond XTR; Kerr) and two universal adhesives [Scotchbond Universal (3M ESPE) and G-Premio Bond (GC)] - were used in self-etch mode to bond a resin composite to dentin at a physiologic frequency of 2 Hz over 50,000, 100,000, and 1,000,000 cycles. A staircase method of fatigue testing was used. Twenty specimens were used for each test condition. There was no significant difference in shear fatigue strength across the cycling periods for the three individual adhesives. Differences in shear fatigue strength were found among the three adhesives within each cycling period. Regardless of the adhesive used in self-etch mode for bonding a resin composite to dentin, shear fatigue strength was not influenced by the number of cycles used for testing.

A Comparative Study of Shade-Matching Reproducibility Using an Intraoral Scanner and a Spectrophotometer.

BACKGROUND: We compared the repeatability of the shade determination of resin composite restorations and acrylic teeth in light and darker shades at baseline and after an aging process through two digital tooth color-matching methods: using a Trios 3Shape intraoral scanner and using a Vita Easyshade Compact spectrophotometer. MATERIAL AND METHODS: Forty upper central incisor acrylic teeth in the shade A1 (n = 10) and A3 (n = 10) were randomly assigned to be restored with Filtek Bulk Fill in the shade A1 (n = 10) or A3 (n = 10). Subsequently, 20 Class V cavities were prepared in a standardized manner (mesio-distal = 3.0 mm, cervical-occlusal = 2.0 mm, depth = 1.5 mm). Cavities were restored using an universal adhesive system and resin composite in two increments and were light-cured. The shade difference between the resin composite Class V restorations in acrylic teeth of the A1 and A3 shades was evaluated at baseline and after aging. Aging was simulated using ultraviolet light for 120 h. An Easyshade device and an intraoral scanner were used under D65 illumination. Measurements were taken five times, on top of the restoration and on the acrylic teeth, in a randomized manner. RESULTS: Data analysis was on the calculation of the arithmetic mean for the percentage of repeatability conducted by the Trios scanner and the Easyshade device. There was no statistically significant comparison between the shade measurement devices (p > 0.05). At baseline, the repeatability for both the Trios intraoral scanner and the Vita Easyshade Compact device for artificial teeth in the shades A1 and A3 was 100%. After aging, the trueness recorded by the intraoral scanner and the Easyshade device for artificial teeth in the shade A1 was 80%. For Class V restoration with shade A1, the intraoral scanner recorded 80% trueness and the Easyshade device recorded 60% trueness at baseline. For shade A3, the intraoral scanner recorded 60% trueness and the Easyshade device recorded 60% trueness. CONCLUSIONS: The intraoral scanner and Easyshade device are reliable for baseline shade selection, but their accuracy decreases after aging, particularly for darker shades.

The Influence of Thickness on Light Transmission for Pre- and Fully Crystallized Chairside CAD/CAM Lithium Disilicate Ceramics.

AIM: This in vitro study aimed to compare the light-transmission properties of two chairside CAD/CAM lithium disilicate (LD) ceramics (a novel fully crystallized and a traditional pre-crystallized) across varying thicknesses. MATERIALS AND METHODS: One hundred flat specimens were obtained from precrystallized (e.max CAD, Ivoclar Vivadent, Schaan, Liechtenstein) and fully crystallized (LiSi GC Block; GC, Tokyo, Japan) LD at five different thicknesses (0.5, 0.75, 1.0, 1.50 and 2.0 mm). All specimens were polished with a polishing system for lithium disilicate restorations following recommendations from the manufacturer. Light transmission was evaluated with a radiometer. The statistical analysis between e.max CAD and LiSi GC Block was performed using a Mann-Whitney test for each thickness at a significance level of 0.05 (p < 0.05), followed by a Kruskal-Wallis test to compare the light transmission between the thicknesses of e.max CAD and LiSi GC Block. RESULTS: Light transmittance was significantly affected by ceramic thickness. The 0.5 mm thick specimens exhibited the highest transmittance values compared to all other groups, while a light transmittance of 0.00 was observed in the 2.0 mm thick specimens for both e.max CAD and LiSi GC Block. In the comparison between e.max CAD and LiSi GC Block according to thickness, there was a statistically significant difference exclusively between groups with a thickness of 1.50 mm (p = 0.002). CONCLUSIONS: Light transmission for pre- and fully crystallized CAD/CAM lithium disilicate ceramics only showed a statistical difference at the thickness of 1.50 mm (p = 0.002). E.max CAD demonstrated acceptable light transmission up to a thickness of 1.5 mm. CLINICAL SIGNIFICANCE: A thickness of 2 mm for chairside CAD/CAM lithium disilicate ceramics, whether pre-crystallized or fully crystallized, necessitates the use of dual-cure resin luting cement due to reduced light transmission.

Interpenetrating nanofibrillar membrane of self-assembled collagen and antimicrobial peptides for enhanced bone regeneration.

Bone regeneration remains a major clinical challenge, especially when infection necessitates prolonged antibiotic treatment. This study presents a membrane composed of self-assembled and interpenetrating GL13K, an antimicrobial peptide (AMP) derived from a salivary protein, in a collagen membrane for antimicrobial activity and enhanced bone regeneration. Commercially available collagen membranes were immersed in GL13K solution, and self-assembly was initiated by raising the solution pH to synthesize the multifunctional membrane called COL-GL. COL-GL was composed of interpenetrating large collagen fibers and short GL13K nanofibrils, which increased hydrophobicity, reduced biodegradation from collagenase, and stiffened the matrix compared to control collagen membranes. Incorporation of GL13K led to antimicrobial and anti-fouling activity against early oral surface colonizer Streptococcus gordonii while not affecting fibroblast cytocompatibility or pre-osteoblast osteogenic differentiation. GL13K in solution also reduced macrophage inflammatory cytokine expression and increased pro-healing cytokine expression. Bone formation in a rat calvarial model was accelerated at eight weeks with COL-GL compared to the gold-standard collagen membrane based on microcomputed tomography and histology. Interpenetration of GL13K within collagen sidesteps challenges with antimicrobial coatings on bone regeneration scaffolds while increasing bone regeneration. This strength makes COL-GL a promising approach to reduce post-surgical infections and aid bone regeneration in dental and orthopedic applications. STATEMENT OF SIGNIFICANCE: The COL-GL membrane, incorporating the antimicrobial peptide GL13K within a collagen membrane, signifies a noteworthy breakthrough in bone regeneration strategies for dental and orthopedic applications. By integrating self-assembled GL13K nanofibers into the membrane, this study successfully addresses the challenges associated with antimicrobial coatings, exhibiting improved antimicrobial and anti-fouling activity while preserving compatibility with fibroblasts and pre-osteoblasts. The accelerated bone formation observed in a rat calvarial model emphasizes the potential of this innovative approach to minimize post-surgical infections and enhance bone regeneration outcomes. As a promising alternative for future therapeutic interventions, this material tackles the clinical challenges of extended antibiotic treatments and antibiotic resistance in bone regeneration scenarios.

Immunomodulatory IL-23 receptor antagonist peptide nanocoatings for implant soft tissue healing.

OBJECTIVE: Peri-implantitis, caused by an inflammatory response to pathogens, is the leading cause of dental implant failure. Poor soft tissue healing surrounding implants - caused by inadequate surface properties - leads to infection, inflammation, and dysregulated keratinocyte and macrophage function. One activated inflammatory response, active around peri-implantitis compared to healthy sites, is the IL-23/IL-17A cytokine axis. Implant surfaces can be synthesized with peptide nanocoatings to present immunomodulatory motifs to target peri-implant keratinocytes to control macrophage polarization and regulate inflammatory axises toward enhancing soft tissue healing. METHODS: We synthesized an IL-23 receptor (IL-23R) noncompetitive antagonist peptide nanocoating using silanization and evaluated keratinocyte secretome changes and macrophage polarization (M1-like "pro-inflammatory" vs. M2-like "pro-regenerative"). RESULTS: IL-23R antagonist peptide nanocoatings were successfully synthesized on titanium, to model dental implant surfaces, and compared to nonfunctional nanocoatings and non-coated titanium. IL-23R antagonist nanocoatings significantly decreased keratinocyte IL-23, and downstream IL-17A, expression compared to controls. This peptide noncompetitive antagonistic function was demonstrated under lipopolysaccharide stimulation. Large scale changes in keratinocyte secretome content, toward a pro-regenerative milieu, were observed from keratinocytes cultured on the IL-23R antagonist nanocoatings compared to controls. Conditioned medium collected from keratinocytes cultured on the IL-23R antagonist nanocoatings polarized macrophages toward a M2-like phenotype, based on increased CD163 and CD206 expression and reduced iNOS expression, compared to controls. SIGNIFICANCE: Our results support development of IL-23R noncompetitive antagonist nanocoatings to reduce the pro-inflammatory IL-23/17A pathway and augment macrophage polarization toward a pro-regenerative phenotype. Immunomodulatory implant surface engineering may promote soft tissue healing and thereby reduce rates of peri-implantitis.

Implant surface physicochemistry affects keratinocyte hemidesmosome formation.

Previous studies have shown hydrophilic/hydrophobic implant surfaces stimulate/hinder osseointegration. An analogous concept was applied here using common biological functional groups on a model surface to promote oral keratinocytes (OKs) proliferation and hemidesmosomes (HD) to extend implant lifespans through increased soft tissue attachment. However, it is unclear what physicochemistry stimulates HDs. Thus, common biological functional groups (NH2 , OH, and CH3 ) were functionalized on glass using silanization. Non-functionalized plasma-cleaned glass and H silanization were controls. Surface modifications were confirmed with X-ray photoelectron spectroscopy and water contact angle. The amount of bovine serum albumin (BSA) and fibrinogen, and BSA thickness, were assessed to understand how adsorbed protein properties were influenced by physicochemistry and may influence HDs. OKs proliferation was measured, and HDs were quantified with immunofluorescence for collagen XVII and integrin ß4. Plasma-cleaned surfaces were the most hydrophilic group overall, while CH3 was the most hydrophobic and OH was the most hydrophilic among functionalized groups. Modification with the OH chemical group showed the highest OKs proliferation and HD expression. The OKs response on OH surfaces appeared to not correlate to the amount or thickness of adsorbed model proteins. These results reveal relevant surface physicochemical features to favor HDs and improve implant soft tissue attachment.

Keratinocyte Proliferation and Hemidesmosome Formation on Surfaces for Dental Implants: In Vitro Study.

PURPOSE: To demonstrate the likelihood of the polyetheretherketone (PEEK), zirconia (ZrO2), and titanium (Ti) disks to support proliferation and hemidesmosome formation of gingival cells. MATERIALS AND METHODS: Water contact angle was performed on each material, and surface roughness (Ra) was measured. Scanning electron microscopy and x-ray photoelectron spectroscopy were used. Later, oral keratinocyte cells were cultured on disks, and metabolic activity and expression of hemidesmosome markers, integrin α6 and ß4, in relation to the biomaterial disks at 1, 3, and 5 days of cell culture were quantified. Tissue culture polystyrene was used as the control. Statistical analysis was performed with analysis of variance (ANOVA) with Tukey post hoc comparison test. A P value of < .05 was considered statistically significant. RESULTS: The water contact angle ranged from 70.2 degrees (Ti) to a maximum of hydrophobicity of 93.3 degrees (PEEK). Ra was highest on ZrO2, followed by PEEK. Ti showed the most keratinocyte metabolic activity at 1, 3, and 5 culture periods. Contrarily, ZrO2 and PEEK disks had lower keratinocyte metabolic activity at all observation times, with no statistical differences between both groups. Integrin α6 and ß4 expression was highest on TCPS and ZrO2 compared to Ti and PEEK. CONCLUSION: Keratinocytes proliferated faster on Ti than on ZrO2 and PEEK substrates, and expression of hemidesmosome formation markers, integrin α6 and ß4, were higher on ZrO2 than either Ti or PEEK. Int J Oral Maxillofac Implants 2023;38:496-502. doi: 10.11607/jomi.9894.

Application and limitations of configuration factor (C-factor) in stress analysis of dental restorations.

OBJECTIVE: The configuration factor (C-factor) is an index used to evaluate the relationship between cavity configuration and the development of polymerization shrinkage stress in dental restorations. Although C-factor has been widely researched, its correlation with stress analysis in dental restorations remains controversial. This review aims to discuss the application and limitations of C-factor and define the restricted conditions under which the C-factor "rule of thumb" is applicable. METHODS: A thorough literature review was conducted on the application and limitations of C-factor in stress analysis of dental restorations. This was principally based on MEDLINE/PubMed and Web of Science databases and a review of the relevant studies and publications in scientific papers in international peer-reviewed journals for the specific topic of C-factor and polymerization shrinkage. RESULTS: The C-factor alone cannot provide an accurate prediction of the shrinkage stress of restorations and the mechanical behavior of material-tooth interfaces. C-factor is only applicable under one condition not typically seen in clinical practice: low, near-rigid compliance. SIGNIFICANCE: Conditions for the application of C-factor have been explicitly defined. A more accurate and precise understanding and utilization of the C-factor is of benefit as it contributes to better understanding of polymerization shrinkage behavior of restorations.

Ultra-Translucent Zirconia Laminate Veneers: The Influence of Restoration Thickness and Stump Tooth-Shade.

This in vitro study aimed to evaluate the final shade of translucent zirconia laminate veneers with varying thicknesses over teeth with different shades. Seventy-five chairside computer-aided design/computer-aided manufacturing (CAD/CAM) shade A1 third-generation zirconia dental veneers, with thicknesses of 0.50 mm, 0.75 mm, and 1.00 mm, were placed on resin composite teeth with shades ranging from A1 to A4. The laminate veneers were divided into groups based on thickness and background shade. All restorations were evaluated with a color imaging spectrophotometer, to map the veneer surface from A1 to D4. Regardless of the thickness or background shade, all dental veneers showed color alteration from the original shade. Veneers with 0.5 mm thickness tended to display the B1 shade, while veneers with 0.75 mm and 1.0 mm thickness primarily exhibited the B2 shade. The thickness of the laminate veneer and background shade significantly modified the original shade of the zirconia veneer. One-way analysis of variance was performed and a Kruskal-Wallis test was used to determine the significance between the three veneer thicknesses groups. The results indicated that the thinner restorations showed higher values with the color imaging spectrophotometer, suggesting that thinner veneers may result in more consistent color matching. This study underscores the importance of carefully considering thickness and background shade when selecting zirconia laminate veneers, to ensure optimal color matching and overall aesthetic outcomes.