Mechanical Properties and Wear Resistance of Commercial Stainless Steel Used in Dental Instruments.

The aim of this study was to investigate the element composition and grain size of commercial dental instruments used for ultrasonic scaler tips, which are composed of stainless-steel materials. The differences in mechanical properties and wear resistances were compared. The samples were classified into 4 groups in accordance with the manufacturer, Electro Medical Systems, 3A MEDES, DMETEC and OSUNG MND, and the element compositions of each stainless-steel ultrasonic scaler tip were analyzed with micro-X-ray fluorescence spectrometry (µXRF) and field-emission scanning electron microscopy (FE-SEM) with energy-dispersive X-ray spectroscopy (EDS). One-way ANOVA showed that there were significant differences in shear strength and Vickers hardness among the stainless-steel ultrasonic scaler tips depending on the manufacturer (p < 0.05). The mass before and after wear were found to have no significant difference among groups (p > 0.05), but there was a significant difference in the wear volume loss (p < 0.05). The results were then correlated with µXRF results as well as observations of grain size with optical microscopy, which concluded that the Fe content and the grain size of the stainless steel have significant impacts on strength. Additionally, stainless-steel ultrasonic scaler tips with higher Vickers hardness values showed greater wear resistance, which would be an important wear characteristic for clinicians to check.

Enhanced Osteogenic Differentiation of Human Mesenchymal Stem Cells on Amine-Functionalized Titanium Using Humidified Ammonia Supplied Nonthermal Atmospheric Pressure Plasma.

The surface molecular chemistry, such as amine functionality, of biomaterials plays a crucial role in the osteogenic activity of relevant cells and tissues during hard tissue regeneration. Here, we examined the possibilities of creating amine functionalities on the surface of titanium by using the nonthermal atmospheric pressure plasma jet (NTAPPJ) method with humidified ammonia, and the effects on human mesenchymal stem cell (hMSC) were investigated. Titanium samples were subjected to NTAPPJ treatments using nitrogen (N-P), air (A-P), or humidified ammonia (NA-P) as the plasma gas, while control (C-P) samples were not subjected to plasma treatment. After plasma exposure, all treatment groups showed increased hydrophilicity and had more attached cells than the C-P. Among the plasma-treated samples, the A-P and NA-P showed surface oxygen functionalities and exhibited greater cell proliferation than the C-P and N-P. The NA-P additionally showed surface amine-related functionalities and exhibited a higher level of alkaline phosphatase activity and osteocalcin expression than the other samples. The results can be explained by increases in fibronectin absorption and focal adhesion kinase gene expression on the NA-P samples. These findings suggest that NTAPPJ technology with humidified ammonia as a gas source has clinical potential for hard tissue generation.

Antibacterial activity and effect on gingival cells of microwave-pulsed non-thermal atmospheric pressure plasma in artificial saliva.

Although various oral pathogens are inactivated by non-thermal atmospheric pressure plasma (NTAPP), the in vivo effects of NTAPP are poorly understood. The first aim of this study was to examine the antibacterial activity of microwave-pulsed NTAPP against Staphylococcus aureus in artificial saliva to mimic oral environmental conditions. The second aim was to determine the influence of microwave-pulsed NTAPP on human gingival fibroblasts (HGFs). The microwave-pulsed NTAPP reduced bacterial viability (as measured by colony forming units [CFU]) to a greater extent in artificial saliva than in saline. Extending the post-treatment incubation time increased bacterial inactivation in artificial saliva compared to saline. HGFs viability was unaffected by microwave-pulsed NTAPP for bacterial inactivation. Rather, HGFs proliferation increased after a 5-min microwave-pulsed NTAPP. Less tumor necrosis factor alpha was released by microwave-pulsed NTAPP-treated HGFs stimulated with lipopolysaccharide (LPS) than by untreated, LPS-stimulated HGFs; thus, plasma appeared to suppress the inflammatory response. Our study suggests that microwave-pulsed NTAPP may have stronger in vivo antibacterial activity than in vitro activity, and that microwave-pulsed NTAPP may have the additional advantage of suppressing gingival inflammatory responses.

Titanium-Silver Alloy Miniplates for Mandibular Fixation: In Vitro and In Vivo Study.

PURPOSE: Titanium (Ti) alloys have received considerable attention as materials for oral and maxillofacial surgery, which require high mechanical strength, osteosynthesis, and biocompatibility. The objective was to implant miniplates fabricated from commercially pure Ti (CP Ti) and newly developed Ti-silver (Ag) alloy in fractured mandibles of adult dogs after preliminary mechanical and biological characterization. MATERIALS AND METHODS: The surface characteristics, biocompatibility, and pre-osteoblast adhesion and proliferation of CP Ti (grade 3) and Ti-Ag (2 at% Ag) alloys were evaluated. Next, the bending strength of 6- and 8-hole miniplates fabricated from CP Ti and Ti-Ag was compared according to ISO (International Organization for Standardization) 9585. Six-hole miniplates were implanted for 12 weeks in fractured mandibles of adult dogs. The Ag ion concentration in each alloy and implanted bone block with soft tissue was measured by inductively coupled plasma mass spectroscopy after euthanasia according to ISO 10993-12. RESULTS: Precipitated Ag was detected in Ti-Ag by alpha- and beta-phase Ti in x-ray powder diffraction. The biocompatibility with pre-osteoblasts of Ti-Ag and CP Ti was comparable in terms of cytotoxicity, cell adhesion, and proliferation (P > .05). Ti-Ag miniplates had up to 3-fold greater bending strength than CP Ti miniplates (P < .05). An in vivo study showed that CP Ti and Ti-Ag miniplates had comparable soft and hard tissue regeneration ability (P > .05). Ag ions were detected in Ti-Ag alloys and applied mandible blocks. CONCLUSIONS: The results of this study suggest that Ti-Ag alloys can be used to produce miniplates with high mechanical properties, as well as considerable biocompatibility, osteosynthesis ability, and Ag ion-release properties. Further studies, including preclinical investigations, are required to enable clinical use of Ti-Ag bone plates.

Selective Killing Effects of Cold Atmospheric Pressure Plasma with NO Induced Dysfunction of Epidermal Growth Factor Receptor in Oral Squamous Cell Carcinoma.

The aim of this study is to investigate the effects of cold atmospheric pressure plasma (CAP)-induced radicals on the epidermal growth factor receptor (EGFR), which is overexpressed by oral squamous cell carcinoma, to determine the underlying mechanism of selective killing. CAP-induced highly reactive radicals were observed in both plasma plume and cell culture media. The selective killing effect was observed in oral squamous cell carcinoma compared with normal human gingival fibroblast. Degradation and dysfunction of EGFRs were observed only in the EGFR-overexpressing oral squamous cell carcinoma and not in the normal cell. Nitric oxide scavenger pretreatment in cell culture media before CAP treatment rescued above degradation and dysfunction of the EGFR as well as the killing effect in oral squamous cell carcinoma. CAP may be a promising cancer treatment method by inducing EGFR dysfunction in EGFR-overexpressing oral squamous cell carcinoma via nitric oxide radicals.

Cytotoxicity and terminal differentiation of human oral keratinocyte by indium ions from a silver-palladium-gold-indium dental alloy.

OBJECTIVE: Dental alloys containing indium (In) have been used in dental restoration for two decades; however, no study has investigated the biological effects of In ions, which may be released in the oral cavity, on human oral keratinocytes. The objective of the present study was to investigate the biological effects of In ions on human oral keratinocyte after confirming their release from a silver-palladium-gold-indium (Ag-Pd-Au-In) dental alloy. METHODS: As a corrosion assay, a static immersion tests were performed by detecting the released ions in the corrosion solution from the Ag-Pd-Au-In dental alloy using inductively coupled plasma atomic emission spectroscopy. The cytotoxicity and biological effects of In ions were then studied with In compounds in three human oral keratinocyte cell lines: immortalized human oral keratinocyte (IHOK), HSC-2, and SCC-15. RESULTS: Higher concentrations of In and Cu ions were detected in Ag-Pd-Au-In (P<0.05) than in Ag-Pd-Au, and AgCl deposition occurred on the surface of Ag-Pd-Au-In after a 7-day corrosion test due to its low corrosion resistance. At high concentrations, In ions induced cytotoxicity; however, at low concentrations (∼0.8In(3+)mM), terminal differentiation was observed in human oral keratinocytes. Intracellular ROS was revealed to be a key component of In-induced terminal differentiation. SIGNIFICANCE: In ions were released from dental alloys containing In, and high concentrations of In ions resulted in cytotoxicity, whereas low concentrations induced the terminal differentiation of human oral keratinocytes via increased intracellular ROS. Therefore, dental alloys containing In must be biologically evaluated for their safe use.

Cellular attachment and differentiation on titania nanotubes exposed to air- or nitrogen-based non-thermal atmospheric pressure plasma.

The surface topography and chemistry of titanium implants are important factors for successful osseointegration. However, chemical modification of an implant surface using currently available methods often results in the disruption of topographical features and the loss of beneficial effects during the shelf life of the implant. Therefore, the aim of this study was to apply the recently highlighted portable non-thermal atmospheric pressure plasma jet (NTAPPJ), elicited from one of two different gas sources (nitrogen and air), to TiO2 nanotube surfaces to further improve their osteogenic properties while preserving the topographical morphology. The surface treatment was performed before implantation to avoid age-related decay. The surface chemistry and morphology of the TiO2 nanotube surfaces before and after the NTAPPJ treatment were determined using a field-emission scanning electron microscope, a surface profiler, a contact angle goniometer, and an X-ray photoelectron spectroscope. The MC3T3-E1 cell viability, attachment and morphology were confirmed using calcein AM and ethidium homodimer-1 staining, and analysis of gene expression using rat mesenchymal stem cells was performed using a real-time reverse-transcription polymerase chain reaction. The results indicated that both portable nitrogen- and air-based NTAPPJ could be used on TiO2 nanotube surfaces easily and without topographical disruption. NTAPPJ resulted in a significant increase in the hydrophilicity of the surfaces as well as changes in the surface chemistry, which consequently increased the cell viability, attachment and differentiation compared with the control samples. The nitrogen-based NTAPPJ treatment group exhibited a higher osteogenic gene expression level than the air-based NTAPPJ treatment group due to the lower atomic percentage of carbon on the surface that resulted from treatment. It was concluded that NTAPPJ treatment of TiO2 nanotube surfaces results in an increase in cellular activity. Furthermore, it was demonstrated that this treatment leads to improved osseointegration in vitro.

BMP-2 promotes oral squamous carcinoma cell invasion by inducing CCL5 release.

Bone morphogenetic protein-2 (BMP-2)-containing bone grafts are useful regenerative materials for oral and maxillofacial surgery; however, several in vitro and in vivo studies previously reported cancer progression-related adverse effects caused by BMP-2. In this study, by quantifying the rhBMP-2 content released from bone grafts, the rhBMP-2 concentration that did not show cytotoxicity in each cell line was determined and applied to the in vitro monoculture or coculture model in the invasion assay. Our results showed that 1 ng/ml rhBMP-2, while not affecting cancer cell viability, significantly increased the invasion ability of the cancer cells cocultured with fibroblasts. Cocultured medium with rhBMP-2 also contained increased levels of matrix metalloproteinases. rhBMP-2-treated cocultured fibroblasts did not show a prominent difference in mRNA expression profile. Some cytokines, however, were detected in the conditioned medium by a human cytokine antibody array. Among them, the cancer invasion-related factor CCL5 was quantified by ELISA. Interestingly, CCL5 neutralizing antibodies significantly reduced the invasion of oral cancer cells. In conclusion, our results suggest that 1 ng/ml rhBMP-2 may induce invasion of oral squamous cell carcinoma (OSCC) cells by CCL5 release in coculture models. Therefore, we propose that a careful clinical examination before the use of rhBMP-2-containing biomaterials is indispensable for using rhBMP-2 treatment to prevent cancer progression.

Modification of TiO(2) nanotube surfaces by electro-spray deposition of amoxicillin combined with PLGA for bactericidal effects at surgical implantation sites.

OBJECTIVE: To fabricate the antibiotic-releasing coatings on TiO(2) nanotube surfaces for wide applications of implant and bone plate in medical and dental surgery, the optimal deposition time of amoxicillin/PLGA solution simultaneously performing non-toxicity and a high bactericidal effect for preventing early implant failures was found. MATERIALS AND METHODS: FE-SEM, ESD and FT-IR were used for confirming deposition of amoxicillin/PLGA on the TiO(2) surface. Also, the elution of amoxicillin/PLGA in a TiO(2) nanotube surface was measured by a UV-VIS spectrophotometer. The bactericidal effect of amoxicillin on the TiO(2) nanotube surface was evaluated by using Staphylococcus aureus (S. aureus). The cytotoxicity and cell proliferation were observed by WST assay using MC3T3-E1 osteoblast cells. RESULTS: The results indicated that the TiO(2) nanotube surface controlled by electro-spray deposition time with amoxicillin/PLGA solution could provide a high bactericidal effect against S. aureus by the bactericidal effect of amoxicillin, as well as good osteoblast cell proliferation at the TiO(2) nanotube surface without toxicity. CONCLUSIONS: This study used electro-spray deposition (ESD) methodology to obtain amoxicillin deposition in nanotube structures of TiO(2) and found the optimal deposition time of amoxicillin/PLGA solution simultaneously performing non-toxicity and a high bactericidal effect for preventing early implant failures.

Antibacterial effect and cytocompatibility of nano-structured TiO2 film containing Cl.

The aim of this study was to investigate the antibacterial effect and cytocompatibility of a nano-structured TiO2 film that contained Cl and had been coated onto commercially pure titanium. First, we prepared nano-structured TiO2 by anodization with hydrofluoric acid. Then, to confer an antibacterial effect, we performed a second anodization with NaCl solutions of different concentrations (0.5 M, 1 M, 2 M). The morphology, composition, and wettability of the surface were investigated by SEM, EDS, and a video contact angle measuring system. The antibacterial effect was evaluated by film adhesion method. And cytotoxicity was determined by the viability of MG-63 cells in a MTT assay. The SEM and EDS results showed that the TiO2 nano-structure containing Cl had successfully formed after the second anodization. The contact angle analysis showed that the anodized titanium had a hydrophilic character. The results of this in vitro investigation demonstrated that the TiO2 nano-structure film anodized in 1 M NaCl had an antibacterial effect and good cell compatibility.

Drug-loaded porous spherical hydroxyapatite granules for bone regeneration.

Porous spherical hydroxyapatite (HAp) granules, which are not only can be used for bone void filler, but also drug delivery systems, were prepared using a liquid nitrogen method. Various pore and channel structures of spherical granules were obtained by adjusting the ratio of water to HAp powder and the amount of sodium chloride (NaCl). By using the water to powder ratio at 2.0 ml/g and the amount of NaCl at 15 wt% by powder, the spherical granules have optimal pore volume, micro-channel structure and strength to handle as well as the ability to work as a drug delivery system. When the NaCl content was 15 wt%, the micro-channel structure was changed, but the pore volume was maintained. For the drug release test, dexamathasone (Dex) was loaded as a model drug on the prepared HAp granules by the immersion method, and the drug release behavior was curved by a UV/vis spectrophotometer. As a result, different drug release behavior was observed according to micro-channel structural differences. Therefore, it was concluded that the NACl could be applied as the pore and micro-channel structure control agent. Porous spherical HAp granules, which were fabricated by a liquid nitrogen method, show potential as bone void filler with the ability of controlled drug release.

Targeting to carcinoma cells with chitosan- and starch-coated magnetic nanoparticles for magnetic hyperthermia.

The delivery of hyperthermic thermoseeds to a specific target site with minimal side effects is an important challenge in targeted hyperthermia, which employs magnetic method and functional polymers. An external magnetic field is used to control the site-specific targeting of the magnetic nanoparticles. Polymer-coated magnetic nanoparticles can confer a higher affinity to the biological cell membranes. In this study, uncoated, chitosan-coated, and starch-coated magnetic nanoparticles were synthesized for use as a hyperthermic thermoseed. Each sample was examined with respect to their applications to hyperthermia using XRD, VSM, and FTIR. In addition, the temperature changes under an alternating magnetic field were observed. As in vitro tests, the magnetic responsiveness of chitosan- and starch-coated magnetite was determined by a simple blood vessel model under various intensities of magnetic field. L929 normal cells and KB carcinoma cells were used to examine the cytotoxicity and affinity of each sample using the MTT method. The chitosan-coated magnetic nanoparticles generated a higher DeltaT of 23 degrees C under an AC magnetic field than the starch-coated magnetite, and the capturing rate of the particles was 96% under an external magnetic field of 0.4 T. The highest viability of L929 cells was 93.7%. Comparing the rate of KB cells capture with the rate of L929 cells capture, the rate of KB cells capture relatively increased with 10.8% in chitosan-coated magnetic nanoparticles. Hence, chitosan-coated magnetic nanoparticles are biocompatible and have a selective affinity to KB cells. The targeting of magnetic nanoparticles in hyperthermia was improved using a controlled magnetic field and a chitosan-coating. Therefore, chitosan-coated magnetic nanoparticles are expected to be promising materials for use in magnetic targeted hyperthermia.

A stainless steel bracket for orthodontic application.

Aesthetics has become an essential element when choosing orthodontic fixed appliances. Most metallic brackets used in orthodontic therapy are made from stainless steel (SS) with the appropriate physical properties and good corrosion resistance, and are available as types 304, 316 and 17-4 PH SS. However, localized corrosion of these materials can frequently occur in the oral environment. This study was undertaken to evaluate the accuracy of sizing, microstructure, hardness, corrosion resistance, frictional resistance and cytotoxicity of commercially available Mini-diamond (S17400), Archist (S30403) and experimentally manufactured SR-50A (S32050) brackets. The size accuracy of Mini-diamond was the highest at all locations except for the external horizontal width of the tie wing (P < 0.05). Micrographs of the Mini-diamond and Archist showed precipitates in the grains and around their boundaries. SR-50A showed the only austenitic phase and the highest polarization resistance of the tested samples. SR-50A also had the highest corrosion resistance [SR-50A, Mini-diamond and Archist were 0.9 x 10(-3), 3.7 x 10(-3), and 7.4 x 10(-3) mm per year (mpy), respectively], in the artificial saliva. The frictional force of SR-50A decreased over time, but that of Mini-diamond and Archist increased. Therefore, SR-50A is believed to have better frictional properties to orthodontic wire than Mini-diamond and Archist. Cytotoxic results showed that the response index of SR-50A was 0/1 (mild), Mini-diamond 1/1 (mild+), and Archist 1/2 (mild+). SR-50A showed greater biocompatibility than either Mini-diamond or Archist. It is concluded that the SR-50A bracket has good frictional property, corrosion resistance and biocompatibility with a lower probability of allergic reaction, compared with conventionally used SS brackets.