Combined Application of Virtual Simulation Technology and 3-Dimensional-Printed Computer-Aided Rapid Prototyping in Autotransplantation of a Mature Third Molar.

The use of computer-aided rapid prototyping (CARP) models was considered to reduce surgical trauma and improve outcomes when autotransplantation of teeth (ATT) became a viable alternative for dental rehabilitation. However, ATT is considered technique-sensitive due to its series of complicated surgical procedures and unfavorable outcomes in complex cases. This study reported a novel autotransplantation technique of a 28-year-old patient with an unrestorable lower first molar (#36) with double roots. Regardless of a large shape deviation, a lower third molar (#38) with a completely single root formation was used as the donor tooth. ATT was performed with a combined use of virtual simulation, CARP model-based rehearsed surgery, and tooth replica-guided surgery. A 3D virtual model of the donor and recipient site was generated from cone-beam computed tomographic (CBCT) radiographs prior to surgery for direct virtual superimposition simulation and CARP model fabrication. The virtual simulation indicated that it was necessary to retain cervical alveolar bone during the surgical socket preparation, and an intensive surgical rehearsal was performed on the CARP models. The donor tooth replica was used during the procedure to guide precise socket preparation and avoid periodontal ligament injury. Without an additional fitting trial and extra-alveolar storage, the donor tooth settled naturally into the recipient socket within 30 s. The transplanted tooth showed excellent stability and received routine root canal treatment three weeks post-surgery, and the one-year follow-up examination verified the PDL healing outcome and normal functioning. Patient was satisfied with the transplanted tooth. This cutting-edge technology combines virtual simulation, digital surgery planning, and guided surgery implementation to ensure predictable and minimally invasive therapy in complex cases.

Effect of Curvature Location on Fatigue Resistance of Five Nickel-titanium Files Determined at Body Temperature.

INTRODUCTION: The purpose of this study was to evaluate the effect of 5 different curvature locations on the fatigue resistance of thermomechanically treated nickel-titanium (NiTi) files and superelastic NiTi files at body temperature and to document the corresponding phase transformations. METHODS: EndoSequence (ES; Brasseler USA, Savannah, GA), EndoSequence CM (ESCM, Brasseler USA), K3 (SybronEndo, Orange, CA), K3XF (SybronEndo), and Vortex Blue (VB; Dentsply Tulsa Dental Specialties, Tulsa, OK) NiTi files (size 25/.04) were subjected to fatigue tests inside customized artificial canals containing a curvature of 60° and a 3-mm radius. There were 5 different canals based on the location of initial curvature; these included groups in which the distance between the canal orifice and the location of the curvature (DOC) was 5, 6, 8, 10, and 11 mm. The model canal was immersed in water at 37°C ± 1°C. The number of cycles to failure (Nf) was recorded, and the fracture surface of the fragments was examined by scanning electron microscopy. Two unused files of each brand were examined by differential scanning calorimetry. RESULTS: The Nf was highest in the 10-mm and 11-mm DOC groups and lowest with the 5-mm and 6-mm DOC groups (P < .05). ESCM files had the highest fatigue resistance followed by the VB, K3XF, K3, and ES files (P < .05). ESCM files had the highest Nf (P < .05), and ES and K3 files had the lowest Nf (P < .05) depending on the curvature location. Two endothermic peaks were observed on the heating curve of the heat-treated files (ESCM, K3XF, and VB). CONCLUSIONS: The location of the canal curvature had a significant effect on the fatigue resistance of both heat-treated and superelastic NiTi files. The fatigue life of files in the coronal curve was quite short.

Effect of Long-term Exposure to Peptides on Mono- and Multispecies Biofilms in Dentinal Tubules.

INTRODUCTION: The aim of this study was to evaluate the antibiofilm effectiveness of 2% chlorhexidine (CHX) and peptides 1018 and DJK-5 used either alone or in a mixture (peptide and 2% CHX) against Enterococcus faecalis and multispecies biofilms in dentin canals after short-term and long-term exposure. METHODS: One hundred eighty dentin blocks were prepared and filled with E. faecalis or multispecies bacteria by centrifugation. Three-week-old biofilms in dentin were subjected to 2% CHX, DJK-5 (10 µg/mL), 1018 (10 µg/mL), DJK-5 + 2% CHX, or 1018 + 2% CHX for short-term (1 or 3 minutes), short-term exposure after 24 hours, and long-term exposure (24 hours of exposure). The antibacterial efficacy was determined by live/dead bacterial viability staining and confocal laser scanning microscopy. RESULTS: Peptide DJK-5 with or without CHX was the most effective agent against all the biofilms (P < .05), killing 77% of biofilm bacteria in 1 minute. No significant difference in bacterial killing was detected between the first 3 minutes of exposure (>81%) and after 24 hours of exposure (83%) to DJK-5 or DJK-5 + CHX. Chlorhexidine and peptide 1018 had a weaker antibiofilm effect than DJK-5, and their effect was time dependent (P < .05) with a maximum killing of 60% after 24 hours of exposure. CONCLUSIONS: Peptide DJK-5 alone and together with CHX had a rapid antibacterial effect against dentin infection. An additional antibacterial effect by CHX and peptide 1018 was achieved after a 24-hour long-term exposure.

Low Environmental Temperature Influences the Fatigue Resistance of Nickel-titanium Files.

INTRODUCTION: The purpose of this study was to evaluate the effect of different temperatures (0°C, 10°C, 22°C, 37°C, and 60°C) on the cyclic fatigue life of nickel-titanium (NiTi) files using a new fatigue test model in zirconium oxide. METHODS: Three superelastic NiTi files (EndoSequence [Brasseler USA, Savannah, GA], ProFile [Dentsply Tulsa Dental Specialties, Tulsa, OK], and K3 [SybronEndo, Orange, CA]), and 3 heat-treated (K3XF [SybronEndo], Vortex [Dentsply Tulsa Dental Specialties], and HyFlex CM [Coltene-Whaledent, Allstetten, Switzerland]) NiTi files, all size 25/.04, were subjected to cyclic fatigue tests inside a novel, artificial ceramic canal with a curvature of 60° and a 5-mm radius. The model was immersed in water at 5 different preset temperatures. The number of cycles to failure (NCF) was recorded, and the fracture surface of the fragments was examined by a scanning electron microscope. The data were analyzed using 2-way analysis of variance with the significance level at 0.05. RESULTS: When the temperature was reduced from 60°C to 0°C, the NCF significantly increased from over 2 to 10 times for the NiTi file groups (P < .01). K3XF had the highest fatigue resistance of all files at 0°C (P < .05). Vortex files had the highest NCF at 10°C-60°C. The NCF of heat-treated files was significantly higher than superelastic NiTi files at 10°C and 20°C (P < .05). There was no significant difference in the NCF of HyFlex CM at 0°C and 22°C. There was little difference in the fractographic appearance among different temperatures, except that the fraction area occupied by the dimple region of some instruments at 0°C was slightly smaller than at 60°C. CONCLUSIONS: Cooling down to low temperatures may be an interesting strategy to improve the fatigue resistance of rotary NiTi files.

Biomarker MicroRNAs for Diagnosis of Oral Squamous Cell Carcinoma Identified Based on Gene Expression Data and MicroRNA-mRNA Network Analysis.

Oral squamous cell carcinoma is one of the most malignant tumors with high mortality rate worldwide. Biomarker discovery is critical for early diagnosis and precision treatment of this disease. MicroRNAs are small noncoding RNA molecules which often regulate essential biological processes and are good candidates for biomarkers. By integrative analysis of both the cancer-associated gene expression data and microRNA-mRNA network, miR-148b-3p, miR-629-3p, miR-27a-3p, and miR-142-3p were screened as novel diagnostic biomarkers for oral squamous cell carcinoma based on their unique regulatory abilities in the network structure of the conditional microRNA-mRNA network and their important functions. These findings were confirmed by literature verification and functional enrichment analysis. Future experimental validation is expected for the further investigation of their molecular mechanisms.

Fatigue Resistance of Nickel-titanium Instruments Exposed to High-concentration Hypochlorite.

INTRODUCTION: The purpose of this study was to introduce a new fatigue test model that simulates the clinical situation for evaluating the corrosion effect of 5.25% sodium hypochlorite (NaOCl) on nickel-titanium (NiTi) files and to evaluate the effect of 3 different temperatures (22°C, 37°C, and 60°C) on the cyclic fatigue of these files. METHODS: Three NiTi files (size 25/.04), K3 (SybronEndo, Orange, CA), K3XF (SybronEndo), and Vortex (Dentsply Tulsa Dental Specialties, Tulsa, OK), were subjected to cyclic fatigue tests inside a novel artificial ceramic canal with a curvature of 60° and a 5-mm radius. A 19-mm-long file segment from the tip was introduced into the canal and immersed in water or 5.25% NaOCl at 3 different temperatures, and the number of revolutions to fracture (Nf) was recorded. The fracture surface of all fragments was examined by a scanning electron microscope. Data were analyzed using univariate analysis of variance with the significance level at 0.05. RESULTS: The Nf of Vortex files was the highest followed by K3XF and K3 (P < .05) at all conditions. The Nf of all files was highest at 22°C and lowest at 60°C (P < .05). However, no difference in Nf was detected in Vortex files between 22°C and 37°C. The Nf of all files in 5.25% NaOCl was shorter than that in water although there was no statistically significant difference. No pitting or crevice corrosion was observed on the fracture surface. CONCLUSIONS: NaOCl, 5.25%, does not significantly affect the fatigue behavior of NiTi files. The fatigue resistance should be tested under specific temperature conditions. The austenite finish temperature of a file is important in determining the fracture risk at body temperature.

Corrigendum to "Biomarker MicroRNAs for Diagnosis of Oral Squamous Cell Carcinoma Identified Based on Gene Expression Data and MicroRNA-mRNA Network Analysis".

[This corrects the article DOI: 10.1155/2017/9803018.].

Fatigue Resistance of a 3-dimensional Conforming Nickel-Titanium Rotary Instrument in Double Curvatures.

INTRODUCTION: Fatigue resistance of ProFile, Vortex Blue, and TRUShape files in artificial single curvature and in 2 different artificial double curvature canals was evaluated. METHODS: Three files (ProFile, Vortex Blue [size 20/.06], and TRUShape [size 20/.06v]) were subjected to fatigue tests in a single curvature (group 1: 60° curvature) and 2 different double curvatures (group 2: 60° and 30° curvatures; group 3: two 60° curvatures). The time to fracture and the total number of cycles to failure were recorded. The fracture surfaces of the fragments were examined with a scanning electron microscope. RESULTS: All files had significantly higher fatigue resistance in a single curvature canal than in the double curvature canals. In a single curvature group, the time to fracture of TRUShape and ProFile was longer than in Vortex Blue files. In both double curvature groups, TRUShape had the longest time to fracture among all files. The fatigue resistance (the time to fracture and number of cycles to failure) of ProFile and Vortex Blue was lower in group 3 than in group 2 (P < .05). However, there was no significant difference in fatigue resistance of TRUShape in the double curvature groups. The length of the fragment of TRUShape was longer than in Vortex Blue and ProFile files in group 3 (P < .05). CONCLUSIONS: The fatigue performance of TRUShape is different in double curvature canals, compared with conventional nickel-titanium rotary files. The fatigue resistance of TRUShape was superior to ProFile and Vortex Blue in double curvature canals.

FGF-2 induces the proliferation of human periodontal ligament cells and modulates their osteoblastic phenotype by affecting Runx2 expression in the presence and absence of osteogenic inducers.

The exact phenotype of human periodontal ligament cells (hPDLCs) remains a controversial area. Basic fibroblast growth factor (FGF­2) exhibits various functions and its effect on hPDLCs is also controversial. Therefore, the present study examined the effect of FGF­2 on the growth and osteoblastic phenotype of hPDLCs with or without osteogenic inducers (dexamethasone and ß­glycerophosphate). FGF­2 was added to defined growth culture medium and osteogenic inductive culture medium. Cell proliferation, osteogenic differentiation and mineralization were measured. The selected differentiation markers, Runx2, collagen type Ⅰ, α1 (Col1a1), osteocalcin (OCN) and epidermal growth factor receptor (EGFR), were investigated by reverse transcription­quantitative polymerase chain reaction (RT­qPCR). Runx2 and OCN protein expression was measured by western blotting. FGF­2 significantly increased the proliferation of hPDLCs, but did not affect alkaline phosphatase activity. RT­qPCR analysis revealed enhanced mRNA expression of Runx2, OCN and EGFR, but suppressed Col1a1 gene expression in the absence of osteogenic inducers, whereas all these gene levels had no clear trend in their presence. The Runx2 protein expression was clearly increased, but the OCN protein level showed no evident trend. The mineralization assay demonstrated that FGF­2 inhibited mineralized matrix deposition with osteogenic inducers. These results suggested that FGF­2 induces the growth of immature hPDLCs, which is a competitive inhibitor of epithelial downgrowth, and suppresses their differentiation into mineralized tissue by affecting Runx2 expression. Therefore, this may lead to the acceleration of periodontal regeneration.

A comparative study of the proliferation and osteogenic differentiation of human periodontal ligament cells cultured on ß-TCP ceramics and demineralized bone matrix with or without osteogenic inducers in vitro.

The repair of bone defects that result from periodontal diseases remains a clinical challenge for periodontal therapy. ß-tricalcium phosphate (ß-TCP) ceramics are biodegradable inorganic bone substitutes with inorganic components that are similar to those of bone. Demineralized bone matrix (DBM) is an acid-extracted organic matrix derived from bone sources that consists of the collagen and matrix proteins of bone. A few studies have documented the effects of DBM on the proliferation and osteogenic differentiation of human periodontal ligament cells (hPDLCs). The aim of the present study was to investigate the effects of inorganic and organic elements of bone on the proliferation and osteogenic differentiation of hPDLCs using three-dimensional porous ß-TCP ceramics and DBM with or without osteogenic inducers. Primary hPDLCs were isolated from human periodontal ligaments. The proliferation of the hPDLCs on the scaffolds in the growth culture medium was examined using a Cell-Counting kit-8 (CCK-8) and scanning electron microscopy (SEM). Alkaline phosphatase (ALP) activity and the osteogenic differentiation of the hPDLCs cultured on the ß-TCP ceramics and DBM were examined in both the growth culture medium and osteogenic culture medium. Specific osteogenic differentiation markers were examined using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). SEM images revealed that the cells on the ß-TCP were spindle-shaped and much more spread out compared with the cells on the DBM surfaces. There were no significant differences observed in cell proliferation between the ß-TCP ceramics and the DBM scaffolds. Compared with the cells that were cultured on ß-TCP ceramics, the ALP activity, as well as the Runx2 and osteocalcin (OCN) mRNA levels in the hPDLCs cultured on DBM were significantly enhanced both in the growth culture medium and the osteogenic culture medium. The organic elements of bone may exhibit greater osteogenic differentiation effects on hPDLCs than the inorganic elements.

Modes of failure of ProTaper nickel-titanium rotary instruments after clinical use.

This study was to investigate the mode of fracture of ProTaper rotary instruments after clinical use and to compare stereomicroscopy with scanning electron microscopy (SEM) to determine which is the better method for establishing the mode of material failure. In all, 100 fractured ProTaper instruments were examined under stereomicroscope for the presence of plastic deformation along the cutting edge near the fracture site. Fractographic and longitudinal examinations were carried out at high-power magnification with SEM. Stereomicroscopy revealed 88 flexural cases and 12 torsional cases. Fractomicrographs verified 91 flexural cases with fatigue striations and three torsional cases with circular abrasion marks. Six instruments showed characteristics of both flexural and torsional failures. Cracks, microcracks, and pittings were common findings on longitudinal micrographs. Our study demonstrated that inspecting the fractured surface at high-power magnification by SEM is a better method to reveal the mode of NiTi rotary instrument separation.