Evaluation of mechanical, optical, and fluoride-releasing properties of a translucent bulk fill glass hybrid restorative dental material.

OBJECTIVE: Measure and compare the mechanical properties, translucency, and fluoride-releasing capabilities of EQUIA Forte HT against Fuji IX GP and ChemFil Rock. MATERIALS AND METHODS: Ten specimens of each material were fabricated for compressive strength (CS), flexural strength (FS), and surface hardness analysis at 24 h and 7 days. The L*a*b* values were measured against a black-and-white background using a spectrophotometer to analyze the translucency parameter (TP). Fluoride release was recorded after 2 months of immersion in distilled water. The mean data was analyzed by 1- and 2-way ANOVA (α = 0.5). RESULTS: EQUIA Forte HT showed higher CS, surface hardness, and FS values (p < 0.05) compared with Fuji IX GIC, while no significant difference was found in FS values between EQUIA Forte HT and Chemfil Rock (p > 0.05). The EQUIA Forte HT exhibited significantly higher translucency in comparison to both ChemFil Rock (p < 0.001) and Fuji IX GICs (p < 0.05). An increase (p > 0.05) of fluoride release was observed for EQUIA Forte HT. CONCLUSION: The EQUIA Forte HT Glass-ionomer cements (GIC) offers enhanced translucency, improved strength, and enhanced fluoride-releasing properties compared to the traditionally used Fuji IX GIC and ChemFil Rock GICs. This material might have a wide range of clinical applications due to its improved strength and optical properties. CLINICAL SIGNIFICANCE: Glass-ionomer dental restorative materials possess unique advantageous characteristics. However, its poor mechanical and optical properties have typically limited its clinical applications. Efforts to improve these properties have resulted in enhanced GICs. EQUIA Forte HT GIC offers enhanced mechanical and optical properties with potential applications in posterior and anterior restorative procedures.

Dynamic navigation may be used for most implant surgery scenarios due to its satisfactory accuracy.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Wei SM, Zhu Y, Wei JX, Zhang CN, Shi JY, Lai HC. Accuracy of dynamic navigation in implant surgery: A systematic review and meta-analysis. Clin Oral Implants Res. 2021 Apr;32(4):383-393. doi: 10.1111/clr.13719. SOURCE OF FUNDING: Shanghai Jiao Tong University School of Medicine (grant no. DLY201822); Shanghai Clinical Research Center for Oral Diseases (grant no. 19,411,950,100); Clinical Research Plan of SHDC (grant no. 16CR3033A). TYPE OF STUDY/DESIGN: Systematic review with meta-analysis.

CAD-CAM acrylic resin prosthesis superstructure: A technique for fabricating an implant-supported fixed complete denture.

The implant-supported fixed complete denture is a common treatment option in implant prosthodontics but has shortcomings that include the high wear rate of the acrylic resin denture material and the displacement of denture teeth from the denture base. This report describes a method for fabricating implant-supported fixed dental prostheses using computer-aided design and computer-aided manufacturing technology.

Comparative evaluation of the physical properties of a reinforced glass ionomer dental restorative material.

STATEMENT OF PROBLEM: While glass ionomer cements have many unique properties and advantages, they still lack favorable mechanical properties. EQUIA Forte Fil is a newly developed glass ionomer cement (GIC) with improved mechanical strength. However, research and data on the physical properties of EQUIA Forte Fil are lacking. PURPOSE: The purpose of this in vitro study was to evaluate and compare the compressive, diametral tensile, and flexural strengths of EQUIA Forte Fil with Fuji IX GP and ChemFil Rock, restorative GICs commonly used in dentistry. Moreover, fluoride-releasing properties and surface hardness of the GICs were also assessed. MATERIAL AND METHODS: Ten disk-shaped specimens of each GIC (EQUIA Forte Fil, Fuji IX GP, and ChemFil Rock) were fabricated for mechanical and surface hardness tests by using polydimethylsiloxane (PDMS) molds. The specimens were tested after 24 hours and 7 days of immersion in distilled water at 37 °C. By using a mechanical testing machine, the compressive, diametral tensile, and flexural strengths of each GIC were measured. Fluoride-releasing properties were also evaluated (10 specimens per group). A microhardness tester was used to measure the surface hardness. The mean data were analyzed by using 1- and 2-way ANOVA (α=.05). RESULTS: EQUIA Forte Fil glass ionomer cements exhibited significantly greater (P<.05) flexural strength and surface hardness than Fuji IX GIC specimens. However, no significant difference (P>.05) was observed between the compressive and diametral tensile strength of EQUIA Forte Fil and Fuji IX GIC specimens. ChemFil Rock exhibited higher flexural strength than EQUIA Forte Fil (P>.05) but significantly lower compressive strength and microhardness (P<.05). Tested GICs matured after 1 week of immersion in distilled water, demonstrating a significant improvement in their mechanical properties. All the examined glass ionomers exhibited comparable initial fluoride-releasing properties, whereas EQUIA Forte Fil exhibited significantly higher (P<.05) amounts of fluoride release from the bulk of the material after 4 weeks. CONCLUSIONS: EQUIA Forte Fil is a promising restorative material with superior flexural strength and surface hardness compared with its predecessor, Fuji IX GP, or other commercially available glass ionomers.

Nanostructured Fibrous Membranes with Rose Spike-Like Architecture.

Nanoparticles have been used for engineering composite materials to improve the intrinsic properties and/or add functionalities to pristine polymers. The majority of the studies have focused on the incorporation of spherical nanoparticles within the composite fibers. Herein, we incorporate anisotropic branched-shaped zinc oxide (ZnO) nanoparticles into fibrous scaffolds fabricated by electrospinning. The addition of the branched particles resulted in their protrusion from fibers, mimicking the architecture of a rose stem. We demonstrated that the encapsulation of different-shape particles significantly influences the physicochemical and biological activities of the resultant composite scaffolds. In particular, the branched nanoparticles induced heterogeneous crystallization of the polymeric matrix and enhance the ultimate mechanical strain and strength. Moreover, the three-dimensional (3D) nature of the branched ZnO nanoparticles enhanced adhesion properties of the composite scaffolds to the tissues. In addition, the rose stem-like constructs offered excellent antibacterial activity, while supporting the growth of eukaryote cells.

Comparison of dimensional accuracy of conventionally and digitally manufactured intracoronal restorations.

STATEMENT OF PROBLEM: Advances have been made in digital dentistry for the fabrication of dental prostheses, but evidence regarding the efficacy of digital techniques for the fabrication of intracoronal restorations is lacking. PURPOSE: The purpose of this in vitro study was to compare the dimensional accuracy of intracoronal restorations fabricated with digital and conventional techniques. MATERIAL AND METHODS: A sound mandibular molar tooth received a standard onlay preparation, and onlays were fabricated with 1 of 3 fabrication techniques. In group CC, the onlays were made after conventional impression and conventional fabrication of a resin pattern. In group CP, the onlays were made after conventional impression and 3-dimensional (3D) printing of the pattern. In group IP, the onlays were made after intraoral scanning, and 3D printing produced the resin pattern. Ten specimens in each group (N=30) were evaluated. Glass-ceramic restorations were fabricated using the press technique. The replica technique was used to assess the marginal fit. Each replica was assessed at 8 points. One-way ANOVA was used to compare the marginal discrepancy among the 3 groups. The Tukey honest significant differences test was applied for pairwise comparisons of the groups (α=.05). RESULTS: No significant differences were noted in the marginal discrepancy at the gingival margin among the 3 groups (P=.342), but significant differences were noted among the 3 groups in the pulpal (P=.025) and lingual (P=.031) areas. Comparison of the absolute discrepancy among the 3 groups revealed that only groups CC and CP were significantly different (P=.020) from each other. CONCLUSIONS: Within the limitations of this in vitro study, the conventional method yielded more accuracy than the 3D printing method, and no differences were found between the methods which used the 3D printer (groups CP and IP).

Effects of an etching solution on the adhesive properties and surface microhardness of zirconia dental ceramics.

STATEMENT OF PROBLEM: Conventional approaches to adhesive bonding are not applicable to zirconia restorations. Recently, an etching solution, Zeta Etching Solution (ZES), has been introduced for etching the surface of zirconia. The effects of this etching solution on the bond strength and mechanical properties of zirconia are unknown. PURPOSE: The purpose of this in vitro study was to examine the effects of ZES on the bond strength and surface hardness of zirconia. MATERIAL AND METHODS: Two different types of partially stabilized tetragonal polycrystalline zirconia (TZP), Prettau zirconia (group P) and anterior Prettau (group AP), were evaluated with and without ZES etching. Each group was bonded to a zirconia substrate by using an adhesive resin cement. After 24 hours of storage in distilled water, the bond strength of the zirconia was analyzed. Vickers hardness was determined by using a microhardness tester. Scanning electron microscopy was used to analyze the surface microstructure and determine the mode of failure for each specimen. Results were analyzed and compared using 1-way ANOVA and Student t tests (α=.05). RESULTS: Scanning electron microscopy analysis showed that etching the surface of zirconia with ZES etching solution for 60 minutes changed the morphological characteristics and microstructure of zirconia, making the surface more irregular. The changes were more pronounced for AP specimens. Etching with ZES significantly increased the shear bond strength of zirconia (P<.05) in AP specimens. The bond strength of Prettau (P group) specimens after ZES etching did not increase significantly (P>.05). An adhesive failure mode was observed for P zirconia specimens, whereas zirconia specimens exhibited a cohesive mode of failure. No significant decrease (P>.05) was observed in the mean Vickers hardness numbers. CONCLUSIONS: Within the limitations of this in vitro study, it was concluded that etching in ZES for 30 minutes significantly enhanced the shear bond strength of highly translucent anterior Prettau (AP) zirconia restorations. Moreover, etching with ZES did not adversely affect the surface hardness of the zirconia specimens tested.

Alginate/hyaluronic acid hydrogel delivery system characteristics regulate the differentiation of periodontal ligament stem cells toward chondrogenic lineage.

Cartilage tissue regeneration often presents a challenging clinical situation. Recently, it has been shown that Periodontal Ligament Stem Cells (PDLSCs) possess high chondrogenic differentiation capacity. In this study, we developed a stem cell delivery system based on alginate/hyaluronic acid (HA) loaded with TGF-ß1 ligand, encapsulating PDLSCs; and investigated the chondrogenic differentiation of encapsulated cells in alginate/HA hydrogel microspheres in vitro and in vivo. The results showed that PDLSCs, as well as human bone marrow mesenchymal stem cells (hBMMSCs), as the positive control, were stained positive for both toluidine blue and alcian blue staining, while exhibiting high levels of gene expression related to chondrogenesis (Col II, Aggrecan and Sox-9), as assessed via qPCR. The quantitative PCR analyses exhibited that the chondrogenic differentiation of encapsulated MSCs can be regulated by the modulus of elasticity of hydrogel delivery system, confirming the vital role of the microenvironment, and the presence of inductive signals for viability and differentiation of MSCs. In vivo, histological and immunofluorescence staining for chondrogenic specific protein markers confirmed ectopic cartilage-like tissue regeneration inside transplanted hydrogels. PDLSCs presented significantly greater capability for chondrogenic differentiation than hBMMSCs (P < 0.05). Altogether, our findings confirmed that alginate/HA hydrogels encapsulating PDLSCs are a promising candidate for cartilage regeneration.

Effect of different thermo-light polymerization on flexural strength of two glass ionomer cements and a glass carbomer cement.

STATEMENT OF PROBLEM: Whether polymerization lights can be used for heating glass ionomer cements (GICs) or glass carbomer (GCP) to improve their mechanical properties is not well established. PURPOSE: The purpose of this in vitro study was to assess the effect of thermo-light polymerization on the flexural strength (FS) of 2 GICs (Fuji IX GP Fast, Ketac Molar) and a GCP. MATERIAL AND METHODS: Specimens (n=10) were prepared in stainless steel molds (2×2×25 mm), compressed, exposed to 3 polymerization lights (500, 1000, 1200 mW/cm2) for 2 cycles of 40 seconds on each side, and stored in petroleum jelly (37°C, 24 hours). RESULTS: Significant FS differences were detected among groups after different thermo-light polymerization regimens (F=50.926, df=11, P<.001). GCP showed the highest mean FS (∼5 times, P<.001) after thermo-light polymerization with power outputs of 1000 (127.1 ±25.8 MPa) and 1200 mW/cm2 (117.4 ±18.5 MPa), with no significance difference between them (P=.98), compared with 500 mW/cm2 (24.1 ±1.7 MPa). For Ketac Molar, compared with autopolymerization setting (15.5 ±3.1 MPa), a significant increase in mean FS (∼2.5 times) was only observed in specimens treated with 1200 mW/cm2 polymerization light (P=.03). For Fuji IX GP Fast, only the light with 1000 mW/cm2 output significantly increased the FS (98.9 ±23.4 MPa, P<.001) compared with the autopolymerization setting (34.9 ±6.4 MPa). CONCLUSIONS: Thermo-light polymerization accelerated the development of FS in the tested GICs, potentially protecting against saliva contamination during the first 3 to 4 minutes after mixing GIC. Thermo-light polymerization of the glass carbomer with power outputs of 1000 and 1200 mW/cm2 also substantially increased FS. The clinical advantages of the findings should be validated by in vivo studies.

Dental and orofacial mesenchymal stem cells in craniofacial regeneration: The prosthodontist's point of view.

Of the available regenerative treatment options, craniofacial tissue regeneration using mesenchymal stem cells (MSCs) shows promise. The ability of stem cells to produce multiple specialized cell types along with their extensive distribution in many adult tissues have made them an attractive target for applications in tissue engineering. MSCs reside in a wide spectrum of postnatal tissue types and have been successfully isolated from orofacial tissues. These dental- or orofacial-derived MSCs possess self-renewal and multilineage differentiation capacities. The craniofacial system is composed of complex hard and soft tissues derived from sophisticated processes starting with embryonic development. Because of the complexity of the craniofacial tissues, the application of stem cells presents challenges in terms of the size, shape, and form of the engineered structures, the specialized final developed cells, and the modulation of timely blood supply while limiting inflammatory and immunological responses. The cell delivery vehicle has an important role in the in vivo performance of stem cells and could dictate the success of the regenerative therapy. Among the available hydrogel biomaterials for cell encapsulation, alginate-based hydrogels have shown promising results in biomedical applications. Alginate scaffolds encapsulating MSCs can provide a suitable microenvironment for cell viability and differentiation for tissue regeneration applications. This review aims to summarize current applications of dental-derived stem cell therapy and highlight the use of alginate-based hydrogels for applications in craniofacial tissue engineering.

Gingival Mesenchymal Stem Cell (GMSC) Delivery System Based on RGD-Coupled Alginate Hydrogel with Antimicrobial Properties: A Novel Treatment Modality for Peri-Implantitis.

PURPOSE: Peri-implantitis is one of the most common inflammatory complications in dental implantology. Similar to periodontitis, in peri-implantitis, destructive inflammatory changes take place in the tissues surrounding a dental implant. Bacterial flora at the failing implant sites resemble the pathogens in periodontal disease and consist of Gram-negative anaerobic bacteria including Aggregatibacter actinomycetemcomitans (Aa). Here we demonstrate the effectiveness of a silver lactate (SL)-containing RGD-coupled alginate hydrogel scaffold as a promising stem cell delivery vehicle with antimicrobial properties. MATERIALS AND METHODS: Gingival mesenchymal stem cells (GMSCs) or human bone marrow mesenchymal stem cells (hBMMSCs) were encapsulated in SL-loaded alginate hydrogel microspheres. Stem cell viability, proliferation, and osteo-differentiation capacity were analyzed. RESULTS: Our results showed that SL exhibited antimicrobial properties against Aa in a dose-dependent manner, with 0.50 mg/ml showing the greatest antimicrobial properties while still maintaining cell viability. At this concentration, SL-containing alginate hydrogel was able to inhibit Aa growth on the surface of Ti discs and significantly reduce the bacterial load in Aa suspensions. Silver ions were effectively released from the SL-loaded alginate microspheres for up to 2 weeks. Osteogenic differentiation of GMSCs and hBMMSCs encapsulated in the SL-loaded alginate microspheres were confirmed by the intense mineral matrix deposition and high expression of osteogenesis-related genes. CONCLUSION: Taken together, our findings confirm that GMSCs encapsulated in RGD-modified alginate hydrogel containing SL show promise for bone tissue engineering with antimicrobial properties against Aa bacteria in vitro.

Regulation of the Stem Cell-Host Immune System Interplay Using Hydrogel Coencapsulation System with an Anti-Inflammatory Drug.

The host immune system is known to influence mesenchymal stem cell (MSC)-mediated bone tissue regeneration. However, the therapeutic capacity of hydrogel biomaterial to modulate the interplay between MSCs and T-lymphocytes is unknown. Here it is shown that encapsulating hydrogel affects this interplay when used to encapsulate MSCs for implantation by hindering the penetration of pro-inflammatory cells and/or cytokines, leading to improved viability of the encapsulated MSCs. This combats the effects of the host pro-inflammatory T-lymphocyte-induced nuclear factor kappaB pathway, which can reduce MSC viability through the CASPASE-3 and CAS-PASE-8 associated proapoptotic cascade, resulting in the apoptosis of MSCs. To corroborate rescue of engrafted MSCs from the insult of the host immune system, the incorporation of the anti-inflammatory drug indomethacin into the encapsulating alginate hydrogel further regulates the local microenvironment and prevents pro-inflammatory cytokine-induced apoptosis. These findings suggest that the encapsulating hydrogel can regulate the MSC-host immune cell interplay and direct the fate of the implanted MSCs, leading to enhanced tissue regeneration.

Pluronic F-127 hydrogel as a promising scaffold for encapsulation of dental-derived mesenchymal stem cells.

Dental-derived mesenchymal stem cells (MSCs) provide an advantageous therapeutic option for tissue engineering due to their high accessibility and bioavailability. However, delivering MSCs to defect sites while maintaining a high MSC survival rate is still a critical challenge in MSC-mediated tissue regeneration. Here, we tested the osteogenic and adipogenic differentiation capacity of dental pulp stem cells (DPSCs) in a thermoreversible Pluronic F127 hydrogel scaffold encapsulation system in vitro. DPSCs were encapsulated in Pluronic (®) F-127 hydrogel and stem cell viability, proliferation and differentiation into adipogenic and osteogenic tissues were evaluated. The degradation profile and swelling kinetics of the hydrogel were also analyzed. Our results confirmed that Pluronic F-127 is a promising and non-toxic scaffold for encapsulation of DPSCs as well as control human bone marrow MSCs (hBMMSCs), yielding high stem cell viability and proliferation. Moreover, after 2 weeks of differentiation in vitro, DPSCs as well as hBMMSCs exhibited high levels of mRNA expression for osteogenic and adipogenic gene markers via PCR analysis. Our histochemical staining further confirmed the ability of Pluronic F-127 to direct the differentiation of these stem cells into osteogenic and adipogenic tissues. Furthermore, our results revealed that Pluronic F-127 has a dense tubular and reticular network morphology, which contributes to its high permeability and solubility, consistent with its high degradability in the tested conditions. Altogether, our findings demonstrate that Pluronic F-127 is a promising scaffold for encapsulation of DPSCs and can be considered for cell delivery purposes in tissue engineering.

Biofilms in restorative dentistry: A clinical report.

This clinical report describes the structure and characteristics of the biofilm formed under a cemented restoration, confirming the need to develop new cementation protocols to disrupt and minimize the formation of biofilm before cementing definitive restorations.

Mandibular implant-supported fixed dental prosthesis with a modified design: a clinical report.

This clinical report describes the rehabilitation of a patient with a mandibular implant-supported fixed dental prosthesis. Because of the limited restorative space available in the posterior mandible and in considering the higher wear rate of acrylic resin in comparison with titanium when it opposes metal ceramic restorations, the treatment used a milled titanium bar with acrylic resin denture teeth, which replaced the anterior teeth with milled titanium for the posterior occluding surfaces.

Effects of setting under air pressure on the number of surface pores and irregularities of dental investment materials.

STATEMENT OF PROBLEM: Surface roughness and irregularities are important properties of dental investment materials that can affect the fit of a restoration. Whether setting under air pressure affects the surface irregularities of gypsum-bonded and phosphate-bonded investment materials is unknown. PURPOSE: The purpose of this study was to investigate the effect of air pressure on the pore size and surface irregularities of investment materials immediately after pouring. MATERIAL AND METHODS: Three dental investments, 1 gypsum-bonded investment and 2 phosphate-bonded investments, were investigated. They were vacuum mixed according to the manufacturers' recommendations, then poured into a ringless casting system. The prepared specimens were divided into 2 groups: 1 bench setting and the other placed in a pressure pot at 172 kPa. After 45 minutes of setting, the rings were removed and the investments were cut at a right angle to the long axis with a diamond disk. The surfaces of the investments were steam cleaned, dried with an air spray, and observed with a stereomicroscope. A profilometer was used to evaluate the surface roughness (µm) of the castings. The number of surface pores was counted for 8 specimens from each group and the means and standard deviations were reported. Two-way ANOVA was used to compare the data. RESULTS: Specimens that set under atmospheric air pressure had a significantly higher number of pores than specimens that set under increased pressure (P<.05). No statistically significant differences for surface roughness were found (P=.078). Also, no significant difference was observed among the 3 different types of materials tested (P>.05). CONCLUSION: Specimens set under positive pressure in a pressure chamber presented fewer surface bubbles than specimens set under atmospheric pressure. Positive pressure is effective and, therefore, is recommended for both gypsum-bonded and phosphate-bonded investment materials.

Implant-abutment interface: a comparison of the ultimate force to failure among narrow-diameter implant systems.

STATEMENT OF PROBLEM: Limited available alveolar ridge bone and space deficiencies are some of the challenging scenarios that have led many dental implant manufacturers to develop narrow-diameter implants of various designs. Clinicians may have concerns about the durability and function of the narrow-diameter implants. PURPOSE: The purpose of this study was to explore and compare the ultimate failure resistance of the smallest diameter of the 2-stage type implant provided by 5 commonly used dental implant systems. MATERIAL AND METHODS: Thirty implants, Astra OsseoSpeed 3.0 mm and 3.5 mm, Straumann Bone Level 3.3 mm, Zimmer Tapered Screw-Vent 3.7 mm, Full Osseotite Certain 3.25 mm, and NobelSpeedy Replace 3.5 mm, 5 of each type, were tested in this study. A rigid clamp was used to hold the implants at a 30-degree angle to a static load vector. The load continued until the specimen broke or obviously deformed. Peak loads were recorded at that point for all the studied implant systems. Student t test and 1-way ANOVA were used to compare the mean peak load values (α=.05). RESULTS: The mean fracture/deformation peak load values were 367.20 N ± 98.05 for Astra OsseoSpeed 3.0 mm; 568.80 N ± 85.24 for Astra OsseoSpeed 3.5 mm; 679.00 N ± 81.09 for Full Osseotite Certain 3.25 mm; 553.4 N ± 56.96 for NobelSpeedy Replace 3.5 mm; 802.80 N ± 134.50 for Zimmer Tapered Screw-Vent 3.7 mm; and 576.20 N ± 71.45 for Straumann Bone Level 3.3 mm. Generally, a higher load was required to cause failure in implants with larger diameters than in narrower-diameter implants, and more force was necessary to cause failure in Ti6Al4V alloy implants than in commercially pure titanium implants. CONCLUSIONS: With regard to implant diameter and ultimate failure strength, Osseotite Certain 3.25 mm was considered to be more advantageous in comparison with the other implants tested.

A technique for retrieving fractured implant screws.

The use of dental implants as a source of support and retention for fixed restorations is common. This report describes the use of a fragment removal instrument together with the use of ultrasonic instrumentation to retrieve a screw fragment.

A multidisciplinary approach for the rehabilitation of a patient with an excessively worn dentition: a clinical report.

This clinical report describes a multidisciplinary approach to the diagnosis and treatment of a patient with a severely worn dentition. The treatment included osteotomy and immediate implant placement and loading in the mandible. The definitive restorations were implant- and tooth-supported metal ceramic restorations. These restorations were fabricated with metal occlusal surfaces at an increased occlusal vertical dimension, which provided acceptable esthetics and function.

Full mouth rehabilitation of a young patient with partial expressions of ectodermal dysplasia: a clinical report.

Ectodermal dysplasia (ED) is a hereditary disorder characterized by the abnormal development of specific tissues and structures of ectodermal origin. This clinical report describes the multidisciplinary approach to the diagnosis and treatment of a 24-year-old patient with partial expression of ED. The treatment plan used dental implants to support fixed prostheses and ceramic restorations to establish acceptable esthetics and provide function.