Comparison of Fracture Resistance of Simulated Immature Teeth Using Four Different Commercially Available Apexification Materials ? An invitro Study

Introduction: The aim of this study was to compare the fracture resistance of simulated immature teeth using four different apical plug materials, i.e. Pro? Root MTA, Neo? MTA Plus, Biodentine, and Bioactive Glass. Materials and Methods: 80 extracted human maxillary anterior teeth were divided into 4 groups for this study. They were prepared using Peeso reamers to simulate immature teeth and to mimic Cvek’s stage 3 of root development. A 5 mm apical barrier was placed using different materials. The remaining canal was obturated using gutta?percha and AH plus sealer. The final samples were stored at 37°C and 100% humidity for 4 weeks. Fracture resistance of the teeth was measured in Newtons using a universal testing machine. The comparison of fracture resistance between the four groups was done using Kruskal Walis ANOVA followed by post hoc Mann Whitney U test for pairwise comparison. Results: Biodentine group showed the highest fracture resistance as compared to the other three groups and the difference was highly significant (P < 0.001). Conclusions: Biodentine can be advocated over MTA as an effective material for the management of teeth with wide open apex. Bioactive glass also has shown promising results in increasing the fracture resistance of simulated immature teeth.

The effect of Phytosphingosine and bioactive glass-ceramics in preventing dental enamel erosion

Abstract This study evaluated the effect of phytosphingosine (PHS) and bioactive glass-ceramic (Biosilicate) on dental enamel in terms of color alteration (ΔE), microhardness, and surface roughness when submitted to erosive challenge (EC). Sixty specimens of bovine teeth (6×6×2mm) were obtained. Initial color (Easyshade, VITA), KHN (HMV-2, Shimadzu), and Ra (SJ-201P, Mitutoyo) measurements were performed. Specimens were separated into groups according to treatments: PHS, 10% Biosilicate, PHS+10% Biosilicate, and artificial saliva (control) and submitted to EC with Coca-Cola for 2 min. This cycle was repeated 4 times daily/15 days. Between cycles, specimens remained in artificial saliva (2 h/37°C). After daily cycles, they were also stored in artificial saliva at 37ºC. Final color, microhardness, and surface roughness measurements were done. Color and KHN data were analyzed by one-way ANOVA, Tukey's test; and Ra, by 2-way ANOVA, repeated measures, and Tukey's test (p<.05). The highest ΔE occurred in Saliva+EC (p<.05). Groups treated with PHS presented lower color change than Saliva+EC (p<.05). All the groups presented mean values above the 50:50% perceptibility (50:50%PT) and acceptability (50:50%AT) thresholds, except for control that showed mean value above 50:50%PT but below 50:50%AT. Biosilicate+EC showed higher relative microhardness than Saliva+EC (p<.05), but was similar to PHS+EC and PHS+Biosilicate+EC. Final enamel surface roughness increased for all the groups (p<.05), except for the control. The Biosilicate may prevent enamel mineral loss induced by erosion better than saliva. The PHS associated or not to Biosilicate demonstrated better color stability than saliva.

Resumo Este estudo avaliou o efeito da Fitoesfingosina (PHS) e da vitrocerâmica bioativa (Biosilicato) sobre o esmalte dental em termos de alteração de cor (ΔE), microdureza (KHN) e rugosidade superficial, quando submetido a desafio erosivo (DE). Sessenta espécimes de dentes bovinos (6×6×2mm) foram obtidos. Foram realizadas leituras de cor inicial (Easyshade, VITA), microdureza (HMV-2, Shimadzu) e rugosidade superfícial (SJ-201P, Mitutoyo). Os espécimes foram separados em grupos de acordo com os tratamentos: PHS, Biosilicato a 10%, PHS+Biosilicato a 10%, e saliva artificial (controle). Em seguida, foram submetidos a DE com Coca-Cola por 2 min. Esse ciclo foi repetido 4 vezes/dia por 15 dias. Entre os ciclos, as amostras foram mantidas em saliva artificial (2 h/37°C). Após os ciclos diários, os espécimes também foram armazenados em saliva artificial a 37ºC. Foram realizadas leituras finais de cor, microdureza e rugosidade superficial. Os dados de cor e microdureza foram analisados ​​por ANOVA de uma via, teste de Tukey; e dados de rugosidade superficial, por ANOVA de duas vias, teste de Tukey (p<.05). A maior ΔE ocorreu em Saliva+DE (p<.05). Grupos tratados com PHS apresentaram menor alteração de cor do que Saliva+DE (p<.05). Biosilicate+DE demonstrou valores intermediários, similar (p>.05) aos outros grupos, exceto Saliva+DE. Todos os grupos presentaram média acima dos limites 50:50% de perceptibilidade (50:50%LP) e aceitabilidade (50:50%LA) exceto o controle que demonstrou média acima do 50:50%LA mas abaixo do 50:50%LP. Biosilicate+DE mostrou maior microdureza realativa do que Saliva+DE (p<.05), mas similar a PHS+DE e PHS+Biosilicato+DE. A rugosidade de superfície do esmalte aumentou para todos os grupos, exceto para o controle que presentou a menor alteração (p<.05). O Biosilicato apode prevenir perda mineral do esmalte indizido pela erosão melhor que a saliva. O PHS associado ou não ao Biosilicato demonstrou melhor estabilidade de cor que a saliva.

Effects of novel bioactive glasses on promoting remineralization of artificial dentin caries / 北京大学学报(医学版)

OBJECTIVE@#To investigate the effects of novel bioactive glasses (BG) including PSC with high phosphorus component and FBG with fluorine-doped element on promoting remineralization of artificial dentin caries.@*METHODS@#(1) BGs were used in this study as follows: PSC (10.8%P2O5-54.2%SiO2-35.0%CaO, mol.%) were synthesized using phytic acid as the phosphorus precursor through sol-gel method. FBG (6.1%P2O5-37.0%SiO2-53.9%CaO-3.0%CaF2, mol.%) and 45S5(6.0%P2O5-45.0%SiO2-24.5%CaO-24.5%Na2O, mol.%) were synthesized by traditional melt method. (2) The above BGs were soaked in simulated body fluid (SBF) for 24 hours. Then X-ray diffraction (XRD) was used to analyze the formation of hydroxyapatite (HA) crystals. (3) Prepared 1 mm thick dentin slices were soaked in 17% ethylene diamine tetraacetic acid (EDTA) for 1 week to demineralize the dentin. Then the dentin slices treated by BG were soaked in SBF for 1 week. Field emission scanning electron micro-scopy (FE-SEM) was used to observe the surface morphology of the dentin slices. (4) Four cavities were prepared to 1 mm depth in each 2 mm thick dentin slice, then were treated with lactic acid for 2 weeks to form the artificial dentin caries. Wax, mineral trioxide aggregate (MTA), PSC and FBG were used to fill four cavities as blank control group, MTA group, PSC group and FBG group respectively. Then the spe-cimens were soaked in SBF for 4 weeks. The changes of depth and density of demineralized dentin were analyzed using Micro-CT before filling and after 2 and 4 weeks filling.@*RESULTS@#(1) PSC and FBG promoted mineral formation on the surfaces of the demineralized dentin. And the speed was faster and crystallinity was higher in PSC group than the FBG and 45S5 groups. (2) The increased mineral density of artificial dentin caries in PSC group were (185.98 ± 55.66) mg/cm3 and (213.64 ± 36.01) mg/cm3 2 and 4 weeks after filling respectively, which were significantly higher than the control group [(20.38 ± 7.55) mg/cm3, P=0.006; (36.46 ± 10.79) mg/cm3, P=0.001]. At meanwhile, PSC group was also higher than MTA group [(57.29 ± 10.09) mg/cm3; (111.02 ± 22.06) mg/cm3], and it had statistical difference (P=0.015; P=0.006). The depth of remineralized dentin in PSC group were (40.0 ± 16.9) μm and (54.5 ± 17.8) μm 2 and 4 weeks respectively, which were also statistically different from the control group (P =0.010;P=0.001). There were no statistical differences between the control group and MTA group. The above effects of FBG group were between PSC and MTA.@*CONCLUSION@#PSC has advantages in the speed, quality and depth of mineral deposition in the demineralized layer of artificial dentin caries. It would be expected to be an ideal material to promote the remineralization of dentin caries.

Influência da adição de partículas de vidro bioativas em adesivos resinosos, na cimentação de bráquetes ortodônticos / Influence of the addition of bioactive glass particles in resin adhesives in the cementation of orthodontic brackets

O objetivo deste estudo foi desenvolver e avaliar um adesivo resinoso modificado com a incorporação de partículas de vidro bioativas (SCHOTT Bioactive Glass) em diferentes concentrações. Foram avaliados a resistência ao cisalhamento (RU), o índice de remanescente dentário (IRA), o grau de conversão (GC) e a liberação de cálcio. Foram utilizados 50 incisivos bovinos que foram fixados, através de suas raízes, em um molde de PVC, com resina acrílica autopolimerizável. As amostras foram alocadas em 5 grupos (n=10): TXT - Adesivo Transbond XT (3M Unitek, Monrovia, CA, EUA) sem adição de partículas de vidro bioativas, TXT20, TXT30, TXT50 ­ Adesivo Transbond XT acrescido respectivamente de 20%, 30% e 50% de partículas de vidro bioativas e SH - Adesivo resinoso FL BOND ll (SHOFU Inc.) com biomaterial SPRG. As amostras receberam uma profilaxia com pedra pomes e condicionamento com ácido fosfórico à 37%. Em seguida foi aplicada uma fina camada do sistema adesivo indicado na face vestibular dos incisivos bovinos, em todos os grupos e fotopolimerizado por 20 segundos, utilizando-se um fotopolimerizador RADII-Cal (SDI, Victoria, Austrália). Depois foi aplicada uma pequena quantidade de pasta resinosa fotopolimerizável Transbond XT (3M Unitek, Monrovia, CA, EUA) sobre a superfície dos bráquetes autoligados (MORELLI, Sorocaba, São Paulo, Brasil) e estes foram devidamente colados na face vestibular, no centro da coroa clínica do incisivo bovino e fotopolimerizado por 20 segundos, em cada face. Posteriormente as amostras foram submetidas ao teste de resistência ao cisalhamento. O índice de remanescente adesivo foi avaliado em estereomicroscópio DISCOVERY V20 (ZEISS). Os adesivos resinosos foram submetidos ao teste de grau de conversão e liberação de cálcio. Os dados foram inicialmente submetidos ao teste de normalidade e depois submetidos ao teste de ANOVA um fator, seguido do teste de Tukey para análise de comparações múltiplas, com nível de significância de 0,05. De acordo com os resultados obtidos na resistência de união ao cisalhamento (MPa±Dp) a maior média foi observada no grupo TXT 19,50±1,40A, seguida do grupo TXT20 18,22±1,04AB, seguida do grupo SH 17,62±1,45B, seguida do grupo TXT30 14,48±1,46C e a menor média TXT50 14,13±1,02C. No grau de conversão a maior média foi observada no grupo TXT20 73,02±3,33A que foi estatisticamente semelhante ao grupo SH 68,50±1,09A, seguida do grupo TXT 60,28±1,06B e TXT30 58,84±4,06B e a menor média foi do grupo TXT50 40,67±1,21C.Para a liberação de cálcio a maior média foi TXT50 2,23±0,11D, seguida por TXT30 0,74±0,00C, TXT20 0,55±0,00B, SH 0,47±0,04B e TXT 0,14±0,00A. Concluiu-se que a incorporação de partículas de vidro bioativas influenciou na resistência de união ao cisalhamento, no grau de conversão e na liberação de cálcio (AU).

The objective of this study was to develop and evaluate a resin adhesive modified with the incorporation of bioactive glass particles (SCHOTT Bioactive Glass) in different concentrations. Shear bond strength (SBS), adhesive remnant index (ARI), degree of conversion (DC) and calcium release were evaluated. Fifty bovine incisors were used, which were fixed through their roots in a PVC mold with self-curing acrylic resin. The samples were allocated into 5 groups (n=10): TXT ­ Transbond XT Adhesive (3M Unitek, Monrovia, CA, USA) without addition of bioactive glass particles, TXT20, TXT30, TXT50 ­ Transbond XT Adhesive rescpectively increased by 20%, 30% and 50% bioactive glass particles and SH ­ FL BOND ll resin adhesive (SHOFU Inc.) with SPRG biomaterial. The samples received prophylaxis with pumice stoe and conditioning with 37% phosphoric acid. Then, a thin layer of the indicated adhesive system was applied to the buccal surface of the bovine incisors, in all groups, and light cured for 20 seconds, using a RADII-Call curing light (SDI, Victoria, Australia). Then, a small amount of Transbond XT light-curing resinous paste (3M Unitek, Monrovia, CA, USA) was applied on the surface of the self-ligating brackets (MORELLI, Sorocaba, São Paulo, Brazil) and these were duly bonded on the buccal surface, in the center of the clinical crown of the bovine incisor and light cured for 20 seconds, on each side. Subsequently, the samples were submitted to the shear bond test. The adhesive remnant index was evaluated using a DISCOVERY V20 stereomicroscope (ZEISS). The resin adhesives were submitted to the degree of conversion and calcium release test. The data were initially submitted to the normality test and then submitted to the one-way ANOVA test, followed by the Tukey test for analysis of multiple comparisons, with a significance level of 0.05. According to the results obtained in the shear bond strength (MPa±Dp), the highest average was observed in the TXT group 19.50±1.40A, followed by the TXT20 group 18.22±1.04AB, followed by the SH group 17.62±1.45B, followed by the TXT30 group 14.48±1.46C and the lowest mean TXT5014.13±1.02C. In the degree of conversion, the highest average was observed in the TXT20 73.02±3.33A group, wich was statiscally like the SH group 68.50±1.09A, followed by the TXT 60.28±1.06B and TXT30 group 58.84±4.06B and the lowest mean was for the TXT50 group 40.67±1.21C. For calcium release, the highest mean was TXT50 2.23±0.11D, followed by TXT30 0.74±0.00C, TXT20 0.55±0.00B, SH 0.47±0.04B and TXT 0.14±0.00A. It was concluded that the incorporation of bioactive glass particles influenced in the shear bond strength, in the degree of conversion and in the release of calcium (AU).

S53p4 bioactive glass putty in the local treatment of cavitary chronic osteomyelitis / Biovidro ativo s53p4 em pasta no tratamento local da osteomielite crônica cavitária

ABSTRACT Objective: Evaluating the clinical results of bioactive glass S53P4 putty for the treatment of cavitary chronic osteomyelitis. Methods: Retrospective observational study, including patients of any age with clinical and radiological diagnosis of chronic osteomyelitis, who underwent surgical debridement and implantation of bioactive glass S53P4 putty (BonAlive® Putty, Turku, Finland). Patients who underwent any plastic surgery on the soft tissues of the affected site or had segmental bone lesions or septic arthritis were excluded. Statistical analysis was performed using Excel®. Demographic data, as well as data on the lesion, treatment, and follow-up, were collected. Outcomes were classified as "disease-free survival," "failure," or "indefinite." Results: This study included 31 patients, of which 71% were men and had with a mean age of 53.6 years (SD ± 24.2). In total, 84% were followed-up for at least 12 months and 67.7% had comorbidities. We prescribed combination antibiotic therapy for 64.5% of patients. In 47.1%, Staphylococcus aureus was isolated. Finally, we classified 90.3% of cases as "disease-free survival" and 9.7% as "indefinite." Conclusion: Bioactive glass S53P4 putty is safe and effective to treat cavitary chronic osteomyelitis, including infections by resistant pathogens, such as methicillin-resistant S. aureus. Level of Evidence IV, Case Series.

RESUMO Objetivo: Avaliar a atividade do vidro bioativo S53P4 em pasta no tratamento de osteomielite crônica. Métodos: Estudo observacional retrospectivo, com inclusão de indivíduos de qualquer idade com diagnóstico clínico e radiológico de osteomielite que realizaram tratamento cirúrgico com limpeza e desbridamento, seguido do preenchimento da cavidade com biovidro S53P4 em pasta (BonAlive ® Putty, Turku, Finland). Foram excluídos pacientes submetidos a procedimentos de cirurgia plástica nos tecidos moles do local afetado, com lesões ósseas segmentares e com presença de artrite séptica. A análise estatística foi realizada em Excel ® . Foram coletados dados demográficos, sobre a lesão, o tratamento e o acompanhamento. O desfecho foi classificado em "sobrevida livre de doença", "falha" ou "indeterminado". Resultados: Dos 31 pacientes analisados, 71% eram homens, com idade média de 53,6 anos (DP ± 24,26). Do total, 84% foram acompanhados por no mínimo 12 meses, e 67,7% apresentaram comorbidades. A terapia antibiótica combinada foi realizada em 64,5% dos pacientes, sendo o patógeno mais frequente o Staphylococcus aureus (47,1%). Ao final, 90,3% dos pacientes obtiveram "sobrevida livre de doenças" e 9,7% foram considerados "indeterminados". Conclusão: O vidro bioativo S53P4 em pasta é seguro e eficaz no tratamento da osteomielite cavitária e de infecções por patógenos resistentes, incluindo o S. aureus multirresistente. Nível de Evidência IV, Série de Casos.

Influence of Bleaching Agent Containing Bioactive Glass on Color and Microhardness of Bovine Enamel

To try to reduce the deleterious effects of tooth whitening, bioactive materials have been used. Forty enamel/dentin blocks were stained on dark tea and randomly assigned into four groups (n=10): control group (unbleached), HP35 % (35 % hydrogen peroxide), BG45S5 (Bioglass 45S5® incorporated into HP35 %), and BIO (Biosilicate® incorporated into HP35 %). Colorimetric analysis and microhardness evaluation was performed at baseline, 24 hours and 7 days after the final whitening session. Two-way ANOVA for repeated measures and Bonferroni test was used at a significance level of 5 %. All the coordinates (ΔL*, Δa*, Δb*, ΔE00 and WID) showed a difference between the control group and the experimental ones (p0.05), which suggest a color stability over a week. In contrast, after 7 days, the WID showed that control and PH35 % were different than the other groups (p 0.05). The microhardness did not change over time (p>0.05), except for 35 % HP. In conclusion Bioglass 45S5® and Biosilicate® prevented enamel damage without negatively affect the whitening efficacy.

Para intentar reducir los efectos nocivos del aclaramiento dental, se han usado materiales bioactivos. Cuarenta bloques de esmalte/dentina se tiñeron con té oscuro y se asignaron al azar en cuatro grupos (n=10): grupo de control (sin blanquear), HP35% (peróxido de hidrógeno al 35 %), BG45S5 (Bioglass 45S5® incorporado en HP35%) y BIO (Biosilicato® incorporado a HP35%). El análisis colorimétrico y la evaluación de la microdureza se realizaron al inicio del estudio, 24 horas y 7 días después de la última sesión de blanqueamiento. Se utilizó ANOVA de dos vías para medidas repetidas y la prueba de Bonferroni a un nivel de significancia del 5 %. Todas las coordenadas (ΔL*, Δa*, Δb*, ΔE00 y WID) mostraron diferencia entre el grupo control y el experimental (p0.05), lo que sugiere una estabilidad del color durante una semana. En cambio, a los 7 días, el WID mostró que el control y el PH35 % eran diferentes a los demás grupos (p 0.05). La microdureza no cambió con el tiempo (p>0.05), excepto para 35 % HP. En conclusión Bioglass 45S5® y Biosilicate® previnieron el daño del esmalte sin afectar negativamente la eficacia del blanqueamiento.

Antibacterial effect of bioactive glass incorporated in acrylic resins against Streptococcus mutans and Lactobacillus acidophilus activity in biofilm / Efeito antibacteriano do vidro bioativo incorporado em resinas acrílicas sobre a atividade de Streptococcus mutans e Lactobacillus acidophilus em biofilme

Objective: The rough surfaces of removable appliances used in pediatric dentistry or orthodontics, may result in an environment for biofilm accumulation, yielding to enamel demineralization. This study aimed to assess the effects of adding nanoparticles of bioactive glass to polymethylmethacrylate to promote the antibacterial activity in acrylic resins. Material and Methods: Acrylic resin specimens (20x20x1mm3) were prepared by adding 2% or 5% bioactive glass. The specimens in the control group without bioactive glass were prepared from the mixture of acrylic powder containing nanoparticles and liquid monomer (n=10 per group). The antibacterial activity of the specimens against Streptococcus mutans and Lactobacillus acidophilus activity in biofilm was investigated through counting colony forming units (CFU). Data were analyzed using a one-way analysis of variance and Tukey's post hoc tests at the significance level of 0.05. Results: The incorporation of 2% (p=0.001) and 5% (p<0.001) bioactive glass in acrylic resin reduced the metabolic activity and CFU of L. acidophilus. For S.mutans, antimicrobial activity was observed only with the 5% concentration of bioactive glass, and this group was statistically different from the control (p<0.001). When L. acidophilus was exposed to polymethyl methacrylate with 5% bioactive glass, significant decrease was observed compared to the control group (p<0.05). Conclusion: Adding bioactive glass nanoparticles into the acrylic resins used for fabricating removable appliances revealed a greater antibacterial effect against cariogenic bacteria tested (AU)

Objetivo: As superfícies rugosas dos aparelhos removíveis utilizados em Odontopediatria ou Ortodontia, podem resultar em um ambiente para acúmulo de biofilme, cedendo à desmineralização do esmalte. Este estudo teve como objetivo avaliar os efeitos da adição de nanopartículas de vidro bioativo ao polimetilmetacrilato para promover a atividade antibacteriana em resinas acrílicas. Material e Métodos: Amostras de resina acrílica (20x20x1 mm3) foram preparadas pela adição de 2% ou 5% de vidro bioativo. Os corpos de prova do grupo controle sem vidro bioativo foram preparados a partir da mistura de pó acrílico contendo nanopartículas e monômero líquido (n=10 por grupo). A atividade antibacteriana dos espécimes sobre a atividade de Streptococcus mutans e Lactobacillus acidophilus em biofilme foi investigada através da contagem de unidades formadoras de colônias (UFC). Os dados foram analisados por meio de análise de variância unidirecional e testes post hoc de Tukey com nível de significância de 0,05. Resultados: A incorporação de 2% (p=0,001) e 5% (p<0,001) de vidro bioativo em resina acrílica reduziu a atividade metabólica e UFC de L. acidophilus. Para S. mutans, a atividade antimicrobiana foi observada apenas com a concentração de 5% de vidro bioativo, sendo este grupo estatisticamente diferente do controle (p<0,001). Quando L. acidophilus foi exposto ao polimetilmetacrilato com 5% de vidro bioativo, foi observada diminuição significativa em relação ao grupo controle (p<0,05). Conclusão: A adição de nanopartículas de vidro bioativo nas resinas acrílicas utilizadas na fabricação de aparelhos removíveis revelou um maior efeito antibacteriano contra as bactérias cariogênicas testadas(AU)

Osteomielitis crónica de tibia; uso de vidrio biactivo como complemento de tratamiento / Chronic osteomyelitis of the tibia; use of bioactive glass as a treatment alternative

Resumen: Introducción: La osteomielitis crónica es una enfermedad generalmente de origen infeccioso, la principal causa es postraumática, afecta el tejido óseo y el tejido circundante, el germen causal más frecuente es Staphylococcus aureus. El hueso más afectado es la tibia. Descripción del caso: Masculino de 42 años con diagnóstico de osteomielitis crónica de tibia, con secuelas de intervenciones quirúrgicas previas, múltiples tratamientos antibióticos y clasificación tipo IV B de Cierny-Mader. Material y métodos: Se optó por un manejo quirúrgico en dos tiempos. En el primer tiempo, desbridamiento óseo extenso y de partes blandas, colocación de perlas de cemento medicado con amikacina en cavidad medular y sistema de osteoclisis para irrigación con vancomicina. En el segundo tiempo, colocación de injerto óseo peroné libre, fijación y estabilización con tornillos, colocación de vidrio bioactivo en zonas de interface entre peroné estabilizado y cortical posterior de tibia. Resultados: Ante una osteomielitis crónica multitratada se tiene que individualizar y valorar alternativas de tratamiento; en este caso el manejo quirúrgico en dos tiempos, el uso de perlas de cemento, injerto óseo y el uso de vidrio bioactivo logró una erradicación de la infección y evolución clínica favorable con recuperación funcional de la extremidad afectada.

Abstract: Introduction: Chronic osteomyelitis is a disease usually of infectious origin. The main cause is post-traumatic, it affects the bone tissue and surrounding tissue, the most frequent causative agent is Staphylococcus aureus. The most affected bone is the tibia. Case description: A 42-year-old male with a diagnosis of chronic tibia osteomyelitis, with sequelae of previous surgical interventions, multiple antibiotic treatments, and type IV B classification by Cierny-Mader. Material and methods: Two-stage surgical management was chosen. Firstly, extensive bone and soft tissue debridement, placement of cement beads medicated with amikacin in the medullary cavity and osteoclast system for irrigation with vancomycin. In the second stage, free fibular bone grafting, fixation and stabilization with screws, bioactive glass placement in areas of interface between stabilized fibula and posterior tibial cortex. Results: Before a multitratada chronic osteomyelitis it is necessary to individualize and evaluate treatment alternatives, in this case the surgical management in two time, the use of medication beads, bone graft and the use of bioactive glass, achieved a complete eradication of the infection and favorable clinical evolution with optimal functional recovery of affected limb.

Reparative regeneration by substitution of bone tissue defects with bioglass, using regeneration technologies / Regeneración reparadora mediante sustitución de defectos del tejido óseo por biovidrio, utilizando tecnologías de regeneración

SUMMARY: Bioactive glass (BG) induces osteogenesis of damaged bone, causing excessive bone formation. This study included a morphological and morphometrical data of the bone tissue regeneration by filling bone defects with BG with autologous native platelet rich plasma (PRP) or fibrin (PRF) and aspirate of bone marrow (ABM). The parameters of newly formed bone in rabbits bone defect were analyzed and compared with terms 4th and 12th week. The groups with ABM-BG, PRF-BG and PRP-BG have shown common tendency: development of newly formed bone tissue, the external contour of the bone has been enlarged; an additional trabecular bone has been formed under the cortical layer, which has often been limited by a solid compact bone from the bone marrow. The induced osteogenesis resulted in the appearance of a significant amount of bone tissue exceeding the original size of the defect. Increased density of the newly formed tissue at the defect level relative to ABM-BG was detected in the PRF-BG group at 12 weeks and PRP-BG at 4 and 12 weeks (p<0.05). In this case, the bone thickness in the substituted defect was greater in the ABM-BG group. The number of newly formed bone tissue in the ABM-BG group at 4 weeks also exceeded the value of the BG group, but the density of such bone did not differ between the groups. That is, ABM-BG stimulated greater trabecular bone formation and fibrous reticular tissue was located in the lacunae between trabeculae. These results indicate that the additional use of tissue technology (ABM, platelet plasma) facilitated osteogenesis, and the newly formed bone tissue was tightly coupled and remodeled to the cortical bone layer in the form of compact bone tissue. PRP, to a greater extent than ABM, promoted the formation of compact bone tissue.

RESUMEN: El vidrio bioactivo (VB) induce la osteogénesis del hueso dañado, provocando una formación excesiva de hueso. Este estudio incluyó datos morfológicos y morfométricos de la regeneración del tejido óseo mediante el llenado de defectos óseos con VB con plasma rico en plaquetas (PRP) nativo autólogo o fibrina (PRF) y aspirado de médula ósea (AMO). Se analizaron los parámetros de hueso recién formado en el defecto óseo de conejos y se compararon a las 4 y 12 semanas. Se observó una tendencia similar en los grupos con AMO-VB, PRF-VB y PRP-VB: el desarrollo de tejido óseo recién formado, aumentó el contorno externo del hueso; formación de un hueso trabecular adicional debajo de la capa cortical, que a menudo ha estado limitada por un hueso sólido compacto de la médula ósea. La osteogénesis inducida dio como resultado la aparición de una cantidad significativa de tejido óseo que excedía el tamaño original del defecto. Se detectó un aumento de la densidad del tejido recién formado a nivel del defecto en relación con AMO-VB en el grupo PRF-VB a las 12 semanas y PRP-VB a las 4 y 12 semanas (p <0,05). En este caso, el grosor óseo en el defecto sustituido fue mayor en el grupo AMO-VB. El número de tejido óseo recién formado en el grupo AMO- VB a las 4 semanas también excedió el valor del grupo VB, pero la densidad de dicho hueso no cambió entre los grupos. Es decir, AMO-VB estimuló una mayor formación de hueso trabecular y se localizó en el tejido reticular fibroso en las lagunas entre trabéculas. Estos resultados indican que el uso adicional de tecnología de tejidos (AMO, plasma plaquetario) facilitó la osteogénesis, y el tejido óseo recién formado se acopló y remodeló estrechamente a la capa de hueso cortical en forma de tejido óseo compacto. El PRP, en mayor medida que el AMO, promovió la formación de tejido óseo compacto.

Effects of bioactive glass on proliferation, differentiation and angiogenesis of human umbilical vein endothelial cells / 北京大学学报(医学版)

OBJECTIVE@#To investigate the effects of phytic acid derived bioactive P2O5-SiO2-CaO gel-glasses (PSC) on the proliferation, differentiation and angiogenesis of human umbilical vein endothelial cells (HUVECs) in vitro.@*METHODS@#HUVECs were cultured in PSC extracts, which were prepared with endothelial cell medium (ECM) at a gradient concentration of 0.01, 0.1, 1 and 2 g/L. Cells cultured in ECM were used as the control. The effect of PSC on HUVECs proliferation was assessed on the 1st, 3rd, 5th, 7th and 10th days with (4, 5-dimethylthiazol-2-yl) 2, 5-diphenyltetrazolium bromide assay (MTT), and the optimum PSC concentration for HUVECs proliferation was used in the following experiments. The subsequent experiments were divided into two groups. The experimental group used PSC extracts to culture HUVECs (PSC group) and the control group used ECM to culture HUVECs (ECM group). Gene expression of angiogenic factors, vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF), was detected on the 2nd, 4th and 7th days by real-time reverse transcription-polymerase chain reaction (real-time RT-PCR). The morphology and number of tubules formation were observed at the 4th and 10th hours. Image J software was used for counting and quantitative analysis.@*RESULTS@#The results of MTT assay showed that 0.1 g/L PSC group had the most significant effect on promoting HUVECs proliferation. The optical density values of 0.1 g/L PSC group on the 5th and 7th days were significantly higher than those of the other PSC groups and the control group (P < 0.05). The result of real-time RT-PCR showed that 0.1 g/L PSC extract up-regulated the mRNA expression of VEGF and bFGF significantly (P < 0.05). On the 4th day, the gene expressions of VEGF and bFGF in PSC group were 1.59 and 1.45 times higher than those in ECM group respectively, and on the 7th day, the gene levels of VEGF and bFGF in PSC group were 1.98 and 1.37 times higher than those in ECM group respectively. The tubule formation assay showed that the maturity and density of the tubules in 0.1 g/L PSC group was much better than that in the ECM group at the 10th hour. The quantitative analysis by Image J indicated that the tubules number in PSC group (29.63±2.29) was higher than in the ECM group (20.13±2.36), with statistical significance (P < 0.05).@*CONCLUSION@#PSC showed significant promoting effects on HUVECs' proliferation, differentiation and angiogenesis in vitro.

The new bone formation in human maxillary sinuses using two bone substitutes with different resorption types associated or not with autogenous bone graft: a comparative histomorphometric, immunohistochemical and randomized clinical study

Abstract Objective The aim of this study is to evaluate the new bone and connective tissue formation and the biomaterial remaining after maxillary sinus bone augmentation using 5 different bone substitutes. The osteocalcin immunolabeling was performed to demonstrate their calcification and the possibility of receiving dental implants. Methodology 40 patients underwent maxillary sinus bone augmentation and were divided in 5 groups: Group 1 with 8 maxillary sinuses were grafted with autogenous bone graft (AB); Group 2 with 8 maxillary sinuses grafted with bioactive glass (BG); Group 3 with 8 maxillary sinuses grafted with bioactive glass added to autogenous bone graft (BG + AB) 1:1; Group 4 with 8 maxillary sinuses grafted with Bio-Oss (BO) and Group 5 with 8 maxillary sinuses grafted with Bio-Oss added to autogenous bone graft (BO + AB) 1:1. Results In group AB, 37.8% of bone was formed in the pristine bone region, 38.1% in the intermediate and 44.5% in the apical region. In group BG, 43.6% was formed in the pristine bone, 37% in the intermediate and 49.3% in the apical region. In group BG + AB 1:1, 39.0% was formed in the pristine bone region, 34.8% in the intermediate and 36.8% in apical region. In group BO, 33.4% was formed in the pristine bone, 32.5% in the intermediate and 34.3% in the apical region. In group BO + AB 1:1, 32.8% was formed in the pristine bone, 36.1% in intermediate and 27.8% in the apical regions. The immunolabeling for osteocalcin showed an intensive staining for all groups, which could demonstrate the calcification of the bone formed. Conclusion This study showed that the groups evaluated formed a suitable lamellar bone in the maxillary sinus reconstruction after six months of bone healing, thus being indicated to receive dental implants.

Effect of bioactive glass pretreatment on the durability of dentin bonding interface / 北京大学学报(医学版)

OBJECTIVE@#To study the effect of bioactive glass (BG) on the dentin bond strength and the microleakage of hybrid layer.@*METHODS@#In the study, 30 dentin planes were prepared from the third molars with no caries and equally assigned to the control group, BG group, and sodium trimetaphosphate (STMP)-polyacrylic acid (PAA)-BG group (S-P-BG group), randomly. After etched with 35% phosphoric acid, the dentin planes of BG group were pretreated with 0.5 g/L BG, and the dentin planes of S-P-BG group were pretreated with 5% STMP, 5% PAA and 0.5 g/L BG. No additional pretreatment was done to the dentin planes of control group. Then the dentin planes were bonded using 3M Single Bond 2 adhesive to 3M Z350XT composite resin, and cut into 0.9 mm×0.9 mm column samples, which were stored at 37 ℃ artificial saliva (AS). After 24 hours, 1 month, and 3 months, the microtensile bond strength test was performed. The data were analyzed using one-way ANOVA and LSD method. The morphology of the bond fracture interface was observed with scanning electron microscope. Other 27 teeth were collected and the enamel layer and roots cut off, with the pulp chamber exposed. 0.1% rhodamine B was added to the 3M Single Bond 2 adhesive, and then the adhesive was applied to complete the bonding procedures as above. The teeth were stored in 37 ℃ AS for 24 hours, 1 month, 3 months, and then 0.1% sodium fluorescein solution was placed in the chambers and stained for 1 hour. Confocal laser scanning microscopy was used to observe the interface morphology and microleakage of the hybrid layer.@*RESULTS@#At the end of 24 hours and 1 month, there was no significant difference in the microtensile bond strength among the three groups (P>0.05). After 3 months of soaking, the S-P-BG group [(36.91±7.07) MPa] had significantly higher microtensile bond strength than the control group [(32.73±8.06) MPa] (P=0.026); For the control group and the BG group, the microtensile bond strength significantly decreased at the end of 3 months compared with 24 hours (control group: P=0.017, BG group: P=0.01); The microtensile bond strength of S-P-BG group af the end of 3 months had no significant difference in compared with 24 hours [(37.99±7.98) MPa] (P>0.05). Observation of the fracture surface at the 24 hours showed no obvious mineralization in all the three groups. After 1 and 3 months, mineral formation was observed in BG group and S-P-BG group, and no obvious collagen exposure was observed in S-P-BG group. Confocal laser scanning microscopy revealed no obvious differences in the morphology and quantity of the resin tag in the control group, BG group and S-P-BG group. At the end of 24 hours, leakage was found in all the three groups. The microleakage of the control group increased at the end of 3 months, while the microleakage of the BG and S-P-BG groups decreased.@*CONCLUSION@#BG pretreatment of dentin bonding interface can induce mineralization at the bonding interface and reduce the microleakage of the hybrid layer; pretreating the dentin bonding interface with STMP, PAA and BG may enhance the maintaining of the dentin bonding durability.

Experimental gel containing bioactive glass-ceramic to minimize the pulp damage caused by dental bleaching in rats

Abstract Objectives This study evaluated if the use of a bioactive glass-ceramic-based gel, named Biosilicate (BS), before, after or mixed with bleaching gel, could influence the inflammation of the dental pulp tissue of rats' molars undergoing dental bleaching with hydrogen peroxide (H2O2). Methodology The upper molars of Wistar rats (Rattus norvegicus, albinus) were divided into Ble: bleached (35% H2O2, 30-min); Ble-BS: bleached and followed by BS-based gel application (20 min); BS-Ble: BS-based gel application and then bleaching; BS/7d-Ble: BS-based gel applications for 7 days and then bleaching; Ble+BS: blend of H2O2 with BS-based gel (1:1, 30-min); and control: placebo gel. After 2 and 30 days (n=10), the rats were euthanized for histological evaluation. The Kruskal-Wallis and Dunn statistical tests were performed (P<0.05). Results At 2 days, the Ble and Ble-BS groups had significant alterations in the pulp tissue, with an area of necrosis. The groups with the application of BS-based gel before H2O2 had moderate inflammation and partial disorganization in the occlusal third of the coronary pulp and were significantly different from the Ble in the middle and cervical thirds (P<0.05). The most favorable results were observed in the Ble+BS, which was similar to the control in all thirds of the coronary pulp (P>0.05). At 30 days, the pulp tissue was organized and the bleached groups presented tertiary dentin deposition. The Ble group had the highest deposition of tertiary dentin, followed by the Ble-BS, and both were different from control (P<0.05). Conclusion A single BS-based gel application beforehand or BS-based gel blended with a bleaching gel minimize the pulp damage induced by dental bleaching.

Application and research status of bioactive glass in bone repair / 中国修复重建外科杂志

Objective: To summarize the clinical application and research status of bioactive glass (BAG) in bone repair. Methods: The recently published literature concerning BAG in bone repair at home and abroad was reviewed and summarized. Results: BAG has been widely used in clinical bone repair with a favorable effectiveness. In the experimental aspect, to meet different clinical application needs, BAG has been prepared in different forms, such as particles, prosthetic coating, drug and biological factor delivery system, bone cement, and scaffold. And the significant progress has been made. Conclusion: BAG has been well studied in the field of bone repair due to its excellent bone repair performance, and it is expected to become a new generation of bone repair material.

Vidrios bioactivos en odontología restauradora / Bioactive glasses in restorative dentistry

Los vidrios bioactivos (vb) son materiales cerámicos con una composición química tal que poseen la propiedad de inducir y conducir la mineralización de los tejidos. La obtención de estos vidrios por medio del método sol-gel y la posibilidad de obtener tamaño nanométrico de partícula, han ampliado y potenciado las indicaciones de estos materiales. Las propiedades antibacterianas de los vb son una característica sobresaliente; es debida a la liberación de iones que alcaliniza el medio, actuando sobre las colonias bacterianas. Las aplicaciones médicas y odontológicas de estos materiales son muy amplias, destacándose la regeneración ósea, la remineralización de los tejidos duros dentarios y el tratamiento de la hipersensibilidad. Sin embargo, por tratarse de materiales con estructura química amorfa, sus propiedades mecánicas no son buenas, siendo esta característica su principal limitación para la aplicación clínica en el área de la odontología restauradora. En este sentido las investigaciones científicas se han enfocado en determinar la posibilidad de incorporar vb a diversos materiales dentales como forma de combinar su bioactividad con propiedades mecánicas apropiadas. Hasta el momento no se ha logrado determinar la proporción y la metodología para incorporar vb en los materiales dentales sin alterar su comportamiento clínico, por lo que son necesarias más investigaciones.

Bioactive glasses (bg) are ceramic materials whose chemical composition allows them to induce and conduct tissue mineralization. As these glasses can be obtained with the sol-gel method and in nanometric particle sizes, their indication has been extended and enhanced. The antibacterial properties of bg are outstanding: they are possible given the release of ions, which alkalinizes the medium, acting on the bacterial colonies. The medical and dental applications of these materials are wide, with an emphasis on bone regeneration, remineralization of hard dental tissues and treatment of hypersensitivity. However, as they are materials with an amorphous chemical structure, their mechanical properties are not good, this being their main limitation for clinical application in restorative dentistry. In this sense, scientificresearch has focused on determining the possibility of including bg in various dental materials as a way to combine bioactivity with appropriate mechanical properties. So far, it has not been possible to determine the proportion and methodology necessary to include bg in dental materials without altering their clinical behavior, which is why further research isnecessary

Os vidros bioativos (vb) são materiais cerâmicos com uma composição química tal que eles possuem a propriedade de induzir e conduzir a mineralização dos tecidos. A obtenção desses vidros por meio do método sol-gel e a possibilidade de obtenção de partículas nanométricas ampliaram e reforçaram as indicações desses materiais. As propriedades antibacterianas dovb são uma característica marcante; é devido à liberação de íons que alcaliniza o meio, atuando nas colônias bacterianas. As aplicações médicas e odontológicas desses materiais são muito amplas, destacando-se a regeneração óssea, a remineralização dos tecidos duros e o tratamento da hipersensibilidade. No entanto, por serem materiais com estrutura química amorfa, suas propriedades mecânicas não são boas, sendo essa a sua principal limitação para aplicação clínica na área de odontologia restauradora. Nesse sentido, a pesquisa científica tem se concentrado em determinar a possibilidade de incorporar vb em vários materiais odontológicos, como forma de combinar sua bioatividade com propriedades mecânicas apropriadas. Até agora, não foi possível determinar a proporção e metodologia para incorporar vb em materiais odontológicos sem alterar seu comportamento clínico, razão pela qual mais pesquisas são necessárias

In Vitro evaluation of remineralization potential of novamin on artificially induced carious lesions in primary teeth using scanning electron microscope and vickers hardness

Aims: The objective of this in vitro study was to find out the efficacy of Novamin in remineralizing enamel surface on which artificial caries lesion had been created. The changes were analyzed using Vickers Hardness Testing Machine and Scanning electron microscope (SEM). Settings and Design: A total of 40 primary teeth were selected and divided into two groups: Control group and SHY NM (Novamin). All the samples were subjected to ph cycle protocol and assessed using Vickers Hardness Testing Machine and Scanning electron microscope. Each demineralized sample was randomly divided into two groups: Gp I –Control group, Gp II – Novamin (SHY NM). After 10-day period of ph cycle, the obtained data was analyzed statistically. Statistical Analysis Used: Pre and post groups were compared by paired t test. The significance of mean difference between the groups was done by Tukey's post hoc test after ascertaining normality by Shapiro-Wilk (W) test and homogeneity of variance by Levene's test. A two-tailed P value less than 0.05 (P < 0.05) was considered statistically significant. All analyses were performed on SPSS software (Windows version 17.0). Results: Statistical analysis showed that bioactive glass (novamin) remineralizes artificially induced carious lesion in primary teeth. Conclusions: SHY NM (Novamin) exhibited superior remineralization potential.

Dental Pulp Stem Cells Response to Chrysanthemum Flower Extract

@#Chrysanthemum rubellum (durian) flower (CR) is well-known for its usefulness in conventional and advanced medicine. Bioactive glass properties are geared towards hard tissue regeneration. Hence, this study aims to investigate the response of dental pulp stem cells (DPSC) when exposed to bioactive glass-chrysanthemum flower extract-conditioned medium. Methods: Chrysanthemum rubellum (durian) yellow coloured petals freeze dried extracts (CRE) was prepared by separation and agitation in distilled water where the final powdery compound was being investigated and combined with melt-derived BG 45S5 powder to produce BGCRE-conditioned medium. The CRE extracts in various concentrations and BGCRE-conditioned medium were exposed to DPSC and the cells responses were assessed using AB and MTT assays. The CRE and BGCRE-conditioned media were also assessed using ICP-OES to check for ionic release profile from both medium. Results: The CRE-conditioned medium (7.81, 15.63, 31.25 and 62.5 μg/ml) showed a dose-dependent effect towards DPSC from Days 1 until 14. The BGCRE-conditioned medium containing BG powders (1 mg/ml) with the lower amount of CRE extracts (0.02 and 0.1 mg/ml) promoted DPSC viability and proliferation rate from Days 1 until 14 based on AB and MTT assays. The BGCRE-conditioned medium has potentially affected the DPSC viability and proliferation. Conclusion: The presence of CRE in BGCRE-conditioned medium enhanced the DPSC viability and proliferation possibly through the combined effect of CRE and BG. This BGCRE combination showed potential as natural medicament for dental tissue regeneration

Microfiltración en un cemento dental tipo MTA modificado con wollastonita y vidrio bioactivo / Microleakage in MTA-type dental cement modified with wollastonite and bioactive glass

Resumen Un material de retroobturación como el MTA (Mineral Trioxide Aggregate) debe de ser de fácil manejo, biocompatible, tener baja o nula solubilidad y ser dimensionalmente estable para evitar filtraciones asociadas a los cambios volumétricos. Objetivo: Medir la filtración en un cemento dental tipo MTA modificado con wollastonita y vidrio bioactivo. Material y métodos: Se establecieron ocho grupos: MTA Angelus (control), MTA Exp (cemento Portland blanco más 20 wt% de trióxido de bismuto), otros seis grupos se formaron con la adición de 10, 20 y 30 wt% de wollastonita y vidrio bioactivo al MTA Exp. Dientes permanentes uniradiculares, raíz recta y con ápice cerrado fueron preparados con técnica crown-down con fuerzas balanceadas para obtener un diámetro estandarizado a lima apical maestra #40. Se cortaron 3 mm del ápice se prepararon retrocavidades de 3 mm de profundidad con punta de ultrasonido donde fueron colocados los cementos, el extremo apical fue sumergido en solución de azul de metileno al 2% durante 24 horas. Resultados: MTA Exp fue el que presentó menor filtración con un promedio de 0.66 mm, mientras que el grupo de WO10 fue el de mayor con 1.61 mm. MTA Angelus usado como control presentó 0.71 mm de microfiltración, se encontraron diferencias estadísticamente significativas con WO10, (ANOVA p < 0.001, Dunett p < 0.001). Conclusiones: Se observa que en el caso de los cementos con los agregados de wollastonita y vidrio bioactivo la microfiltración disminuye conforme aumenta el porcentaje del agregado, se sugiere el uso de otras técnicas complementarias para medir la microfiltración.

Abstract Retro-filling material such as MTA (mineral trioxide aggregate) should be biocompatible, easy to handle, with low or nil solubility as well as dimensionally stable in order to avoid filtrations associated to volumetric changes. Objective: To measure filtration in a MTA-type dental cement modified with wollastonite and bioactive glass. Material and methods: Eight groups were established: MTA Angelus (control), MTA Exp (white Portland cement plus 20% wt of bismuth trioxide), another six groups were formed with the addition to MTA Exp of 10, 20 and 30% wt of wollastonite and bioactive glass . Single rooted teeth, with straight root and closed apex were prepared with crown-down technique with balanced forces in order to obtain standardized diameter to fit a number 40 master apical file; 3 mm from the apex were excised, 3 mm deep retro-cavities were prepared with ultrasound point, where cements were placed, apical end was submerged in a 2% methylene blue solution for 24 hours. Results: MTA Exp exhibited least filtration with an average of 0.66 mm, WO10 group exhibited the greatest leakage with average of 1.61 mm. MTA Angelus, used as control exhibited 0.71 mm microleakage. Statistically significant differences were found with WO10, (ANOVA p < 0.001), Dunett p < 0.001). Conclusions: It was observed that in the case of cements with aggregate of wollastonite and bioactive glass, microleakage decreased according to the aggregate's percentage. For microleakage measurement, use of other supporting techniques is advised.

Mechanical properties and Biological behavior of bioactive glass in restorative dentistry

Generally recent bioactive glasses are finding increasing applications in dentistry due to their potential of hard tissue remineralization stimulation New compositions of bioactive glasses incorporating specific ions added in polymers will be the most important direction for future restorative dentistry researches Until now, it shows weaker mechanical properties than commercially available restorative materials Studying of new compositions for enhancing their mechanical properties with bioactivity maintaining is a big challenge in restorative dentistry

Biomateriais com aplicabilidade na ortopedia: avanços e desafios na área da infectologia / Biomaterials with applicability in orthopedics: advances and challenges in the infectology area

O controle na formação do biofilme em implantes e próteses ortopédicas continua sendo um dos grandes desafios acerca da infeção relacionada aos dispositivos na área da saúde. O objetivo desta pesquisa foi investigar biomateriais com aplicabilidade na ortopedia, visando os avanços e enfrentamentos dos desafios na área da infectologia. Uma revisão integrativa foi realizada a respeito da formação de biofilme em biomateriais de próteses de quadril com a finalidade de contribuir com as medidas de prevenção e controle aos agravos infecciosos. Além disso, a formação in vitro do biofilme em função dos biomateriais (titânio e titânio revestido com biovidro F18), microrganismos (Staphylococcus epidermidis e Candida albicans) e tempos de incubação (2, 4 e 8 horas) foi avaliada por microscopia de fluorescência. A revisão integrativa foi realizada no portal PubMed da National Library of Medicine, bem como nas bases Cochrane, Embase, Web of Science, CINAHL e LILACS com a inclusão de estudos primários sobre a temática, publicados online até novembro de 2017, em português, inglês e espanhol. Na fase experimental / laboratorial, biofilmes de S. epidermidis (ATCC 12228) e C. albicans (ATCC 90028) foram formados em corpos de prova de titânio e titânio revestido com biovidro F18 após 2, 4 e 8 horas de incubação a 37?C sob agitação orbital. As áreas das imagens dos corpos de prova, em porcentagem, recobertas com biofilme (células vivas) foram avaliadas por microscopia de fluorescência. Os dados coletados foram submetidos à análise estatística empregando-se os testes de normalidade Shapiro Wilk, U de Mann-Whitney e t de Student por meio do software IBM SPSS Statistics (versão 25) e nível de significância ?=5%. Na revisão integrativa, os resultados demonstraram que dos 16 estudos primários, 81,25% eram pesquisas experimentais in vitro e que novos biomateriais foram desenvolvidos para prevenir a formação de biofilme. Com relação à fase experimental / laboratorial, houve menor formação de biofilme por S. epidermidis e C. albicans (p<0,001) no titânio revestido com biovidro F18 do que no titânio, após 8 horas de incubação. Entretanto, houve maior formação de biofilme por S. epidermidis e C. albicans após 8 horas do que em 2 horas de incubação, tanto no titânio quanto no titânio revestido com biovidro F18 (p<0,05). Em suma, a revista da literatura mencionou o desenvolvimento de biomateriais novos para prevenir a formação de biofilme. Na fase laboratorial / experimental, o titânio revestido com biovidro F18 apresentou atividade antibiofilme em comparação com o titânio, e os tempos de incubação de 2 para 8 horas aumentaram a formação de biofilme em ambos os biomateriais. Ainda, pesquisas futuras acerca do biovidro F18 fundamentadas nos aspectos físicoquímicos, bioquímicos e microbiológicos são importantes para a elucidação dos mecanismos de ação relacionados ao controle dos biofilmes

The control of biofilm formation on implants and orthopedic prostheses still is one of the major challenges concerning infection related to devices in the health field. The objective of this research was to investigate biomaterials with applicability in orthopedics, aiming for advances and facing challenges in the infectology area. An integrative review was performed regarding biofilm formation on hip prosthesis biomaterials in order to contribute to the preventive and infection control measures. Moreover, the in vitro biofilm formation according to biomaterials (titanium and titanium coated with F18 bioglass), microorganisms (Staphylococcus epidermidis and Candida albicans) and incubation times (2, 4 and 8 hours) was evaluated by fluorescence microscopy. The integrative review was performed on PubMed portal from National Library of Medicine as well as on Cochrane, Embase, Web of Science, CINAHL and LILACS databases with the inclusion of primary studies about the topic, published online up until November 2017, in Portuguese, English and Spanish. In the experimental / laboratory step, S. epidermidis (ATCC 12228) and C. albicans (ATCC 90028) biofilms were formed on proof bodies of titanium and titanium coated with F18 bioglass after 2, 4 and 8 hours of incubation at 37?C under orbital shaking. The image areas of proof bodies, in percentage, coated with biofilm (living cells) were evaluated by fluorescence microscopy. The data collected were submitted to statistical analysis using normality tests Shapiro Wilk, U from Mann-Whitney and t from Student through IBM SPSS Statistics (version 25) software and significance level ?=5%. In the integrative review, the results showed that among 16 primary studies, 81.25% were in vitro experimental studies and that new biomaterials were developed to prevent biofilm formation. Regarding experimental / laboratory step, there was less biofilm formation by S. epidermidis and C. albicans (p<0.001) on titanium coated with F18 bioglass than on titanium, after 8 hours of incubation. However, there was more biofilm formation by S. epidermidis and C. albicans after 8 hours than in 2 hours of incubation, both on titanium and on titanium coated with F18 bioglass (p<0.05). In sum, the literature review mentioned the development of new biomaterials to prevent biofilm formation. In laboratory / experimental step, titanium coated with F18 bioglass presented antibiofilm activity in comparison with titanium, and the incubation times of 2 to 8 hours increased biofilm formation on both materials. Besides, future studies about F18 bioglass based on physicochemical, biochemical and microbiological aspects are important for the elucidation of action mechanisms related to biofilms control