Investigation of a new implant surface modification using phosphorylated pullulan.

Various implant surface treatment methods have been developed to achieve good osseointegration in implant treatment. However, some cases remain impossible to treat with implants because osseointegration is not obtained after implantation, and the implants fail. Thus, this study focused on phosphorylated pullulan because of its adhesiveness to titanium (Ti) and bone, high biocompatibility, and early replacement with bone. In this study, the response of bone-related cells to phosphorylated pullulan was evaluated to develop a new surface treatment method. Saos-2 (human osteosarcoma-derived osteoblast-like cells), MC3T3-E1 (mouse calvaria-derived osteoblast-like cells), and RAW264.7 (mouse macrophage-like cells) were used. In evaluating cellular responses, phosphorylated pullulan was added to the culture medium, and cell proliferation and calcification induction tests were performed. The proliferation and calcification of cells on the surface of Ti disks coated with phosphorylated pullulan were also evaluated. In addition, bone morphogenetic protein-2 (BMP-2), an osteogenic factor, was used to evaluate the role of phosphorylated pullulan as a drug carrier in inducing calcification on Ti disks. Phosphorylated pullulan tended to promote the proliferation of osteoblast-like cells and the formation of calcification on Ti disks coated with phosphorylated pullulan. Ti disks coated with phosphorylated pullulan loaded with BMP-2 enhanced calcification. Phosphorylated pullulan inhibited osteoclast-like cell formation. These results are due to the properties of phosphorylated pullulan, such as adhesiveness to titanium and drug-loading function. Therefore, phosphorylated pullulan effectively promotes bone regeneration when coated on titanium implants and is useful for developing a new surface treatment method.

Sealing ability of various endodontic sealers with or without ethylenediaminetetraacetic acid (EDTA) treatment on bovine root canal.

This study investigated the wettability and consistency of various endodontic sealers, both inorganic and organic, and evaluated their sealing ability of root canals using the single-cone obturation technique, with and without ethylenediaminetetraacetic acid (EDTA) treatment. Bovine root canals were endodontically prepared and filled in preparation for the dye penetration test with toluidine blue solution. All sealers exhibited contact angles similar to or lower than dentin and displayed superior consistency. Among the sealers, organic sealers used without EDTA treatment showed reduced dye penetration compared to inorganic sealers. However, some inorganic and organic sealers showed dye penetration in the sealer and dentin of root canals subjected to EDTA treatment. In conclusion, the single-cone obturation technique, combined with these endodontic sealers, achieved close contact with root canal dentin due to their wettability and consistency. However, the sealing ability of certain sealers was influenced by EDTA treatment.

The Wear Behavior of Glass-Ceramic CAD/CAM Blocks against Bovine Enamel.

The wear of enamel and crown restorative materials often occur by occlusion. The purpose of this study was to evaluate the wear volume between glass-ceramics used for CAD/CAM blocks (lithium disilicate: Initial LiSi block (LIS), IPS e.max CAD (IPS), zirconia-reinforced lithium silicate glass-ceramics: Celtra DUO (DUO), VITA Suprinity (VITS) and feldspar-based glass-ceramics: Vitablocs Mark II (MAK)) and bovine tooth enamel using a two-body wear test, the hardness, three-point bending strength, micro-structure and the element components of glass-ceramics. The data were analyzed using a one-way analysis of variance and Tukey's multiple comparison test (α = 0.05). IPS and DUO with relatively large size crystal gain had significantly larger abrader wear volumes. Zirconia-reinforced lithium silicate glass-ceramics (DUO, VITS) caused significantly greater wear volume in antagonist enamel. MAK with scale-shape crystals grains produced distinct scratches after wear tests, both in the material itself and in the enamel. A strong correlation between the mechanical properties (hardness, three-point bending strength) and wear volume could not be confirmed. The type of glass-ceramic, size, and shape of the crystal grains affected the wear behavior of the glass-ceramics for CAD/CAM blocks. Therefore, dentists should consider that wear behavior varies with crystal structure, size, and shape in glass-ceramics for CAD/CAM blocks.

Tensile and shear bond strengths of a stainless steel used in orthodontic brackets bonded to bovine enamel using two types of resin cement.

The purpose of this study was to examine the relationship between the bond strength of stainless steel with two types of resin cements (MMA- and composite-based) on bovine enamel depending on the directionality of the applied force. The specimens were either placed in water or subjected to thermal cycles (TC), and the shear or tensile bond strengths (SBS or TBS) were determined. The SBS showed significantly greater than the TBS for both types of cement, and the SBS and TBS for composite-based cement had larger than MMA-based one. No significant difference in SBS was observed in the cements even after being subjected to TC. Cohesive failures of the cement and bovine enamel in the composite-based group, while adhesive failures were observed in MMA-based one. Consequently, the direction of the force at both cements affected the retention of stainless steel, and MMA-based cement was preferred when prioritizing less enamel damages.

Wear Behavior between Aesthetic Restorative Materials and Bovine Tooth Enamel.

Tooth enamel wear occurs because of daily mastication and occlusion. This study investigated the wear behavior of bovine teeth against aesthetic restorative materials in vitro. Abrader specimens were fabricated using four tooth-colored restorative materials (zirconia, lithium disilicate glass ceramic, dental porcelain, and resin composite), with bovine tooth enamel as a control. Flattened bovine tooth enamel was used as the substrate specimen. These materials were characterized by Vickers hardness tests and surface roughness measurements. Two-body wear tests between the abrader and substrate specimens were performed, and the worn topographies were evaluated using a contour-measuring instrument and 3D laser microscope. The restorative materials and bovine tooth enamel had similar surface roughness but different hardness and wear behaviors. Bovine teeth showed the largest wear in tooth-tooth contact as the abrader and substrate specimens. Compared to bovine teeth, zirconia, lithium disilicate glass ceramic, and dental porcelain showed greater hardness and less wear on their surfaces, and less substrate wear of the opposite tooth enamel. The lowest hardness resin composite showed intermediate wear on its surface, resulting in the lowest substrate wear. Accordingly, dentists should pay attention to the selection of restorative materials to reconstruct their morphologies owing to different wear behaviors.

Bone Regeneration of Critical-Size Calvarial Defects in Rats Using Highly Pressed Nano-Apatite/Collagen Composites.

Osteo-conductive bone substitute materials are required in dentistry. In this study, highly pressed nano-hydroxyapatite/collagen (P-nHAP/COL) composites were formed by a hydraulic press. Critical-size bone defects (Φ = 6 mm) were made in the cranial bones of 10-week-old Wistar rats, in which P-nHAP/COL and pressed collagen (P-COL) specimens were implanted. Defect-only samples (DEF) were also prepared. After the rats had been nourished for 3 days, 4 weeks, or 8 weeks, ossification of the cranial defects of the rats was evaluated by micro-computed tomography (micro-CT) (n = 6 each). Animals were sacrificed at 8 weeks, followed by histological examination. On micro-CT, the opacity of the defect significantly increased with time after P-nHAP/COL implantation (between 3 days and 8 weeks, p < 0.05) due to active bone regeneration. In contrast, with P-COL and DEF, the opacity increased only slightly with time after implantation, indicating sluggish bone regeneration. Histological inspections of the defect zone implanted with P-nHAP/COL indicated the adherence of multinucleated giant cells (osteoclasts) to the implant with phagocytosis and fragmentation of P-nHAP/COL, whereas active bone formation occurred nearby. Fluorescent double staining indicated dynamic bone-formation activities. P-nHAP/COL is strongly osteo-conductive and could serve as a useful novel bone substitute material for future dental implant treatments.

Effect of bone defect width and a ferrule on the fracture characteristics of vertically fractured teeth reattached with adhesive resin cement: An in vitro study.

This study aimed to clarify the effects of vertical bone defect width and a ferrule on fracture of the fragments of fractured tooth reattached with adhesive resin cement (reattached tooth). The reattached tooth was built up by a fiber post and composite resin core for abutment and formed to the abutment with or without a ferrule. The vertical bone defect was fabricated with a V-shaped defect in different widths. The fracture load was evaluated using a universal testing machine. The vertical bone defect did not affect the fracture load, but a ferrule increased the root fracture load. For the specimens without a ferrule, debonding between the composite resin core and the root at the coronal loading side and fractures at the apical side of the root were found. In conclusion, the ferrule at abutment could affect fracture load and modes, and the bone defect width did not.

Characterization of Five Collagenous Biomaterials by SEM Observations, TG-DTA, Collagenase Dissolution Tests and Subcutaneous Implantation Tests.

Collagenous biomaterials that are clinically applied in dentistry have dermis-type and membrane-type, both of which are materials for promoting bone and soft tissue formation. The properties of materials supplied with different types could affect their biodegradation periods. The purpose of this study was to characterize five of these products by four different methods: scanning electron microscopy (SEM) observation, thermogravimetry-differential thermal analysis (TG-DTA), 0.01 wt% collagenase dissolution test, and subcutaneous implantation test in vivo. SEM micrographs revealed that both dermis and membranous materials were fibrous and porous. The membranous materials had higher specific derivative thermal gravimetry (DTG) peak temperatures in TG-DTA at around 320 °C, longer collagenase dissolution time ranging from about 300 to 500 min, and more longevity in mice exceeding 9 weeks than the dermis materials. There existed a correlation between the peak temperature in TG-DTA and the collagenase dissolution time. It was considered that higher cross-link degree among collagen fibrils of the membrane-type collagenous materials might account for these phenomena. The experimental protocol and numerical results obtained could be helpful for selection and future development of fibrous collagenous biomaterials in clinical use.

Influence of one-wall remaining coronal tooth with resin abutment and fiber post on static and dynamic fracture resistance.

The objective of this study was to determine the influence of height and thickness of the one wall remaining coronal tooth structure on the fracture resistance of an endodontically treated root with resin abutment build-up using resin composite and fiber-reinforced resin composite post. Static and dynamic fracture tests were performed by placing the remaining tooth wall on the tensile side and applying loads at an angle of 30° from the tooth axis. Superior static fracture resistance was observed when the wall remaining on the tooth had a height and thickness greater than 1.0 mm. The dynamic fatigue test showed high loading capacity or fracture resistance in specimens with large height and thickness. The dynamic fatigue test showed the influence of the remaining tooth structure on fracture resistance clearly. In conclusion, the static and dynamic fracture resistances increased with the height and thickness of the one wall remaining tooth structure.

Effects of different bonding systems with various polymerization modes and root canal region on the bond strength of core build-up resin composite.

Purpose The aim of this study was to clarify the effects of different bonding systems (BSs) with various polymerization modes and root canal regions on the bond strength of core build-up resin composite to dentin.Methods Post cavities were prepared in the roots of 54 bovine teeth. Three types of BS with various polymerization modes (light, chemical, and dual-cure) were applied to the walls of the cavities, which were subsequently filled with core build-up resin composite, and stored in 37°C water for 7 days. Each tooth was then sectioned perpendicular to the long axis of the tooth into 9-disk from the coronal to the apical side. Bond strengths were measured on two-thirds of the disks, while dye penetration was examined in the remaining third.Results Statistical analysis revealed significant differences between the bond strengths of BSs with different polymerization modes, indicating chemical-cured BS had higher bond strength than light-cured BS. The chemical-cured BS group showed cohesive failure in both resin composite and dentin regardless of the root canal region, while adhesive failure was observed in the coronal region for dual-cured BS and in the apical region for light-cured BS. Dye penetration was significantly more at the bonding interface at the apical region of the light-cured BS.Conclusions Chemical-cured BS displayed a greater bond strength than light-cured BS. Cohesive failure was observed in both core build-up resin and dentin, indicating that the integration of tooth structure with resin composite was effective for retaining the resin core and sealing the root canal.

Retention force of fiber-reinforced composite resin post on resin composite for core buildup -Effects of fiber orientation, silane treatment and thermal cycling.

The purpose of this study was to investigate the effects of fiber orientation, silane treatment, and thermal cycling on the retention force of fiber-reinforced composite resin (FRC) posts on resin composite. Two types of FRC posts (linear and woven) were prepared with and without silane treatment. Pull-out test specimens were made of FRC posts and resin composite for core buildup. Specimens were either incubated in distilled water for 24 h or subjected to 10,000 thermal cycles. The maximum fracture load obtained by a pull-out test was defined as the retention force. Fracture modes were observed after the test. Fiber orientation and thermal cycling did not affect the retention force on resin composite, and the retention force was improved by silane treatment. Whereas, fiber orientation affected the fracture mode. The result showed woven fiber orientation could contribute to the mechanically interlocking with the resin composite.

Bio-functionalized titanium surfaces with modified silk fibroin carrying titanium binding motif to enhance the ossific differentiation of MC3T3-E1.

Silk fibroin (SF) from Bombyx mori has superior properties as both a textile and a biomaterial, and has been used to functionalize the surfaces of various medical inorganic materials including titanium (Ti). In this study, we endowed SF with reversible binding ability to Ti by embedding a titanium binding motif (minTBP-1 and RKLPDA). Artificial SF proteins were first created by conjugating gene cassettes for SF motif (AGSGAG) and minTBP-1 motif with different ratios, which have been shown to bind reversibly to Ti surfaces in quartz crystal microbalance analyses. Based on these results, the functionalized SF (TiBP-SF) containing the designed peptide [TS[(AGSGAG)3 AS]2 RKLPDAS]8 was prepared from the cocoon of transgenic B. mori, which accelerates the ossific differentiation of MC3T3-E1 cells when coated on titanium substrates. Thus, TiBP-SF presents an alternative for endowing the surfaces of titanium materials with osseointegration functionality, which would allow the exploration of potential applications in the medical field.

Effects of repetitive insertion/removal cycles and simulated occlusal loads on retention of denture retainers.

The purpose of this study was to investigate the effects of repetitive insertion/removal cycle tests on denture retainers with simulated occlusal loads on the retentive force and deformation of clasp. Abutment teeth in the form of mandibular secondary premolars and clasp in the form of Akers clasps were prepared. The retentive force of the clasp on the abutment teeth were evaluated before and after undergoing repetitive insertion/removal cycle tests with or without cyclic loading. Changes in the clasp shape were monitored using a 3D scanner and scanning electron microscope. The initial retentive force was approximately 10 N and this value later decreased due to deformation of the clasp tips. In contrast to the non-load group, the load group exhibited a reduction in retentive force during earlier stages. Therefore, cyclic loading was related to a decrease in retentive forces, specifically in the early stages of repetitive insertion/removal cycles.

Comparison of retentive forces between telescopic crowns made of poly(ether ether ketone) and type 4 gold alloy.

In this study, retentive forces were compared between telescopic crowns (TSC) made with poly(ether ether ketone) (PEEK) using computer-aided design and manufacturing and type 4 gold alloy using the conventional method. The retentive forces of TSCs were evaluated by performing a pull-out test with primary and secondary crowns. Initial retentive force was approximately 12 N for both PEEK and gold alloy TSCs. The retentive force of PEEK TSC was approximately 6.5 N after 10,000 cycles of insertion and removal. The reduction rate in retentive force was smaller for gold alloy TSC. PEEK TSC displayed greater surface roughness on the primary crown compared to the gold alloy TSC. Surface roughness slightly increased at the cervical margin after repetitive insertion and removal. The retentive force of PEEK TSC was smaller than gold alloy TSC, however the retentive force of PEEK TSC was adequate for stabilizing dental prostheses even after 10,000 cycles.

Bond strength of commercial veneering porcelain to experimental cast Ti-Cr alloy.

This study evaluated bond strengths of three commercial veneering porcelains to experimental cast titanium-chromium (Ti-Cr) alloy and commercially pure titanium (cp-Ti) via three-point bending test. After the bending test, the fractured specimens were analyzed using an electron probe microanalyzer (EPMA). The Ti-Cr specimens showed lower bond strengths than the cp-Ti specimens, irrespective of the layering porcelain material; however, all the strengths exceeded the minimum requirement of ISO 9693-1:2012 (>25 MPa). EPMA revealed that titanium and/or chromium elements were detected on the debonded porcelain surface of the Ti-Cr and cp-Ti specimens in the case of the higher bond strength. Contrastingly, the residual porcelain was retained on the metallic surface in the case of the lower bond strength. Although porcelain bonding to the titanium alloy is influenced by porcelain type, the Ti-Cr alloy could be feasible for porcelain-fused-to-metal restorations.

Low-temperature degradation of high-strength Y-TZP (yttria-stabilized tetragonal zirconia polycrystal).

The objective of this study was to investigate the low temperature degradation characteristics of 2 types of high strength yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) in order to evaluate its suitability for implant body, implant superstructure or abutment. Disk-shaped conventional Y-TZP (0.25 mass% alumina) subjected to hot isostatic press treatment (HIP-Y-TZP) and Y-TZP/4Al2O3 with additional alumina (4.0 mass%) were mirror-polished. Accelerated aging tests with 134°C for 5 h at 0.2 MPa and 180°C for 5 h at 1.0 MPa were performed using an autoclave. Biaxial flexural strength and crystal phases were evaluated. Strength decreased as the proportion of monoclinic phase increased after accelerated aging treatment for both types of high-strength Y-TZPs. Despite the low alumina content, HIP-Y-TZP showed higher static strength and strength after accelerated aging treatment compared to Y-TZP/4Al2O3. However, both types of Y-TZP had adequate strength to be used as dental restorations even after accelerated aging treatment, therefore, its clinical suitability was considered high.

In vitro wear behavior of restorative resin composites against bovine enamel.

The purpose of this study was to clarify the effects of fabrication method of restorative resin-based composites on its wear using enamel as antagonist teeth. Wear evaluation was performed via two-body wear test using hemispherical samples of restorative resin-based composite (abrader specimen) fabricated through direct restoration method, indirect restoration method, and CAD/CAM, and bovine enamel (substrate specimen). As a result, there was a difference in wear volume between resin-based composite and bovine enamel depending on the fabrication method. Resin composite used for indirect restoration method showed more wear in both the abrader and substrate specimens. Resin composite used for CAD/CAM crowns showed greater wear volume in the abrader specimen. In conclusion, results clarified that fabrication method of restorative resin-based composite has an influence on the wear of the resin composite itself and enamel as antagonist teeth.

Optical properties and flexural strength of translucent zirconia layered with high-translucent zirconia.

This study investigated the optical properties and flexural strength of translucent TZP layered with high-translucent PSZ using resin cement of various shades. Zirconia specimens (translucent TZP; Zpex and high-translucent PSZ; ZpexSmile) were 13 mm in diameter, layered at thickness ratios of 0.3/0.7, 0.5/0.5, and 0.7/0.3 mm (ZpexSmile/Zpex), and then luted using resin cement of 3 shades. Monolithic specimens of both were used as controls. CIE L*a*b* color coordinates and translucency parameter (TP) were evaluated as optical properties. Biaxial flexural strength was also determined as a mechanical evaluation. The a* and b* values of layered specimens varied depending on the shade of cement. TP values were not affected by shade of cement and thickness ratio. The biaxial flexural strength was intermediate value between both monolithic specimens. The layering method of zirconia with various translucencies using resin cement of different shades can improve color expression while maintaining clinically sufficient flexural strength.

Change in the retentive force of Akers clasp for zirconia crown by repetitive insertion and removal test.

PURPOSE: The objective of this study was to evaluate the suitability of monolithic zirconia crowns (MZC) as abutment teeth of Akers clasps on removable partial dentures (RPD) by determining the change in retentive force after repetitive insertion/removal test. METHODS: MZC and silver palladium copper alloy (Ag-Pd) full-metal crowns (FMC) for the mandibular second premolar were fabricated. Resin patterns of Akers clasps made with a 3D printer were casted with Ag-Pd or cobalt chromium alloy (Co-Cr). Clasp retentive force was measured with combinations of the crown and clasp materials. After measuring the initial retentive force of the clasp, repetitive insertion/removal test was carried out. The surface of the crown before and after the test was observed with an optical microscope and a scanning electron microscope; some specimens were subjected to element analysis by an electron probe microanalyzer. RESULTS: The initial retentive force of the Co-Cr clasp was greater than the Ag-Pd clasp for both MZC and FMC. Clasp retentive force decreased with increasing number of insertion/removal cycles, and least reduction in force was observed for the Ag-Pd clasp on MZC. Wear marks were detected where FMC contacted the clasp. Discoloration of MZC due to wear of the Co-Cr clasp was observed. CONCLUSIONS: When repetitive insertion/removal of the clasp was performed on MZC, retentive force decreased depending on clasp materials. However, the amount of decrease in retentive force was comparable or small compared to conventional FMC. As a result, it was suggested that MZC could be used on abutment tooth for RPD.

Effect of occlusal groove on abutment, crown thickness, and cement-type on fracture load of monolithic zirconia crowns.

The aim of this study was to investigate the effects of occlusal form of abutment, occlusal thickness of monolithic zirconia crowns (MZC), and cement type on the fracture load of MZC. Abutments were prepared with 2 types of occlusal forms: groove-type and flat-type. These were designed so that thickness at the central fissure region of MZC was 0.3, 0.5, or 0.7 mm. Glass ionomer cement and resin cement were used to lute MZC to their corresponding abutment. Fracture load was determined using a universal testing machine. As a result, groove-type abutment had lower fracture load compared to flat-type abutment; however, the decline in strength was smaller when resin cement was used. Additionally, specimens with larger occlusal thickness had greater fracture load regardless of groove or cement-type. The fracture of MZC occurred on the central fissure region of MZC except for 0.7 mm groove-type MZC luted with resin cement.