A finite element evaluation of mechanical function for 3 distal extension partial dental prosthesis designs with a 3-dimensional nonlinear method for modeling soft tissue.

STATEMENT OF PROBLEM: The mechanical evaluation of the function of partial removable dental prostheses with 3-dimensional finite element modeling requires the accurate assessment and incorporation of soft tissue behavior. The differential behaviors of the residual ridge mucosa and periodontal ligament tissues have been shown to exhibit nonlinear displacement. The mathematic incorporation of known values simulating nonlinear soft tissue behavior has not been investigated previously via 3-dimensional finite element modeling evaluation to demonstrate the effect of prosthesis design on the supporting tissues. PURPOSE: The purpose of this comparative study was to evaluate the functional differences of 3 different partial removable dental prosthesis designs with 3-dimensional finite element analysis modeling and a simulated patient model incorporating known viscoelastic, nonlinear soft tissue properties. MATERIAL AND METHODS: Three different designs of distal extension removable partial dental prostheses were analyzed. The stress distributions to the supporting abutments and soft tissue displacements of the designs tested were calculated and mechanically compared. RESULTS: Among the 3 dental designs evaluated, the RPI prosthesis demonstrated the lowest stress concentrations on the tissue supporting the tooth abutment and also provided wide mucosa-borne areas of support, thereby demonstrating a mechanical advantage and efficacy over the other designs evaluated. CONCLUSIONS: The data and results obtained from this study confirmed that the functional behavior of partial dental prostheses with supporting abutments and soft tissues are consistent with the conventional theories of design and clinical experience. The validity and usefulness of this testing method for future applications and testing protocols are shown.

[Development of a light-polymerized resin for the record base. Part 1 Comparison with autopolymerizing resin].

PURPOSE: The record block for maxillomandibular registration of the denture is absolutely necessary in order to decide the mandibular position. This record block must provide sufficient strength so as not to cause deformation in the oral cavity. It must also fit the alveolar ridge well in order to keep accurate registration. Since most of the conventional materials for this purpose are not sufficient, a new specific light-polymerized resin was experimentally developed for the record base. METHODS: The mechanical strength and suitability of the new material were examined in comparison with a conventional autopolymerizing resin. RESULTS: 1) The transverse strength was equivalent to that of the autopolymerizing resin. 2) Although the shear bond strength was equivalent to the autopolymerizing resin, the intensity was drastically improved by the application of composite primer. 3) The light-polymerized resin and the autopolymerizing resin did not show any difference in suitability, and it was a clinical value without problem. CONCLUSIONS: From these findings, it was confirmed that the new light-polymerized resin had the physical property for clinical application as a material for the record base.

Transplantation of dental pulp stem cells suppressed inflammation in sciatic nerves by promoting macrophage polarization towards anti-inflammation phenotypes and ameliorated diabetic polyneuropathy.

AIMS/INTRODUCTION: Dental pulp stem cells (DPSCs) are thought to be an attractive candidate for cell therapy. We recently reported that the transplantation of DPSCs increased nerve conduction velocity and nerve blood flow in diabetic rats. In the present study, we investigated the immunomodulatory effects of DPSC transplantation on diabetic peripheral nerves. MATERIALS AND METHODS: DPSCs were isolated from the dental pulp of Sprague-Dawley rats and expanded in culture. Eight weeks after the streptozotocin injection, DPSCs were transplanted into the unilateral hindlimb skeletal muscles. Four weeks after DPSC transplantation, neurophysiological measurements, inflammatory gene expressions and the number of CD68-positive cells in sciatic nerves were assessed. To confirm the immunomodulatory effects of DPSCs, the effects of DPSC-conditioned media on lipopolysaccharide-stimulated murine macrophage RAW264.7 cells were investigated. RESULTS: Diabetic rats showed significant delays in sciatic nerve conduction velocities and decreased sciatic nerve blood flow, all of which were ameliorated by DPSC transplantation. The number of CD68-positive monocytes/macrophages and the gene expressions of M1 macrophage-expressed cytokines, tumor necrosis factor-α and interleukin-1ß, were increased in the sciatic nerves of the diabetic rats. DPSC transplantation significantly decreased monocytes/macrophages and tumor necrosis factor-α messenger ribonucleic acid expression, and increased the gene expression of the M2 macrophage marker, CD206, in the sciatic nerves of the diabetic rats. The in vitro study showed that DPSC-conditioned media significantly increased the gene expressions of interleukin-10 and CD206 in lipopolysaccharide-stimulated RAW264.7 cells. CONCLUSIONS: These results suggest that DPSC transplantation promoted macrophages polarization towards anti-inflammatory M2 phenotypes, which might be one of the therapeutic mechanisms for diabetic polyneuropathy.

[Application of sintered Ti powder to dental prostheses].

PURPOSE: Powder metallurgy is a metal processing technology. Porous titanium produced from powder is widely used. The method is applied to titanium, which is not easy to cast as it sinters under melting point. In prosthetic dentistry, powder metallurgy can be applied to high fusing metal that is biocompatible. In this study, we examined the mechanical characteristics of the Ti sheet produced by sintering and discussed its application to dental prosthesis manufacturing. METHODS: Ti sheets of 1-mm thickness, in which a binder was added to spherical Ti powder, were produced with the Doctor Blade Method. The sintering was carried out between 900-1150 degrees C at 6 temperatures. The sintered compact was evaluated by dimensional change rate, hardness test, bending strength, tensile strength and SEM observation. Another compact was sintered on the refractory cast. RESULTS: Mechanical strength significantly increased with sintering temperature. In addition, excellent mechanical strength was acquired by adding crushed powder and performing the de-binder process. In the sintering on the refractory cast, pre-baking for more than 100 minutes and sintering at over 1050 degrees C was needed for practical application. CONCLUSIONS: It thus seems possible to apply sintered titanium to dental prostheses. However, it will be necessary to examine the control of the shrinkage of the sintered compact in the future too.

Reactivity of zirconia with phosphate-bonded investments for hot-pressing.

PURPOSE: The aim of the present study was to investigate the reactivity of zirconia to phosphate-bonded investment on the process of hot-pressing technique. METHODS: Disc-shaped specimens, 16 mm diameter and 0.4mm thick were prepared by cutting and grinding. These specimens were finally sintered. Half of them were sandblasted. The non-sandblasted specimens were used for controls. Both of zirconia discs with and without sandblasting were invested into the three kinds of phosphate-bonded investment. The investments were fired and broken to take out specimens. The biaxial strengths were measured in the way of the biaxial flexural tests according to ISO-6872. RESULTS: The biaxial strengths were ranged 762-1200 MPa at the average. The biaxial strengths of sandblasted zirconia discs heated with phosphate-bonded investment were decreased significantly (p < 0.01). SEM and EPMA revealed that the various compounds were observed on the sandblasted specimens. XRD revealed that surfaces of specimens heated with the phosphate-bonded investment showed the formation of phosphate compounds. CONCLUSIONS: The phosphate compounds inhibit stress-induction phase transformation of zirconia and decrease the biaxial strength.

Transplantation of cultured dental pulp stem cells into the skeletal muscles ameliorated diabetic polyneuropathy: therapeutic plausibility of freshly isolated and cryopreserved dental pulp stem cells.

INTRODUCTION: Dental pulp stem cells (DPSCs) are mesenchymal stem cells located in dental pulp and are thought to be a potential source for cell therapy since DPSCs can be easily obtained from teeth extracted for orthodontic reasons. Obtained DPSCs can be cryopreserved until necessary and thawed and expanded when needed. The aim of this study is to evaluate the therapeutic potential of DPSC transplantation for diabetic polyneuropathy. METHODS: DPSCs isolated from the dental pulp of extracted incisors of Sprague-Dawley rats were partly frozen in a -80 °C freezer for 6 months. Cultured DPSCs were transplanted into the unilateral hindlimb skeletal muscles 8 weeks after streptozotocine injection and the effects of DPSC transplantation were evaluated 4 weeks after the transplantation. RESULTS: Transplantation of DPSCs significantly improved the impaired sciatic nerve blood flow, sciatic motor/sensory nerve conduction velocity, capillary number to muscle fiber ratio and intra-epidermal nerve fiber density in the transplanted side of diabetic rats. Cryopreservation of DPSCs did not impair their proliferative or differential ability. The transplantation of cryopreserved DPSCs ameliorated sciatic nerve blood flow and sciatic nerve conduction velocity as well as freshly isolated DPSCs. CONCLUSIONS: We demonstrated the effectiveness of DPSC transplantation for diabetic polyneuropathy even when using cryopreserved DPSCs, suggesting that the transplantation of DPSCs could be a promising tool for the treatment of diabetic neuropathy.

Increased expression of interleukin (IL)-35 and IL-17, but not IL-27, in gingival tissues with chronic periodontitis.

BACKGROUND: Interleukin (IL)-35 plays an important role in immune regulation through the suppression of effector T-cell populations, including T-helper 17 (Th17) cells. Although Th17 cells and IL-17 are involved in the pathogenesis of periodontitis, the level of IL-35 in inflamed periodontal tissues is unclear. Here, IL-35, IL-17, and IL-27 production/expression in gingival crevicular fluid (GCF) and human gingival tissue were investigated. METHODS: GCF samples were collected from buccal (mesial, center, and distal) sites of teeth from patients with chronic periodontitis (CP) and healthy controls and were analyzed by enzyme-linked immunosorbent assay for IL-35 (periodontitis, n = 36; healthy, n = 30) and IL-17 (periodontitis, n = 16; healthy, n = 13). Gingival tissue, including sulcus/pocket epithelium and underlying connective tissue, was collected from an additional 10 healthy participants and 10 patients with CP and were analyzed by quantitative polymerase chain reaction (qPCR) for Epstein Barr virus-induced gene 3 (EBI3), IL12A, and IL17A. IL27p28 was also tested by qPCR. RESULTS: IL-35 and IL-17 were significantly higher in GCF from patients with periodontitis than healthy participants (P <0.01, P <0.05, respectively). In both healthy participants and those with periodontitis, positive correlations were found among IL-35 and probing depth and clinical attachment level (CAL) as well as between IL-17 and CAL. EBI3, IL12A (components of IL-35), and IL17A messenger RNA expression levels were significantly higher in inflamed gingival tissue than in healthy control tissues (P <0.05). IL27p28 was not detected in any sample, suggesting that IL-27 is not produced in large quantities in periodontal tissue. CONCLUSION: IL-35 and IL-17, but not IL-27, may play important roles in the pathogenesis of periodontitis.

[Human papillomavirus infection in the oral cavity of denture wearers].

PURPOSE: The purpose of this study was to determine the frequency of human papillomavirus(HPV)infections in the oral cavity of middle-aged and elderly dental patients with dentures. METHODS: In this study, 47 patients (20 men and 27 women), aged from 50 to 78 years, were randomly selected from the patients in the Department of Prosthodontics, Aichi-Gakuin University Affiliated Dental Hospital. Oral squamous cells were collected from swabs of the buccal mucosa. For this procedure, informed consent was obtained. Extracted DNA was evaluated for HPV infections by PCR methods, using consensus and specific primers, and direct DNA sequencing analysis. RESULTS: Twenty-four of 47 specimens (51.1%) were positive for HPV DNA. A statistically significant association was not found in the HPV positivity between men and women. The high rate of infection was recognized from 60 or more years old. A statistically significant association was found in the HPV positivity between non-denture wearers and denture wearers. Frequent HPV types in the specimens of all were HPV11, 4 and 16. Frequent HPV types in the specimens of non-denture wearers and denture wearers were HPV4, 11 and HPV11, 16 and 4, respectively. CONCLUSIONS: The results of the present investigation indicate that HPV is present in the oral cavity, especially those of denture wearers, of middle-aged and elderly patients. It is suggested, therefore, that the oral cavity of middle-aged and elderly patients with dentures is a reservoir of HPVs where later HPV-associated diseases, such as oral cancer and other oral lesions, may develop.

The influence of a glucosyltransferase, encoded by gtfP, on biofilm formation by Streptococcus sanguinis in a dual-species model.

Streptococcus sanguinis is an early colonizer of tooth surfaces and forms biofilms with other species of microorganisms. In vitro, S. sanguinis produces water-soluble glucans from sucrose and releases them into the culture supernatant; however, the role played by these glucans in biofilm formation is unclear. The present study examined both the effect of glucans on biofilm formation by S. sanguinis and the proportion of this bacterial species within the biofilms. Inactivation of the gtfP gene, annotated as glucosyltransferase in the S. sanguinis genome database, caused a marked reduction in the amount of water-soluble glucans in the culture supernatant, but not in the amount of water-insoluble glucans expressed on the bacterial cell surface. Scanning electron microscopy revealed that wild-type S. sanguinis, but not the gtfP-deficient mutant, produced large amounts of sticky material in the presence of 1% (w/v) sucrose. In addition, biofilm production by wild-type bacteria was greater than that by the mutant strain. By contrast, co-culture of mutant bacteria with Streptococcus mutans, S. sobrinus, S. oralis, S. gordonii, S. anginosus, or S. salivarius showed that inactivating the gtfP gene had little effect on the amount of biofilm produced. Furthermore, inactivating the gtfP gene did not greatly alter the proportion of S. sanguinis in the biofilms formed by the co-cultures. Thus, despite the role of S. sanguinis glucosyltransferase in formation of water-soluble glucans and biofilms in monoculture, the functional gene contributed little to biofilms in co-culture experiments.

Mechanical stretch increases the proliferation while inhibiting the osteogenic differentiation in dental pulp stem cells.

Dental pulp stem cells (DPSCs), which can differentiate into several types of cells, are subjected to mechanical stress by jaw movement and occlusal forces. In this study, we evaluated how the uniaxial mechanical stretch influences proliferation and differentiation of DPSCs. DPSCs were isolated and cultured from male Sprague-Dawley rats. Cultured DPSCs were identified by surface markers and the differentiation capabilities as adipocytes or osteoblasts. To examine the response to mechanical stress, uniaxial stretch was exposed to cultured DPSCs. We evaluated the impact of stretch on the intracellular signaling, proliferation, osteogenic differentiation, and gene expressions of DPSCs. Stretch increased the phosphorylation of Akt, ERK1/2, and p38 MAP kinase as well as the proliferation of DPSCs. The stretch-induced proliferation of DPSCs was abolished by the inhibition of the ERK pathway. On the other hand, stretch significantly decreased the osteogenic differentiation of DPSCs, but did not affect the adipogenic differentiation. We also confirmed mRNA expressions of osteocalcin and osteopontin were significantly suppressed by stretch. In conclusion, uniaxial stretch increased the proliferation of DPSCs, while suppressing osteogenic differentiation. These results suggest a crucial role of mechanical stretch in the preservation of DPSCs in dentin. Furthermore, mechanical stretch may be a useful tool for increasing the quantity of DPSCs in vitro for regenerative medicine.

Three-dimensional finite element stress analysis: the technique and methodology of non-linear property simulation and soft tissue loading behavior for different partial denture designs.

The purpose of this study was to develop and report upon a methodology for a non-linear capacity 3D modeling finite element analysis evaluating the loading behavior of different partial denture designs. A 3D finite element model using human CT data was constructed. An original material constant conversion program was implemented in the data simulation of non-linear tissue behavior. The finite element method material properties of residual ridge mucosa were found to have seven material constants and six conversion points of stress values. Periodontal tissues were found to have three constants, and two conversion points. Three magnetic attachment partial denture designs with different bracing elements were evaluated. Technical procedures for finite element model simulation of nonlinear tissue behavior properties evaluating the oral behavior of prosthetic device designs are reported for prosthodontic testing. The use of horizontal cross-arch bracing positively impacts upon the comparative stability of the partial denture designs tested.

An experimental study of bone grafting using rat milled tooth.

PURPOSE: The aim of this study was to develop a novel bone graft material that used extracted teeth. MATERIALS AND METHODS: Thirty-six 10-week-old male Wistar rats were used. The incisors were extracted, immediately frozen and milled, mixed with hydroxypropyl cellulose (HPC), and injected into the socket. The remaining rats received HPC alone, or the socket was left to heal untreated. Socket healing and bone formation in all three groups were evaluated by three-dimensional image analysis from microcomputed tomography examination and histologic observation. RESULTS: Quantitative morphologic measurements demonstrated that bone formation was significantly stimulated in the group that received milled tooth and HPC at 2 and 4 weeks after extraction compared to that of the control (untreated) group, which showed normal healing without any intervention. Histologic observation revealed that the compound of milled tooth and HPC promoted early healing of the socket and initiation of bone formation in the surrounding area. Interestingly, HPC injection alone decreased bone formation and bone mineral content at 2 weeks and then increased bone formation at 4 weeks. CONCLUSION: A bone graft material composed of milled tooth promotes early healing and bone formation, while HPC, which is chemically stable in vivo, affects bone formation in the extraction socket.

High-throughput gene expression analysis in bone healing around titanium implants by DNA microarray.

OBJECTIVE: Bone generation occurs around titanium implants; however, its underlying mechanisms are relatively unknown. We attempt to identify gene transcripts specifically upregulated in in vivo bone healing with titanium implants using DNA microarray. MATERIAL AND METHODS: Titanium implants were placed into rat femurs, and total RNA was extracted from the implant-associated tissue at weeks 1, 2 and 4 of healing. As a control, RNA was extracted from the tissue undergoing osteotomy healing. The RNA samples were hybridized onto oligo DNA microarray. RESULTS: Most of the 20,000 genes tested were expressed similarly in both the implant- and osteotomy-healing groups. Eighty-six genes were upregulated (>2-fold) in the implant-healing group compared with the osteotomy-healing group in at least one time point of healing. Twelve genes were upregulated in the implant healing at week 2 and earlier, while 31 genes were upregulated at week 2 and later. Only one gene was upregulated specifically at week 1, while three genes were consistently upregulated from weeks 1 to 4. The upregulated genes included collagenous and non-collagenous extracellular matrix (ECM)-related genes, proteoglycans and bone resorption-related genes. Pathway analysis revealed the involvement of ECM and receptor interaction in implant healing. CONCLUSIONS: This study provides evidence that a set of gene transcripts is upregulated in the implant healing over the osteotomy healing, which seems to represent the coordinated biological events of long-lasting osteogenesis and bone remodeling required for osseointegration. Further studies are needed to identify the significance and biological roles of the transcripts in osseointegration. Proven reliability and usefulness of microarray technology should encourage future approaches to develop a high-throughput molecular assessment for osseointegration capacity of new implant surfaces.