Injectable platelet rich fibrin: cell content, morphological, and protein characterization.

OBJECTIVES: The aim of the present study was to evaluate the blood cell content, morphological aspects, gene expression of type I collagen, and release of growth factors on an injectable platelet rich fibrin (i-PRF). MATERIALS AND METHODS: Blood samples were collected from 15 volunteers to prepare i-PRF samples. Peripheral blood was used as a control group. Blood clot and i-PRF samples were cultured for 10 days. The supernatant of the samples was collected for ELISA immunoassay quantification of PDGF and VEGF growth factors over periods of 1, 8, 24, 72, and 240 h. I-PRF and blood clot samples were biologically characterized using histological and immunohistochemistry analysis for IL-10, osteocalcin, and TGF-ß. Scanning electron microscopy (SEM) was used to inspect the fibrin network and distribution of blood platelets and leukocytes. Reverse transcriptase polymerase chain reaction (RT-PCR) method was used to evaluate gene expression for type I collagen. RESULTS: A higher concentration of platelets and lymphocytes was recorded in i-PRF than in peripheral blood (p < 0.05). The release of VEGF was higher in blood clot samples (1933 ± 704) than that for i-PRF (852 ± 376; p < 0.001). Immunohistochemistry showed upregulation of TGF-B, IL-10, and osteocalcin in the i-PRF group. RT-PCR showed increased type I collagen gene expression in i-PRF (p < 0.05). SEM images revealed agglomeration of platelets in some regions, while a fibrin networking was noticeable in the entire i-PRF sample. CONCLUSIONS: Injectable platelet rich fibrin becomes a good approach for soft and mineralized tissue healing considering the formation of a three-dimensional fibrin network embedding platelets, leukocytes, type I collagen, osteocalcin, and growth factors. Indeed, the injectable platelet rich fibrin can be indicated in several medical applications regarding bioactivity, simplied technique, and flowable mixing with other biomaterials. CLINICAL RELEVANCE: Morphological, cell, and protein characterization of platelet rich fibrin provides a better understanding of the clinical effects and improvement of clinical guidelines for several medical applications. Once well physicochemical and biologically characterized, the use of an injectable platelet rich fibrin can be extended to other applications in the field of orthopedics, periodontics, and implant dentistry on the repairing process of both soft and mineralized tissues.

Wear of Morse taper and external hexagon implant joints after abutment removal.

The aim of this in vitro study was to evaluate the removal torque values on abutments and the morphological wear aspects of two different dental implant joints after immersion in a medium containing biofilm from human saliva. Twenty implant-abutment assemblies were divided into four groups in this study: (A) Morse taper free of medium containing biofilm, and (B) after contact with a medium containing biofilm from human saliva; (C) External Hexagon free of medium containing biofilm, and (D) after contact with medium containing biofilm from human saliva. The abutments were firstly torqued to the implants according to the manufacturer´s recommendations, using a handheld torque meter. Groups B and D were immersed into 24 well-plates containing 2 ml BHI medium with microorganisms for 72 h at 37 °C under microaerophilic conditions. After detorque evaluation, the abutments were removed and the implants were analyzed by scanning electron microscopy (SEM) and profilometry. On the detorque evaluation, the torque values decreased for the external hexagon implants and increased for the Morse taper implants. However, the values were lower when both implant-abutment assemblies were in contact with a medium containing biofilm from human saliva. The wear areas of contacting surfaces of the implants were identified by SEM. The highest average roughness values were recorded on the surfaces free of biofilm. The medium containing biofilm from human saliva affected the maintenance of the torque values on Morse taper and external hexagon abutments. Additionally, the removal of abutment altered the inner implant surfaces resulting in an increase of wear of the titanium-based connection.

Effect of Zirconia and Alumina Fillers on the Microstructure and Mechanical Strength of Dental Glass Ionomer Cements.

BACKGROUND: Glass-ionomer cements perform a protective effect on the dentin-pulp complex considering the F ions release and chemical bonding to the dental structures. On the other hand, those materials have poor physic-mechanical properties in comparison with the restorative resin composite. The main aim of this work was to evaluate the influence of zirconia and/or alumina fillers on the microstructure and strength of a resin modified glass-ionomer cement after thermal cycling. METHODS: An in vitro experimental study was carried out on 9 groups (n = 10) of cylindrical samples (6 x 4 mm) made from resin modified glass-ionomer (Vitremer, 3M, USA) with different contents of alumina and/or zirconia fillers. A nano-hybrid resin composite was tested as a control group. Samples were mechanically characterized by axial compressive tests and electron scanning microscopy (SEM) coupled to energy dispersive X-ray spectrophotometry (EDS), before and after thermal cycling. Thermal cycling procedures were performed at 3000, 6000 and 10000 cycles in Fusayama´s artificial saliva at 5 and 60 (o)C. RESULTS: An improvement of compressive strength was noticed on glass-ionomer reinforced with alumina fillers in comparison with the commercial glass ionomer. SEM images revealed the morphology and distribution of alumina or zirconia in the microstructure of glass-ionomers. Also, defects such as cracks and pores were detected on the glass-ionomer cements. The materials tested were not affected by thermal cycling in artificial saliva. CONCLUSION: Addition of inorganic particles at nano-scale such as alumina can increase the mechanical properties of glass-ionomer cements. However, the presence of cracks and pores present in glass-ionomer can negatively affect the mechanical properties of the material because they are areas of stress concentration.

Removal Torque and Biofilm Accumulation at Two Dental Implant-Abutment Joints After Fatigue.

PURPOSE: The aim of this study was to evaluate the removal torque and in vitro biofilm penetration at Morse taper and hexagonal implant-abutment joints after fatigue tests. MATERIALS AND METHODS: Sixty dental implants were divided into two groups: (1) Morse taper and (2) external hexagon implant-abutment systems. Fatigue tests on the implant-abutment assemblies were performed at a normal force (FN) of 50 N at 1.2 Hz for 500,000 cycles in growth medium containing human saliva for 72 hours. Removal torque mean values (n = 10) were measured after fatigue tests. Abutments were then immersed in 1% protease solution in order to detach the biofilms for optical density and colony-forming unit (CFU/cm²) analyses. Groups of implant-abutment assemblies (n = 8) were cross-sectioned at 90 degrees relative to the plane of the implant-abutment joints for the microgap measurement by field-emission guns scanning electron microscopy. RESULTS: Mean values of removal torque on abutments were significantly lower for both Morse taper (22.1 ± 0.5 µm) and external hexagon (21.1 ± 0.7 µm) abutments after fatigue tests than those recorded without fatigue tests (respectively, 24 ± 0.5 µm and 24.8 ± 0.6 µm) in biofilm medium for 72 hours (P = .04). Mean values of microgap size for the Morse taper joints were statistically signicantly lower without fatigue tests (1.7 ± 0.4 µm) than those recorded after fatigue tests (3.2 ± 0.8 µm). Also, mean values of microgap size for external hexagon joints free of fatigue were statistically signicantly lower (1.5 ± 0.4 µm) than those recorded after fatigue tests (8.1 ± 1.7 µm) (P < .05). The optical density of biofilms and CFU mean values were lower on Morse taper abutments (Abs630nm at 0.06 and 2.9 × 104 CFU/cm²) than that on external hexagon abutments (Abs630nm at 0.08 and 4.5 × 104 CFU/cm²) (P = .01). CONCLUSION: The mean values of removal torque, microgap size, and biofilm density recorded at Morse taper joints were lower in comparison to those recorded at external hexagon implant-abutment joints after fatigue tests in a simulated oral environment for 72 hours.

Mechanical and chemical analyses across dental porcelain fused to CP titanium or Ti6Al4V.

The aim of this study was to evaluate the evolution of mechanical properties and chemical variation across veneering dental porcelain fused to different titanium-based substrates. Test samples were synthesized by fusing dental feldspar-based porcelain onto commercially pure titanium grade II or Ti6Al4V alloy. Samples were cross-sectioned at angles of 10 and 90° to the interface plane. Afterwards, nanoindentation tests and Scanning Electron Microscopy (SEM) imaging coupled to an Energy Dispersive Spectroscopy (EDS) system were carried out across interfaces extending from the metal towards the porcelain area. Elemental diffusion profiles across the porcelain-to-metal interfaces were also obtained by EDS analysis. The mismatch in mechanical properties found in porcelain-to-Ti6Al4V interfaces was lower than that of porcelain-to-CP titanium. Cracking was noticed at low-thickness veneering dental porcelain regions after the nanoindentation tests of samples cross-sectioned at low angles to the interface plane. A wide reaction zone between titanium and porcelain as well as higher incidence of defects was noticed at the porcelain-to-CP titanium interfaces. This study confirmed Ti6Al4V as an improved alternative to CP-titanium as it showed to establish a better interface with the veneering dental porcelain considering the slight chemical interaction and the lower mechanical properties mismatch. The elastic modulus of porcelain-to-Ti6Al4V samples showed to be less sensitive to porcelain thickness variations.

Fracture and shear bond strength analyses of different dental veneering ceramics to zirconia.

The purpose of this work was to evaluate the interaction of different layering porcelains with zirconia via shear bond strength test and microscopy. Four different groups of dental veneering porcelains (VM9, Zirkonzanh, Ceramco, IPS) were fused onto forty zirconia-based cylindrical substrates (8mm in diameter and 12 mm in height) (n=10), according to the manufacturer's recommendations. Additionally, layered dental porcelain (D-sign, Ivoclar) was fired on ten Ni-Cr cylindrical substrates Shear bond strength tests of the veneering porcelain to zirconia or Ni-Cr were carried out at a crosshead speed of 0.5mm/min. After the shear bond tests, the interfaces were analyzed by scanning electron microscopy (SEM). The fracture type exhibited by the different systems was also assessed. The results were statistically analyzed by ANOVA at a significant level of p<.05. The shear bond strength values of the porcelain-to-NiCr interfaces (25.3±7.1 MPa) were significantly higher than those recorded for the following porcelain-to-zirconia systems: Zirkonzanh (18.8±1 MPa), Ceramco (18.2±4.7 MPa), and IPS (16±4.5 MPa). However, no significant differences were found in the shear bond strength values between the porcelain-to-NiCr and porcelain (VM9)-to-zirconia (23.2±5.1 MPa) groups (p>.05). All-ceramic interfaces revealed mixed failure type, cohesive in the porcelain and adhesive at the interface. This study demonstrated that all-ceramic systems do not attain yet the same bond strength standards equivalent to metal-ceramic systems. Therefore, despite the esthetic appeal of all-ceramic restorations, the adhesion between the porcelain and zirconia framework is still an issue considering the long term success of the restoration.