Assessment of Inhibition of Biofilm Formation on Non-Thermal Plasma-Treated TiO2 Nanotubes.

Peri-implantitis is an inflammatory disease similar to periodontitis, caused by biofilms formed on the surface of dental implants. This inflammation can spread to bone tissues and result in bone loss. Therefore, it is essential to inhibit the formation of biofilms on the surface of dental implants. Thus, this study examined the inhibition of biofilm formation by treating TiO2 nanotubes with heat and plasma. Commercially pure titanium specimens were anodized to form TiO2 nanotubes. Heat treatment was performed at 400 and 600 °C, and atmospheric pressure plasma was applied using a plasma generator (PGS-200, Expantech, Suwon, Republic of Korea). Contact angles, surface roughness, surface structure, crystal structure, and chemical compositions were measured to analyze the surface properties of the specimens. The inhibition of biofilm formation was assessed using two methods. The results of this study showed that the heat treatment of TiO2 nanotubes at 400 °C inhibited the adhesion of Streptococcus mutans (S. mutans), associated with initial biofilm formation, and that heat treatment of TiO2 nanotubes at 600 °C inhibited the adhesion of Porphyromonas gingivalis (P. gingivalis), which causes peri-implantitis. Applying plasma to the TiO2 nanotubes heat-treated at 600 °C inhibited the adhesion of S. mutans and P. gingivalis.

Novel ß-TCP Coated Titanium Nanofiber Surface for Enhanced Bone Growth.

In this study, we examined the effect of ß-tricalcium phosphate (ß-TCP) coating on alkali-treated CP Grade II titanium surface via RF magnetron sputtering on osteoblast like cell (MC3T3-E1) viability and bone formation in rat tibia. The specimens were divided into three groups; commercially pure titanium (control group), alkali-treated titanium with nanofiber structure (NF group) and ß-TCP coating on alkali-treated titanium with nanofiber structure (TNF group). The surface characteristics of specimens were observed under a field emission scanning electron microscope (FE-SEM), and contact angle was measured. The cell viability was assessed in vitro after 1 day, 3 days and 7 days. Implants of 2.0 mm diameter and 5.0 mm length were inserted into the tibia of rats. After 4 wks, the histomorphometric analysis was performed. Group NF and group TNF showed improved hydrophilicity of Ti. Group TNF showed significantly higher cell viability (P < 0.05) after 7 days. The bone to implant contact (BIC) ratio of the control group, NF group, and TNF group were 32.3%, 35.5%, and 63.9%, respectively. The study results suggested that ß-TCP coated alkali-treated titanium surface via RF magnetron sputtering might be effective in implant dentistry due to enhanced hydrophilicity, improved cell response, and better osseointegration.

Hydroxyapatite Coating on TiO2 Nanotube by Sol-Gel Method for Implant Applications.

The aim of this study was to determine the effect of hydroxyapatite (HA) coating on titanium dioxide (TiO2) nanotube by sol-gel process on viability of osteoblast like cell (MC3T3-E1) and bone formation in rat tibia. Specimens were divided into three groups including commercially pure titanium (control group), TiO2 nanotubes (group N), and HA coated TiO2 nanotubes (group HN). Surface characteristics were determined using field emission scanning electron microscope (FE-SEM; S-4700, Hitachi, Japan) and contact angles were measured. Cell viability was investigated in vitro after 1 day, 3 days, and 7 days of incubation. Implants (2.0 mm in diameter and 5.0 mm in length) were inserted into the tibia of rats. After 4 weeks, histomorphometric analysis was performed. Both N and HN groups showed enhanced hydrophilicity compared to control group. After 7 days of implantation, group HN showed higher cell viability with marginal significance (0.05 < P < 0.1). Bone to implant contact (BIC) ratio in the control group, group N, and group HN were 32.5%, 33.1%, and 43.8%, respectively. Results of this study showed that HA coated TiO2 nanotube using sol-gel process could be used to enhance hydrophilicity and improve osseointegration of dental implant surface.

Evaluation of the Fitness of Glass-Infiltrated Zirconia Core in Maxillary Central Incisor.

The purpose of this study was to evaluate the fitness of zirconia cores according to the amount and treated surface of glass infiltration. A maxillary right central incisor customized abutment was milled to have a 6° slope and a 1 mm deep chamfer margin and was manufactured in an intaglio mold using silicone impression material. Fifty-six stone dies were produced by injecting high strength dental stone into a mold and then zirconia cores were milled with CAD/CAM systems. The control group (Control) used non glass-infiltrated zirconia, and the experiment group was divided by one with the glass and distilled water ratio of 1:300 and the other with the ratio of 1:100. Each group was divided into subgroups by glasstreated surface: external surface infiltration, internal surface infiltration, and both surface infiltration. The zirconia cores sintered after glass infiltration were attached to the stone dies and then cut. Afterwards, the absolute marginal discrepancies and internal gaps of the buccal and lingual sides were measured. The buccal absolute marginal discrepancies and lingual internal gaps were influenced by the glass infiltration amount (p < 0.05); while fitness of zirconia core were not affected by the glasstreated surface (p > 0.05). As a result of the above experiments, the glass-infiltrated zirconia cores showed a clinically acceptable fitness, which is within 120 µm. This means that glass infiltration can be clinically used.

Effect on Adhesion of Porphyromonas gingivalis by Titanium Nitride Sputter Coating or Plasma Nitriding of Titanium.

Porphyromonas gingivalis (P. gingivalis) is one of main bacteria that adheres to the surface of dental implants and causes peri-implantitis. The purpose of this study was to observe the surface characteristics of titanium processed with either titanium nitride (TiN) sputter coating or plasma nitriding and to evaluate the subsequent adhesion of P. gingivalis. Specimens were divided into three groups: commercially pure (CP) titanium (control group), TiN sputter­coated titanium (group S), and plasma-nitrided titanium (group P). Surface characteristics such as roughness, morphology, and the formation of a thin TiN film or a nitriding layer were assessed. Adhesion of P. gingivalis in the three groups was determined by means of the crystal violet staining assay, and results were compared with one-way ANOVA, with post hoc comparison using Tukey's test (α = 0.05). Surface roughness values for the control group, group S, and group P were 0.08±0.02 µm, 0.19±0.04 µm, and 0.13±0.02 µm, respectively. In group S, the TiN layer was 1.36±0.1 µm thick, and nitrogen was detected on the surface of the specimens in group P, confirming formation of a nitrided layer. The level of adhesion in group P was significantly higher than that in the control group and in group S (p < 0.05), but there was no significant difference between the control group and group S. Within the limitations of this study, TiN sputter coating did not affect adhesion of P. gingivalis on the titanium surface, whereas adhesion was increased on the plasma-nitrided titanium surface.

Evaluation of Sandblasting on Mechanical Properties and Cell Response of Bioactive Glass Infiltrated Zirconia.

This study investigated the mechanical properties and initial cell response of bioactive glass infiltrated zirconia before and after sandblasting. One hundred zirconia specimens were divided into the following four groups: untreated zirconia (ZR), sandblasted zirconia (ZS), glass infiltrated zirconia (ZG), and sandblasted glass infiltrated zirconia (ZGS). Surface roughness, biaxial flexural strength, hardness and osteoblast cells proliferation were evaluated. ZGS group showed a slight decrease in hardness. However it has improvement in flexural strength (686.2 MPa). After sandblasting, the ZGS group had the highest surface roughness (R a = 1.24 µm) with enhanced osteoblast cells response. Our results indicated that sandblasting method can improve the mechanical properties of bioactive glass infiltrated zirconia with better osteoblast cell response. This new surface is promising for zirconia dental implant application in the future.

Surface Characteristics of Bioactive Glass-Infiltrated Zirconia with Different Hydrofluoric Acid Etching Conditions.

The purpose of this study was to examine the surface characteristics of bioactive glass-infiltrated zirconia specimens that underwent different hydrofluoric acid (HF) etching conditions. Specimens were classified into the following six groups: Zirconia, Zirliner, Porcelain, Bioactive glass A1, Bioactive glass A2, and Bioactive glass A3. Zirliner and porcelain were applied to fully sintered zirconia followed by heat treatment. Bioactive glass was infiltrated into presintered zirconia using a spin coating method followed by complete sintering. All the specimens were acid-etched with 10% or 20% HF, and surface roughness was measured using a profiler. The surface roughness of the zirconia group was not affected by the etching time or the concentration of the acid. The roughness of the three bioactive glass groups (A1, A2, and A3) was slightly increased up until 10 minutes of etching. After 1 hour of etching, the roughness was considerably increased. The infiltrated bioactive glass and acid etching did not affect the adhesion and proliferation of osteoblasts. This study confirmed that surface roughness was affected by the infiltration material, etching time, and acid concentration. For implant surfaces, it is expected that the use of etched bioactive glass-infiltrated zirconia with micro-topographies will be similar to that of machined or sand-blasted/acid-etched (SLA) titanium.

Evaluation of Osteoblast-Like Cell Viability and Differentiation on the Gly-Arg-Gly-Asp-Ser Peptide Immobilized Titanium Dioxide Nanotube via Chemical Grafting.

This study examined the effect of the immobilization of the Gly-Arg-Gly-Asp-Ser (GRGDS) peptide on titanium dioxide (TiO2) nanotube via chemical grafting on osteoblast-like cell (MG-63) viability and differentiation. The specimens were divided into two groups; TiO2 nanotubes and GRGDS-immobilized TiO2 nanotubes. The surface characteristics of GRGDS-immobilized TiO2 nanotubes were observed by using X-ray photoelectron spectroscopy (XPS) and a field emission scanning electron microscope (FE-SEM). The morphology of cells on specimens was observed by FE-SEM after 2 hr and 24 hr. The level of cell viability was investigated via a tetrazolium (XTT) assay after 2 and 4 days. Alkaline phosphatase (ALP) activity was evaluated to measure the cell differentiation after 4 and 7 days. The presence of nitrogen up-regulation or C==O carbons con- firmed that TiO2 nanotubes were immobilized with GRGDS peptides. Cell adhesion was enhanced on the GRGDS-immobilized TiO2 nanotubes compared to TiO2 nanotubes. Furthermore, significantly increased cell spreading and proliferation were observed with the cells grown on GRGDS-immobilized TiO2 nanotubes (P < .05). However, there was no significant difference in ALP activity between GRGDS-immobilized TiO2 nanotubes and TiO2 nanotubes. These results suggest that the GRGDS-immobilized TiO2 nanotubes might be effective in improving the osseointegration of dental implants.

Analysis of Removal Torque of Injection Molded Zirconia Implants; An Experimental Study on Beagles.

This study compared the removal torque between injection molded zirconia implants and titanium implants with resorbable blast media (RBM) surfaces in beagle humeri. Fifteen screw-shaped implants were classified into 3 groups; titanium implant with RBM surface (Group RT), injection molded zirconia implant (Group Zr) and injection molded zirconia implant with sand-blasted surface (Group ZrS). Implants were inserted into beagle humeri. After 12 weeks, removal torque values were measured. The Zr group has a slightly higher removal torque value than the RT and ZrS groups but there were no significant differences among groups. Zirconia implants shows a similar removal torque to RBM titanium implants. This in vivo study showed injection molded zirconia implants could be an alternative to RBM titanium implants in terms of removal torque.

Shear bond strength between resin cement and colored zirconia made with metal chlorides.

STATEMENT OF PROBLEM: Although the application of zirconia in esthetic prostheses has increased, the shear bond strength (SBS) between colored zirconia and resin cement has not been investigated. PURPOSE: The purpose of this study was to compare the SBS between resin cement and colored zirconia made with metal chlorides. MATERIAL AND METHODS: Sixty-four zirconia specimens were divided into 2 groups: one in which the specimens were bonded with resin cement, including 4-META (4-methacryloxyethyl trimellitic anhydride), and one in which the specimens were bonded with resin cement (SEcure, Sun Medical) after being processed with zirconia primer (Zirconia Liner), including 4-META. Each group was then divided into 4 subgroups depending on the coloring liquid. The subgroups were noncolored (control), commercial coloring liquid VITA In-Ceram 2000 YZ LL1, aqueous chromium chloride solution 0.1 wt%, and aqueous molybdenum chloride solution 0.1 wt%. Composite resin cylinders (Filtek Z250, 3M ESPE) were fabricated and bonded to the surface of the zirconia specimen with resin cement (SEcure). All specimens were stored in 37°C distilled water for 24 hours, and the SBS was measured with a universal testing machine. All data were analyzed statistically with 2-way ANOVA and tested post hoc with the Tukey test (α=.05). RESULTS: Significant differences were observed among the SBS values of the colored zirconia depending on the coloring liquid (P<.001) and whether they were processed with zirconia primer (P<.001). The SBS between colored zirconia and resin cement was significantly higher than that of noncolored zirconia and resin cement in groups processed with zirconia primer (P<.05). Colored zirconia immersed in aqueous molybdenum chloride solution showed a significantly higher SBS. CONCLUSIONS: Coloring liquid enhanced the SBS between resin cement and zirconia processed with zirconia primer. In particular, colored zirconia immersed in aqueous molybdenum chloride solution showed the highest SBS.

Effect of transition metal dopants on mechanical properties and biocompatibility of zirconia ceramics.

In this study, the effect of transition metal dopants, originally added as colouring agents, on the mechanical properties and biocompatibility of sintered zirconia was investigated. This study confirmed that transition metal dopants could have a slight detrimental effect on the mechanical properties of zirconia. The addition of metal dopants did not affect the adhesion and proliferation of gingival fibroblasts.

Effect on Cell Viability with the Passage of Time After Atmospheric Plasma Treatment on Titanium Dioxide Surface.

Various attempts to modify the surface of dental implants have been made in order to improve the adhesion of osteocytes. Plasma treatment on dental implants has been suggested to improve osseointegration. This study examined the effect on cell viability with the passage of time after atmospheric plasma treatment. An atmospheric plasma generator (PGS-200 Plasma generator, Expantech Co., Korea) was used and the gas was mixed with the Ar2(99%)/O2(1%) composition and applied to the specimens. The passage of time was set to 7 immediately after treatment, after 30 minutes of treatment, after 60 minutes of treatment, after 90 minutes of treatment, after 24 hours of treatment, and after 48 hours of treatment. Surface property change with the passage of time after plasma treatment were confirmed by FE-SEM, surface roughness and X-ray photoelectron spectroscopy. Cell viability was evaluated by the WST-8 assay. The data were analyzed statistically using a 1-way ANOVA and Tukey's multiple comparisons test (α = .05). It was confirmed that the chemical composition of the surface changes as the passage of time increases after plasma treatment. The viability of L-929 cells was the highest immediately after plasma treatment, and cell viability decreased with increasing the passage of time. As a result of this study, it was confirmed that passage of time is a very important factor for the plasma treated surface.

Assessment of Inhibition of Biofilm Formation on TiO2 Nanotubes According to Non-Thermal Plasma Treatment Conditions and the Elapsed Time in the Atmosphere.

Periimplantitis is an inflammation similar to periodontitis, and is caused by biofilms formed on the surface of dental implants. Application of plasma on biomaterials has been reported to decrease the initial adhesion of microorganism by causing chemical changes without changing the surface morphology. The purpose of this study is to evaluate the effect of inhibition of biofilm formation on the elapsed time after plasma treatment. Non thermal plasma generator (PGS-200 Plasma generator, Expantech Co., Korea) was applied to the specimens. The elapsed time in the atmosphere was set to 5 immediately after treatment, after 30 minutes of treatment, after 60 minutes of treatment, after 90 minutes of treatment. Surface property change with the elapsed time in the atmosphere after plasma treatment were confirmed by X-ray photoelectron spectroscopy and contact angle. Inhibition of biofilm formation was evaluated by the fluorescent nucleic acid staining. It was confirmed that the chemical composition and bonding state of the surface changes as the elapsed time in the atmosphere increases after plasma treatment. The adhesion of Porphyromonas gingivalis was the lowest immediately after plasma treatment, and increased again with increasing elapsed time in the atmosphere after plasma treatment. As a result of this study, it was confirmed that elapsed time in the atmosphere is a very important factor for inhibition of biofilm formation.

Wear Behavior of the Human Enamel Antagonist to Different Glazed Zirconia.

In this study, the wear behavior of glazed zirconia was investigated to the antagonist with human enamel after simulated mastication. Twenty Y-TZP specimens were divided into 4 groups: untreated zirconia (Z), glazed zirconia with IPS e.max Ceram (GZE), glazed zirconia with VITA AKZENT® Plus (GZV), and glazed zirconia with glass (GZG). Glazing glass was mainly composed of SiO2, B2O3, Al2O3, Na2O and K2O (nearly 91 wt%). The surface roughness of the specimens was evaluated using roughness profiler. The maxillary premolar teeth were selected as the antagonist. The wear of human enamel against human enamel was used as a control. Five-disc specimens per group were subjected to chewing stimulation CS-4 (SD Mechatronic GmbH, Germany) for 240,000 cycles against human enamel. The wear loss of antagonistic teeth was calculated using a three-dimensional profiling system and the volume loss of the tooth was scanned using a 3D scanner. 3D data obtained before and after testing were overlapped using 3D software (Dentacian Software, EZplant, Korea). The wear loss of glazed zirconia GZE, GZV and GZG groups showed significantly lower than that of human enamel. Whereas, the zirconia (Z) group exhibits significantly lower volume loss than glazed zirconia and enamel. These results show that the wear of the glazing glass is comparable to other commercial glazing materials. Glazing materials are both more susceptible to wear the antagonist relative to zirconia.

A New Fast and Simple Border Molding Process for Complete Dentures Using a Compound Stick Gun.

This article describes the use of a newly invented compound stick gun to take impressions for complete denture. The border molding process involves loading the modeling compound in an electric heating device and applying an even thickness of compound on the flange of a custom tray at a proper temperature without hot water tempering. This method provides a quicker and easier border molding process alternative to conventional techniques.

Evaluation of marginal fit of 2 CAD-CAM anatomic contour zirconia crown systems and lithium disilicate glass-ceramic crown.

PURPOSE: This study was to evaluate the marginal fit of two CAD-CAM anatomic contour zirconia crown systems compared to lithium disilicate glass-ceramic crowns. MATERIALS AND METHODS: Shoulder and deep chamfer margin were formed on each acrylic resin tooth model of a maxillary first premolar. Two CAD-CAM systems (Prettau®Zirconia and ZENOSTAR®ZR translucent) and lithium disilicate glass ceramic (IPS e.max®press) crowns were made (n=16). Each crown was bonded to stone dies with resin cement (Rely X Unicem). Marginal gap and absolute marginal discrepancy of crowns were measured using a light microscope equipped with a digital camera (Leica DFC295) magnified by a factor of 100. Two-way analysis of variance (ANOVA) and post-hoc Tukey's HSD test were conducted to analyze the significance of crown marginal fit regarding the finish line configuration and the fabrication system. RESULTS: The mean marginal gap of lithium disilicate glass ceramic crowns (IPS e.max®press) was significantly lower than that of the CAD-CAM anatomic contour zirconia crown system (Prettau®Zirconia) (P<.05). Both fabrication systems and finish line configurations significantly influenced the absolute marginal discrepancy (P<.05). CONCLUSION: The lithium disilicate glass ceramic crown (IPS e.max®press) had significantly smaller marginal gap than the CAD-CAM anatomic contour zirconia crown system (Prettau®Zirconia). In terms of absolute marginal discrepancy, the CAD-CAM anatomic contour zirconia crown system (ZENOSTAR®ZR translucent) had under-extended margin, whereas the CAD-CAM anatomic contour zirconia crown system (Prettau®Zirconia) and lithium disilicate glass ceramic crowns (IPS e.max®press) had overextended margins.

Sintering behavior and mechanical properties of zirconia compacts fabricated by uniaxial press forming.

PURPOSE: The purpose of this study was to compare the linear sintering behavior of presintered zirconia blocks of various densities. The mechanical properties of the resulting sintered zirconia blocks were then analyzed. MATERIALS AND METHODS: Three experimental groups of dental zirconia blocks, with a different presintering density each, were designed in the present study. Kavo Everest® ZS blanks (Kavo, Biberach, Germany) were used as a control group. The experimental group blocks were fabricated from commercial yttria-stabilized tetragonal zirconia powder (KZ-3YF (SD) Type A, KCM. Corporation, Nagoya, Japan). The biaxial flexural strengths, microhardnesses, and microstructures of the sintered blocks were then investigated. The linear sintering shrinkages of blocks were calculated and compared. RESULTS: Despite their different presintered densities, the sintered blocks of the control and experimental groups showed similar mechanical properties. However, the sintered block had different linear sintering shrinkage rate depending on the density of the presintered block. As the density of the presintered block increased, the linear sintering shrinkage decreased. In the experimental blocks, the three sectioned pieces of each block showed the different linear shrinkage depending on the area. The tops of the experimental blocks showed the lowest linear sintering shrinkage, whereas the bottoms of the experimental blocks showed the highest linear sintering shrinkage. CONCLUSION: Within the limitations of this study, the density difference of the presintered zirconia block did not affect the mechanical properties of the sintered zirconia block, but affected the linear sintering shrinkage of the zirconia block.