Estimation of stress distribution and risk of failure for maxillary premolar restored by occlusal veneer with different CAD/CAM materials and preparation designs.

OBJECTIVES: To compare stress distribution and failure probability in maxillary premolars restored by simple occlusal veneer (SOV) and buccal-occlusal veneer (BOV) with 3 different CAD/CAM materials. MATERIALS AND METHODS: A maxillary premolar was digitized by a micro-CT scanner. Three-dimensional dynamic scan data were transformed, and finite element models of 2 different models (SOV and BOV restored teeth) were designed. Three different CAD/CAM materials, including lithium disilicate glass ceramic (LD) IPS e.max CAD, polymer-infiltrated ceramic-network (PICN) Vita Enamic, and resin nano-ceramic (RNC) Lava Ultimate, were designated to both veneers. Maximum principle stresses were determined by applying a 300-N axial load to the occlusal surface. Weibull analyses were performed to calculate the failure probability of the models. RESULTS: LD-restored teeth showed the highest stress in the veneer, lowest stress in substrate teeth, and lowest failure probability for the overall system; RNC-restored teeth showed the lowest stress in the veneer, highest stress in substrate teeth, and highest failure probability. No significant differences were found in the cement layer among the different models. No significant differences of stress and failure probability existed between SOV and BOV preparations. CONCLUSIONS: CAD/CAM composite resin occlusal veneers bear lower maximum stress than ceramic veneers. Teeth restored by composite veneers are more prone to failure than those restored by ceramic veneers. Additional reduction of the buccal surface did not increase the stress on the occlusal veneer under axial load. CLINICAL RELEVANCE: Both occlusal veneers could be used under physiological masticatory force. CAD/CAM glass ceramic was safer than composite resins.

Effects of acid etching and adhesive treatments on host-derived cysteine cathepsin activity in dentin.

PURPOSE: To analyze the effects of different processes during bonding on endogenous cysteine cathepsin activity in dentin. MATERIALS AND METHODS: Dentin powder, prepared from extracted human third molars, was divided into 10 groups. Two lots of dentin powder were used to detect the effects of the procedure of protein extraction on endogenous cathepsin activity. The others were used to study effects of different acid-etching or adhesive treatments on enzyme activity. Concentrations of 37% phosphoric acid or 10% phosphoric acid, two etch-and-rinse adhesive systems, and two self-etching adhesive systems were used as dentin powder treatments. The untreated mineralized dentin powder was set as the control. After treatment, the proteins of each group were extracted. The total cathepsin activity in the extracts of each group was monitored with a fluorescence reader. RESULTS: In the control group, there were no significant differences in cathepsin activity between the protein extract before EDTA treatment and the protein extract after EDTA treatment (p > 0.05). The cathepsin activities of the three different extracts in the 37% phosphoric acid-treated group were different from each other (p < 0.05). The two acid-etching groups and two etch-and-rinse groups showed significant enzyme activity reduction vs the control group (p < 0.05). There were no significant differences between those four groups (p > 0.05). Treating the dentin powder with any of the two self-etching adhesives resulted in an increase in cathepsin activity (p < 0.05). CONCLUSIONS: The activity of cysteine cathepsins can be detected in dentin powder. Treatment with EDTA during protein extraction exerted an influence on cathepsin activity. Acid etching or etch-and-rinse adhesive systems may reduce the activity of endogenous cathepsins in dentin. Self-etching adhesive systems may increase the enzyme activity.

All-in-one porous membrane enables full protection in guided bone regeneration.

The sophisticated hierarchical structure that precisely combines contradictory mechanical and biological characteristics is ideal for biomaterials, but it is challenging to achieve. Herein, we engineer a spatiotemporally hierarchical guided bone regeneration (GBR) membrane by rational bilayer integration of densely porous N-halamine functionalized bacterial cellulose nanonetwork facing the gingiva and loosely porous chitosan-hydroxyapatite composite micronetwork facing the alveolar bone. Our GBR membrane asymmetrically combine stiffness and flexibility, ingrowth barrier and ingrowth guiding, as well as anti-bacteria and cell-activation. The dense layer has a mechanically matched space maintenance capacity toward gingiva, continuously blocks fibroblasts, and prevents bacterial invasion with multiple mechanisms including release-killing, contact-killing, anti-adhesion, and nanopore-blocking; the loose layer is ultra-soft to conformally cover bone surfaces and defect cavity edges, enables ingrowth of osteogenesis-associated cells, and creates a favorable osteogenic microenvironment. As a result, our all-in-one porous membrane possesses full protective abilities in GBR.

Near-Infrared Responsive Biomimetic Titanate/TiO2-X Heterostructure: A Therapeutic Strategy for Combating Implant-Associated Infection and Enhancing Osseointegration.

Implant-associated infections and delayed osseointegration are major challenges for the clinical success of titanium implants. To enhance antibacterial effects and promote early osseointegration, we developed a synergistic photothermal (PTT)/photodynamic (PDT) therapy strategy based on near-infrared (NIR) responsive biomimetic micro/nano titanate/TiO2-X heterostructure coatings (KMNW and NaMNS) in situ constructed on the surface of titanium implants. Specifically, KMNW and NaMNS significantly enhanced photothermal conversion capabilities, achieving localized high temperatures of 48-51 °C and promoting substantial amounts of reactive oxygen species production under 808 nm irradiation. In vitro antibacterial experiments demonstrated that KMNW achieved the highest antibacterial rates against Staphylococcus aureus and Escherichia coli, at 98.78 and 98.33% respectively. Moreover, by mimicking the three-dimensional fibrous network of the extracellular matrix during bone healing, both KMNW and NaMNS markedly promoted the proliferation and osteogenic differentiation of osteoblasts. In vivo implantation studies further confirmed these findings, with KMNW and NaMNS exhibiting superior antibacterial performance under NIR irradiation─94.45% for KMNW and 92.66% for NaMNS. Moreover, KMNW and NaMNS also significantly promoted new bone formation and improved osseointegration in vivo. This study presents a promising PTT/PDT therapeutic strategy for dentistry and orthopedics by employing NIR-responsive biomimetic coatings to combat implant-associated infection and accelerate osseointegration.

Mussel byssus-inspired dual-functionalization of zirconia dental implants for improved bone integration.

Zirconia faces challenges in dental implant applications due to its inherent biological inertness, which compromises osseointegration, a critical factor for the long-term success of implants that rely heavily on specific cell adhesion and enhanced osteogenic activity. Here, we fabricated a dual-functional coating that incorporates strontium ions, aimed at enhancing osteogenic activity, along with an integrin-targeting sequence to improve cell adhesion by mussel byssus-inspired surface chemistry. The results indicated that although the integrin-targeting sequence at the interface solely enhances osteoblast adhesion without directly increasing osteogenic activity, its synergistic interaction with the continuously released strontium ions from the coating, as compared to the release of strontium ions alone, significantly enhances the overall osteogenic effect. More importantly, compared to traditional polydopamine surface chemistry, the coating surface is enriched with amino groups capable of undergoing various chemical reactions and exhibits enhanced stability and aesthetic appeal. Therefore, the synergistic interplay between strontium and the functionally customizable surface offers considerable potential to improve the success of zirconia implantation.

A new method for fabricating orbital prosthesis with a CAD/CAM negative mold.

The challenge of fabricating an orbital prosthesis is how to position the iris and pupil properly. Computer simulation can be a more effective and simpler approach to measuring and evaluating these features than the conventional method. However, transferring the optimal position of the iris determined in the virtual design procedure to the real definitive prosthesis can be difficult. The purpose of this article is to demonstrate a method of fabricating an orbital prosthesis with a negative mold designed and produced by a computer-aided design and computer-aided manufacturing technique. With this method, the iris can be designed in the most favorable position, and this position can be transferred to the silicone prosthesis correctly.

Causal effects of gut microbiota on the risk of periodontitis: a two-sample Mendelian randomization study.

Introduction: The oral cavity and the gut tract are interconnected, and both contain abundant natural microbiota. Gut microbiota may interact with oral flora and participate in the development of periodontitis. However, the specific role of certain gut microbiota taxa for periodontitis has not been investigated. Mendelian Randomization is an ideal method to explore causal relationships avoiding reverse causality and potential confounding factors. Thus, we conducted a two-sample Mendelian Randomization study to comprehensively reveal the potential genetic causal effect of gut microbiota on periodontitis. Methods: SNPs strongly associated with 196 gut microbiota taxa (18,340 individuals) were selected as instrument variables, and periodontitis (17,353 periodontitis cases and 28,210 controls) was used as the outcome. The causal effect was analyzed via random effect inverse variance-weighted, weighted median, and MR-Egger. The sensitivity analyses were conducted using Cochran's Q tests, funnel plots, leave-one-out analyses, and MR-Egger intercept tests. Results: Nine gut microbiota taxa (Prevotella 7, Lachnospiraceae UCG-008, Enterobacteriales, Pasteurellales, Enterobacteriaceae, Pasteurellaceae, Bacteroidales S24.7 group, Alistipes, and Eisenbergiella) are predicted to play a causal role in enhancing the risk of periodontitis (p< 0.05). Besides, two gut microbiota taxa (Butyricicoccus and Ruminiclostridium 6) have potentially inhibitive causal effects on the risk of periodontitis (p< 0.05). No significant estimation of heterogeneity or pleiotropy is detected. Conclusion: Our study demonstrates the genetic causal effect of 196 gut microbiota taxa on periodontitis and provides guidance for the clinical intervention of periodontitis.

Long-lasting renewable antibacterial porous polymeric coatings enable titanium biomaterials to prevent and treat peri-implant infection.

Peri-implant infection is one of the biggest threats to the success of dental implant. Existing coatings on titanium surfaces exhibit rapid decrease in antibacterial efficacy, which is difficult to promisingly prevent peri-implant infection. Herein, we report an N-halamine polymeric coating on titanium surface that simultaneously has long-lasting renewable antibacterial efficacy with good stability and biocompatibility. Our coating is powerfully biocidal against both main pathogenic bacteria of peri-implant infection and complex bacteria from peri-implantitis patients. More importantly, its antibacterial efficacy can persist for a long term (e.g., 12~16 weeks) in vitro, in animal model, and even in human oral cavity, which generally covers the whole formation process of osseointegrated interface. Furthermore, after consumption, it can regain its antibacterial ability by facile rechlorination, highlighting a valuable concept of renewable antibacterial coating in dental implant. These findings indicate an appealing application prospect for prevention and treatment of peri-implant infection.

Preparation of Zirconium Hydrogen Phosphate Coatings on Sandblasted/Acid-Etched Titanium for Enhancing Its Osteoinductivity and Friction/Corrosion Resistance.

BACKGROUND: Sandblasted/acid-etched titanium (SLA-Ti) implants are widely used for dental implant restoration in edentulous patients. However, the poor osteoinductivity and the large amount of Ti particles/ions released due to friction or corrosion will affect its long-term success rate. PURPOSE: Various zirconium hydrogen phosphate (ZrP) coatings were prepared on SLA-Ti surface to enhance its friction/corrosion resistance and osteoinduction. METHODS: The mixture of ZrCl4 and H3PO4 was first coated on SLA-Ti and then calcined at 450°C for 5 min to form ZrP coatings. In addition to a series of physiochemical characterization such as morphology, roughness, wettability, and chemical composition, their capability of anti-friction and anti-corrosion were further evaluated by friction-wear test and by potential scanning. The viability and osteogenic differentiation of MC3T3-E1 cells on different substrates were investigated via MTT, mineralization and PCR assays. RESULTS: The characterization results showed that there were no significant changes in the morphology, roughness and wettability of ZrP-modified samples (SLA-ZrP0.5 and SLA-ZrP0.7) compared with SLA group. The results of electrochemical corrosion displayed that both SLA-ZrP0.5 and SLA-ZrP0.7 (especially the latter) had better corrosion resistance than SLA in normal saline and serum-containing medium. SLA-ZrP0.7 also exhibited the best friction resistance and great potential to enhance the spreading, proliferation and osteogenic differentiation of MC3T3-E1 cells. CONCLUSION: We determined that SLA-ZrP0.7 had excellent comprehensive properties including anti-corrosion, anti-friction and osteoinduction, which made it have a promising clinical application in dental implant restoration.

Multifunctional TaCu-nanotubes coated titanium for enhanced bacteriostatic, angiogenic and osteogenic properties.

In this study, multifunctional tantalum copper composite nanotubes (TaCu-NTs) were coated on titanium for enhanced bacteriostatic, angiogenic and osteogenic properties. Three coatings of Ta, TaCu1 (Ta: Cu = 4:1 at.%), and TaCu2 (Ta: Cu = 1:1 at.%) were deposited on titanium by magnetron sputtering. The bare titanium and the three coatings were subsequently anodized into four kinds of nanotubes (NT) of TNT, Ta-NT, TaCu1-NT, and TaCu2-NT, respectively. The released copper ions measured by inductively coupled plasma atomic emission spectroscopy (ICP/AES) presented that TaCu2-NT coating released the highest amount of copper ions, which led to the best bacteriostasis against Escherichia coli and Staphylococcus aureus. Potentiodynamic polarization tests clarified that Ta-NT showed the highest corrosion resistance, followed by TaCu1-NT and TaCu2-NT. TaCu2-NT showed not only the best angiogenic property in terms of cell migration, tube formation, and real-time quantitative polymerase chain reaction (RT-qPCR) of human umbilical vein endothelial cells (HUVECs), but also the best osteogenic property in terms of cell viability, alkaline phosphatase activity, and mineralization of MC3T3-E1 cells. Therefore, TaCu2-NT coating has a greater potential than the other coatings of TNT, Ta-NT and TaCu1-NT in promoting bacteriostasis, angiogenesis and osteointegration for titanium implants.

A novel experimental design model for increasing occlusal vertical dimension.

UNLABELLED: This study aimed to establish a rat model of increasing occlusal vertical dimension (iOVD) using a prosthodontic approach. The OVD was increased by bonding a maxillary, bilateral, posterior dental splint with a bearing ball while the occlusal stops that were made on the stone casts adjusted the occlusion and bonded in the mouths of adult Wistar rats (iOVD group); the controls did not receive a splint. Both groups were subdivided after splint insertion: 3 days and 1, 2, 3, or 4 weeks (n = 6/subgroup). The effects of iOVD were evaluated by radiographs, body weight, and histologic diagnosis of tooth and temporomandibular joints. There were no differences in body weights between the 2 groups; occlusal asymmetric dentition abrasions did not occur in the iOVD rats. The occlusal splints caused the remodeling of the periodontal tissue and condylar cartilage. Overall, an iOVD rat model can be constructed using prosthodontic techniques ensuring a balance of bilateral occlusal height. ABBREVIATIONS: OVD, occlusal vertical dimension; iOVD, increasing occlusal vertical dimension; TMJ, temporomandibular joint; TMD, temporomandibular disorders.

Effect of preparation design on the fracture behavior of ceramic occlusal veneers in maxillary premolars.

OBJECTIVES: The fracture strengths of four types of occlusal veneers and a traditional full crown ceramic restoration and the influence of preparation design on the stress of restorations were examined. METHODS: Forty intact maxillary premolars randomly divided into five groups were prepared based on the demands of type O (occlusal surface coverage), OF (occlusal and lingual surface coverage), POF (occlusal, lingual, and mesial surface coverage), and POFP (occlusal, lingual, mesial, and distal surface coverage) veneers and full crown, and then restored by glass ceramic. Specimens were subjected to fracture resistance tests after cyclic loading. The fracture strengths and modes were analyzed statistically. The level of significance was set at α = 0.05. One maxillary premolar was prepared for type O, OF, POF, POFP veneer and full crown, and then scanned to establish finite element models. The mean fracture load was applied vertically to calculate the maximum principal stress on the ceramic. RESULTS: Type O veneer showed higher fracture strength than type POF and POFP veneers (P < 0.05). Both type O and OF veneers exhibited higher fracture strength than full crown (P < 0.05). No significant difference in failure mode was observed. The maximum principal stress for type O, OF, POF, POFP veneers, and full crown increased progressively and concentrated at the bonding surface directly beneath the loading area. CONCLUSIONS: Four types of occlusal veneer showed fracture strengths that considerably exceeded normal biting forces. They represent conservative alternatives to full crowns and present a viable treatment for severely worn teeth. CLINICAL SIGNIFICANCE: The occlusal veneers with different preparation designs, including type O, OF, POF and POFP veneers, show higher fracture resistances than traditional full coverage crowns that considerably exceed the normal biting forces. Therefore, these represent conservative alternatives to crown restorations and present a viable treatment for restoring severely worn teeth.

Effects of Baicalein on the Expression of Collagenolytic Enzymes in Human Dental Pulp Cells and Durability of Resin-Dentin Bonding.

PURPOSE: In order to provide an experimental basis for the use of baicalein (BAI) as an enzyme inhibitor to improve resin-dentin bonding durability, this study explored the effect of BAI on the expression of matrix metalloproteinases (MMPs) and cathepsins in human dental pulp cells (HDPCs). MATERIALS AND METHODS: The effects of various concentrations of BAI on the viability and cell cycle arrest of HDPCs were investigated in vitro. qPCR and Western blot analysis were performed to determine the effects of BAI on the expression of MMP-2, MMP-9, cathepsin-B, and cathepsin-K in HDPCs. Thermocycling (aging) was performed to determine the effect of BAI on the microtensile bond strength of aged resin-dentin bonding. RESULTS: Our results showed that BAI at concentrations below 25 µmol/l did not affect cell viability in HDPCs. Moreover, low concentrations of BAI effectively inhibited the expression of MMP-2, MMP-9, cathepsin-B, and cathepsin-K in HDPCs and improved the strength of aged resin-dentin bonding. CONCLUSION: BAI is a promising preconditioner for improving the durability of resin-dentin bonding by protecting against collagen degradation via the inhibition of MMPs and cathepsins.

pH-responsive poly (acrylic acid)-gated mesoporous silica and its application in oral colon targeted drug delivery for doxorubicin.

Oral chemotherapy is the preferred route for cancer treatment because it can improve the efficacy and decrease the side effects. Unfortunately, most anticancer drugs suffered from their poor oral bioavailability. Herein, we construct a novel pH-triggered oral drug delivery system by capping of mesoporous silica SBA-15 with pH-responsive polymer poly (acrylic acid) (PAA) via a facile graft-onto strategy. The experiment results demonstrated that the PAA brushes were anchored on the pore outlets of mesoporous silica SBA-15, which can be acted as the gatekeeper to control the drug molecules transport in and out of the pore channels. The PAA capped mesoporous SBA-15 (PAA/SBA-15) exhibited a high drug loading capacity (785.7mg/g), excellent pH-sensitivity and good biocompatibility. In gastric environment (pH=2.0), the drug doxorubicin (DOX) molecules were encapsulated in the pore channels because the pore outlets were capped with collapsed PAA. In contrast, in colonic environment (pH=7.6), it exhibited a fast release because of the removal of capping. In addition, the water solubility of DOX in colonic environment was enhanced after DOX being loaded into the pores of PAA/SBA-15. This pH-triggered oral drug delivery system has promising applications for treatment of colon cancer and other colon diseases.

[Effect of baicalein and quercetin on enzymatic resistance of dentin collagen].

OBJECTIVE: To investigate the effect of baicalein and quercetin on the enzymatic resistance of dentin matrix collagen. METHODS: Baicalein, quercetin and proanthocyanidin were dissolved in 20% dimethyl sulfoxide (DMSO) ethanol and prepared into pretreatment agents with a concentration of 50 g/L. Demineralized dentin specimens were prepared and immersed in pretreatment agents at 37 °C for 24 h, then they were digested in solution containing type?collagenase. The pretreatment agents of blank control group and negative control group were 20% DMSO ethanol, blank control group were digested in solution without collagenase. The ultimate tensile strength (UTS) and the hydroxyproline content of enzymolysis liquid in each group were measured respectively after collagenase digestion for 24 h, the dentin collagen morphology were observed under a field emission scanning electron microscopic (FE-SEM) after collagenase digestion for 12 h. RESULTS: After collagenase digestion for 24 h, the baicalein group had the highest UTS [(16.00±1.31) MPa], followed by proanthocyanidin group [(12.64±0.91) MPa], blank control group [(7.84±1.18) MPa], quercetin group [(3.20±1.07) MPa], and negative control group (0 MPa). Significant differences were detected among the UTS in each two group (P < 0.01). The hydroxyproline content in blank control group was the lowest [(0.40 ± 0.16) mg/L], followed by baicalein group[(2.95 ± 0.18) mg/L], proanthocyanidin group [(4.78±0.38) mg/L], quercetin group[(28.22±1.53) mg/L], and negative control group [(34.39±0.39) mg/L]. There were significant differences among the hydroxyproline contents in each group (P < 0.01). After collagenase digestion for 12 h, intact collagen network could be seen in blank control group under a FE-SEM. Collagen network in negative control group suffered nearly complete destruction and collapsed. In quercetin group, most of collagen collapsed. In proanthocyanidin group, a small portion of collagen destruction and collapse could be seen. In baicalein group, collagen network remained intact. CONCLUSIONS: The use of baicalein and quercetin could improve enzymatic resistance of dentin matrix collagen at a concentration of 50 g/L. The effect of baicalein was better than that of proanthocyanidin while the effect of quercetin was weaker than that of proanthocyanidin.

[Effect of different molarity cathepsins specific inhibitor E-64 on dentin-resin bonding durability].

OBJECTIVE: To investigate, in vitro, the effect of cathepsins specific inhibitor N-(trans-epoxysuccinyl)-L-leucine 4-guanidinobutylamide(E-64) on dental endogenous cathepsins and to find its most effective molarity to elevate dentin-resin bonding durability. METHODS: Fifty recently extracted human third molars were divided into five groups according to random number table, and treated with different molarity of E-64 as follow: 0, 2.5, 5.0, 10.0 and 20.0 µmol/L. The group 0 µmol/L was control group. Then 20 specimens of dentin-resin composite were fabricated in each group. Half of the specimens were tested after 24 h water storage(37 °C) and the other half were tested after 90 days water storage(37 °C) followed by 3000 cycles'thermocyling(5-55 °C) as aging treatment. Fractured specimens were analyzed using scanning electron microscopy(SEM). RESULTS: After 24 h water storage, no significant differences were found in micro-tensile bond strength(µTBS) of samples between different groups (P > 0.05). However, after ageing treatment, µTBS of the samples in group 2.5, 5.0, 10.0 and 20.0 µmol/L [(18.7 ± 2.7), (20.8 ± 3.4), (18.3 ± 2.8) and (19.1 ± 2.7) MPa] were significantly higher than that in group 0 µmol/L [(15.1 ± 3.0) MPa] (P < 0.05). Only in the group 5.0 µmol/L no significant difference was found between the original and the decreased value of µTBS(P > 0.05), while the µTBS in other groups decreased significantly after aging treatment(P < 0.05). Failure types were almost adhesive and mixed types. Collagens in hybrid layer were less degraded in the groups using E-64 after aging treatment than control group. CONCLUSIONS: E-64 was effective on inhibiting cathepsins activity in dentin, and induced less collagens degradation in smear layer for better dentin-resin bond durability.

Dark fermentative hydrogen production from neutralized acid hydrolysates of conifer pulp.

Concentrated acid hydrolysis of cellulosic material results in high dissolution yields. In this study, the neutralization step of concentrated acid hydrolysate of conifer pulp was optimized. Dry conifer pulp hydrolysis with 55 % H(2)SO(4) at 45 °C for 2 h resulted in total sugar yields of 22.3-26.2 g/L. The neutralization step was optimized for solid Ca(OH)(2), liquid Ca(OH)(2) or solid CaO, mixing time, and water supplementation. The highest hydrogen yield of 1.75 mol H(2)/mol glucose was obtained with liquid Ca(OH)(2), while the use of solid Ca(OH)(2) or CaO inhibited hydrogen fermentation. Liquid Ca(OH)(2) removed sulfate to below 30 mg SO(4) (2-)/L. Further optimization of the neutralization conditions resulted in the yield of 2.26 mol H(2)/mol glucose.