Biomaterials science and surface engineering strategies for dental peri-implantitis management.

Peri-implantitis is a bacterial infection that causes soft tissue inflammatory lesions and alveolar bone resorption, ultimately resulting in implant failure. Dental implants for clinical use barely have antibacterial properties, and bacterial colonization and biofilm formation on the dental implants are major causes of peri-implantitis. Treatment strategies such as mechanical debridement and antibiotic therapy have been used to remove dental plaque. However, it is particularly important to prevent the occurrence of peri-implantitis rather than treatment. Therefore, the current research spot has focused on improving the antibacterial properties of dental implants, such as the construction of specific micro-nano surface texture, the introduction of diverse functional coatings, or the application of materials with intrinsic antibacterial properties. The aforementioned antibacterial surfaces can be incorporated with bioactive molecules, metallic nanoparticles, or other functional components to further enhance the osteogenic properties and accelerate the healing process. In this review, we summarize the recent developments in biomaterial science and the modification strategies applied to dental implants to inhibit biofilm formation and facilitate bone-implant integration. Furthermore, we summarized the obstacles existing in the process of laboratory research to reach the clinic products, and propose corresponding directions for future developments and research perspectives, so that to provide insights into the rational design and construction of dental implants with the aim to balance antibacterial efficacy, biological safety, and osteogenic property.

[Fracture analyses of casting framework removable partial dentures].

OBJECTIVE: To compare the clinical fracture rates of removable partial denture (RPD) made of titanium with that of Co-Cr alloy, to analyze the fracture modes and reasons of two kinds of metal frameworks, and to explore the effect of defects on the fracture process. METHODS: Following totally 30 618 RPDs made by titanium and by Co-Cr alloy, the fracture rates in 18-month were calculated individually. The fractured surfaces of failed RPDs were examined by fractography investigations using a field emission scanning electron microscope to disclose the fracture mode and damage character. The energy-dispersive X-ray spectroscopy analysis was performed to examine the chemical compositions. RESULTS: The fracture rate of titanium framework was 1.75%, comparing with 0.57% of Co-Cr alloy framework. The reasons included teeth preparing, framework design, and defects during casting. The fracture modes of titanium and Co-Cr alloy framework performed toughness fracture character. The fissures were found in both titanium and Co-Cr alloy frameworks, and pores were detected in titanium frameworks. CONCLUSION: The higher fracture rate of titanium framework is related to the defects during casting.

Calcification capacity of porous pHEMA-TiO2 composite hydrogels.

Many investigations have been attempted to promote calcification of synthetic polymers for applications as orthopaedic and dental implants. In this study, novel titanium dioxide (TiO(2)) reinforced porous poly(2-hydroxyethyl methacrylate) (pHEMA) hydrogels were synthesized. Calcification capacity of the composite polymers was examined using light microscopy, scanning electron microscopy and Fourier transform infrared spectroscopy after incubation of the materials in a simulated body fluid up to 53 days. Mechanical strength, porosity and in vitro cytotoxicity were also investigated. Calcification capacity of porous pHEMA was significantly enhanced by the addition of TiO(2) particulates. Infiltration of calcium phosphate, up to 1000 mum, was observed. The diffusion capacity of calcium ions was affected by the porosity and the interconnectivity of pores in the hydrogel polymers which were influenced by the presence of TiO(2) and the monomer concentration. Cell viability tests indicated that porous hydrogels containing 7.5% TiO(2) were not toxic to 3T3 fibroblast cells. These results demonstrate that incorporating TiO(2) nanoparticulates can promote enhanced formation of calcium phosphate whilst maintaining the porosity and interconnectivity of the hydrogel polymers and would be very useful for the development of orthopaedic tissue engineering scaffolds.

Corrosion resistance and antibacterial activity of zinc-loaded montmorillonite coatings on biodegradable magnesium alloy AZ31.

A Zinc-loaded montmorillonite (Zn-MMT) coating was hydrothermally prepared using Zn2+ ion intercalated sodium montmorillonite (Na-MMT) upon magnesium (Mg) alloy AZ31 as bone repairing materials. Biodegradation rate of the Mg-based materials was studied via potentiodynamic polarization curves, electrochemical impedance spectroscopy (EIS) and hydrogen evolution tests. Results revealed that both Na-MMT and Zn-MMT coatings exhibited better corrosion resistance in Dulbecco's modified eagle medium (DMEM) + 10% calf serum (CS) than bare Mg alloy AZ31 counterparts. Hemolysis results demonstrated that hemocompatibility of the Na-MMT and Zn-MMT coatings were 5%, and lower than that of uncoated Mg alloy AZ31 pieces. In vitro MTT tests and live-dead stain of osteoblast cells (MC3T3-E1) indicated a significant improvement in cytocompatibility of both Na-MMT and Zn-MMT coatings. Antibacterial properties of two representative bacterial strains associated with device-related infection, i.e. Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus), were employed to explore the antibacterial behavior of the coatings. The measured inhibitory zone and bacterial growth rate confirmed that Zn-MMT coatings exhibited higher suppression toward both E. coli and S. aureus than that of Na-MMT coatings. The investigation on antibacterial mechanism through scanning electron microscopy (SEM) and lactate dehydrogenase (LDH) release assay manifested that Zn-MMT coating led to severe breakage of bacterial membrane of E. coli and S. aureus, which resulted in a release of cytoplasmic materials from the bacterial cells. In addition, the good inhibition of Zn-MMT coatings against E. coli and S. aureus might be attributed to the slow but sustainable release of Zn2+ ions (up to 144 h) from the coatings into the culture media. This study provides a novel coating strategy for manufacturing biodegradable Mg alloys with good corrosion resistance, biocompatibility and antibacterial activity for future orthopedic applications. STATEMENT OF SIGNIFICANCE: The significance of the current work is to develop a corrosion-resistant and antibacterial Zn-MMT coating on magnesium alloy AZ31 through a hydrothermal method. The Zn-MMT coating on magnesium alloy AZ31 shows better corrosion resistance, biocompatibility and excellent antibacterial ability than magnesium alloy AZ31. This study provides a novel coating on Mg alloys for future orthopedic applications.

Phase transformation analysis of varied nickel-titanium orthodontic wires.

BACKGROUND: The shape memory effect of nickel-titanium (NiTi) archwires is largely determined by the phase transition temperature. It is associated with a reversible transformation from martensite to austenite. The aim of this study was to characterize austenite, martensite and R phase temperatures as well as transition temperature ranges of the commonly used clinical NiTi orthodontic arch wires selected from several manufacturers. METHODS: Differential scanning calorimetry (DSC) method was used to study the phase transformation temperatures and the phase transition processes of 9 commonly used clinical NiTi alloys (types: 0.40 mm (0.016 inch), 0.40 mm x 0.56 mm (0.016 inch x 0.022 inch)). RESULTS: The austenite finish temperatures (Af) of 0.40 mm Smart, Ormco and 3M NiTi wires were lower than the room temperature, and no phase transformation was detected during oral temperature. Therefore, we predicted that these types of NiTi did not possess shape memory property. For 0.40 mm and 0.40 mm x 0.56 mm Youyan I NiTi wires, no phase transformation was detected during the scanning temperature range, suggesting that these two types of wires did not possess shape memory either. The Af of 0.40 mm x 0.56 mm Smart, L&H, Youyan II Ni-Ti wires were close to the oral temperature and presented as martensitic-austenitic structures at room temperature, suggesting the NiTi wires listed above have good shape memory effect. Although the 0.40 mm x 0.56 mm Damon CuNiTi wire showed martensitic-austenitic structures at oral temperature, its Af was much higher than the oral temperature. It means that transformation from martensite to austenite for this type of NiTi only finishes when oral temperature is above normal. CONCLUSION: The phase transformation temperatures and transformation behavior varied among different commonly used NiTi orthodontic arch wires, leading to variability in shape memory effect.

Design, synthesis and characterization of poly (methacrylic acid-niclosamide) and its effect on arterial function.

We have found that niclosamide induced relaxation of constricted artery. However, niclosamide is insoluble, the low bioavailability and the resultant low plasma concentration limit its potential exertion in vivo. The aim of the present study is to synthesize a soluble poly (methacrylic acid-niclosamide) polymer (PMAN) and study the effects of PMAN on arterial function in vitro and the blood pressure and heart rate of rats in vivo. We synthesized the poly (methacrylic acid-niclosamide) polymer (PMAN), the chemical structure of which was identified by FTIR and 1H NMR spectra. The average molecular weight and polydispersity index of PMAN were 5138 and 1.193 respectively. Compared with niclosamide, the water solubility of niclosamide in PMAN was significantly increased. PMAN showed dose-dependent vasorelaxation effect on rat mesenteric arteries with intact or denuded endothelium in phenylephrine (PE) and high K+ (KPSS)-induced vasoconstriction models in vitro. The efficacy of vasorelaxant effect and the cytotoxic effect of PMAN on vascular smooth muscle cells (A10) were lower than that of niclosamide. The LD50 of PMAN in mice (iv) was 80mg/kg. Venous injection of PMAN (equivalent 5mg niclosamide per kg) showed acute reduction of the rat blood pressure and heart rate in vivo. In conclusion, the solubility of niclosamide was increased in the way of poly (methacrylic acid-niclosamide) polymer, which relaxes the constricted arteries in vitro and reduces the rat blood pressure and heart rate in vivo, indicating that modifying niclosamide solubility through polymerization is a feasible approach to improve its pharmacokinetic profiles for potential clinic application.

In Vitro Corrosion and Cytocompatibility of a Microarc Oxidation Coating and Poly(L-lactic acid) Composite Coating on Mg-1Li-1Ca Alloy for Orthopedic Implants.

Manipulating the degradation rate of biomedical magnesium alloys poses a challenge. The characteristics of a microarc oxidation (MAO), prepared in phytic acid, and poly(L-lactic acid) (PLLA) composite coating, fabricated on a novel Mg-1Li-1Ca alloy, were studied through field emission scanning electron microscopy (FE-SEM), electron probe X-ray microanalysis (EPMA), energy dispersive X-ray spectroscopy (EDS) and X-ray diffraction (XRD). The corrosion behaviors of the samples were evaluated via hydrogen evolution, potentiodynamic polarization and electrochemical impedance spectroscopy in Hanks' solution. The results indicated that the MAO/PLLA composite coatings significantly enhanced the corrosion resistance of the Mg-1Li-1Ca alloy. MTT and ALP assays using MC3T3 osteoblasts indicated that the MAO/PLLA coatings greatly improved the cytocompatibility, and the morphology of the cells cultured on different samples exhibited good adhesion. Hemolysis tests showed that the composite coatings endowed the Mg-1Li-1Ca alloys with a low hemolysis ratio. The increased solution pH resulting from the corrosion of magnesium could be tailored by the degradation of PLLA. The degradation mechanism of the composite coatings was discussed. The MAO/PLLA composite coating may be appropriate for applications on degradable Mg-based orthopedic implants.

Azo polymeric micelles designed for colon-targeted dimethyl fumarate delivery for colon cancer therapy.

UNLABELLED: Colon-targeted drug delivery and circumventing drug resistance are extremely important for colon cancer chemotherapy. Our previous work found that dimethyl fumarate (DMF), the approved drug by the FDA for the treatment of multiple sclerosis, exhibited anti-tumor activity on colon cancer cells. Based on the pharmacological properties of DMF and azo bond in olsalazine chemical structure, we designed azo polymeric micelles for colon-targeted dimethyl fumarate delivery for colon cancer therapy. We synthesized the star-shape amphiphilic polymer with azo bond and fabricated the DMF-loaded azo polymeric micelles. The four-arm polymer star-PCL-azo-mPEG (sPCEG-azo) (constituted by star-shape PCL (polycaprolactone) and mPEG (methoxypolyethylene glycols)-olsalazine) showed self-assembly ability. The average diameter and polydispersity index of the DMF-loaded sPCEG-azo polymeric micelles were 153.6nm and 0.195, respectively. In vitro drug release study showed that the cumulative release of DMF from the DMF-loaded sPCEG-azo polymeric micelles was no more than 20% in rat gastric fluid within 10h, whereas in the rat colonic fluids, the cumulative release of DMF reached 60% in the initial 2h and 100% within 10h, indicating that the DMF-loaded sPCEG-azo polymeric micelles had excellent colon-targeted property. The DMF-loaded sPCEG-azo polymeric micelles had no significant cytotoxicity on colon cancer cells in phosphate buffered solution (PBS) and rat gastric fluid. In rat colonic fluid, the micelles showed significant cytotoxic effect on colon cancer cells. The blank sPCEG-azo polymeric micelles (without DMF) showed no cytotoxic effect on colon cancer cells in rat colonic fluids. In conclusion, the DMF-loaded sPCEG-azo polymeric micelles show colon-targeted DMF release and anti-tumor activity, providing a novel approach potential for colon cancer therapy. STATEMENT OF SIGNIFICANCE: Colon-targeted drug delivery and circumventing drug resistance are extremely important for colon cancer chemotherapy. Our previous work found that dimethyl fumarate (DMF), the approved drug by the FDA for the treatment of multiple sclerosis, exhibited anti-tumor activities on colon cancer cells (Br J Pharmacol. 2015 172(15):3929-43.). Based on the pharmacological properties of DMF and azo bond in olsalazine chemical structure, we designed azo polymeric micelles for colon-targeted dimethyl fumarate delivery for colon cancer therapy. We found that the DMF-loaded sPCEG-azo polymeric micelles showed colon-targeted DMF release and anti-tumor activities, providing a novel approach potential for colon cancer therapy.

In vitro cytotoxicity of calcium silicate-containing endodontic sealers.

INTRODUCTION: The cytotoxicity of 2 novel calcium silicate-containing endodontic sealers to human gingival fibroblasts was studied. METHODS: EndoSequence BC (Brasseler, Savannah, GA), MTA Fillapex (Angelus Indústria de Produtos Odontológicos S/A, Londrina, PR, Brazil) and a control sealer (AH Plus; Dentsply DeTrey GmbH, Konstanz, Germany) were evaluated. Human gingival fibroblasts were incubated for 3 days both with the extracts from fresh and set materials in culture medium and cultured on the surface of the set materials in Dulbecco-modified Eagle medium. Fibroblasts cultured in Dulbecco-modified Eagle medium were used as a control group. Cytotoxicity was evaluated by flow cytometry, and the adhesion of the fibroblasts to the surface of the set materials was assessed using scanning electron microscopy. The data of cell cytotoxicity were analyzed statistically using a 1-way analysis of variance test at a significance level of P < .05. RESULTS: Cells incubated with extracts from BC Sealer showed higher viabilities at all extract concentrations than cells incubated with extracts from freshly mixed AH Plus and fresh and set MTA Fillapex, esspecially for the high extract concentrations (1:2 and 1:8 dilutions). Extracts from set MTA Fillapex of 2 weeks and older were more cytotoxic than extracts from freshly mixed and 1-week-old cement. With extract concentrations of 1:32 and lower, MTA Fillapex was no longer cytotoxic. After setting, AH Plus was no longer cytotoxic, and the fibroblast cells grew on set AH Plus equally as well as on BC Sealer. CONCLUSIONS: BC Sealer and MTA Fillapex, the 2 calcium silicate-containing endodontic sealers, exhibited different cytotoxicity to human gingival fibroblasts.

ProFile Vortex and Vortex Blue Nickel-Titanium Rotary Instruments after Clinical Use.

INTRODUCTION: The aim of this study was to analyze the incidence and mode of ProFile Vortex and Vortex Blue instrument defects after clinical use in a graduate endodontic program and to examine the impact of clinical use on the instruments' metallurgical properties. METHODS: A total of 330 ProFile Vortex and 1136 Vortex Blue instruments from the graduate program were collected after each had been used in 3 teeth. The incidence and type of instrument defects were analyzed. The lateral surfaces and fracture surfaces of the fractured files were examined by using scanning electron microscopy. Unused and used instruments were examined by full and partial differential scanning calorimetry. RESULTS: No fractures were observed in the 330 ProFile Vortex instruments, whereas 20 (6.1%) revealed bent or blunt defects. Only 2 of the 1136 Vortex Blue files fractured during clinical use. The cause of fracture was shear stress. The fractures occurred at the tip end of the spirals. Only 1.8% (21 of 1136) of the Vortex Blue files had blunt tips. Austenite-finish temperatures were very similar for unused and used ProFile Vortex files and were all greater than 50°C. The austenite-finish temperatures of used and unused Vortex Blue files (38.5°C) were lower than those in ProFile Vortex instruments (P < .001). However, the transformation behavior of Vortex Blue files had an obvious 2-stage transformation, martensite-to-R phase and R-to-austenite phase. The trends of differential scanning calorimetry plots of unused Vortex Blue instruments and clinically used instruments were very similar. CONCLUSIONS: The risk of ProFile Vortex and Vortex Blue instrument fracture is very low when instruments are discarded after clinical use in the graduate endodontic program. The Vortex Blue files have metallurgical behavior different from ProFile Vortex instruments.

Current challenges and concepts of the thermomechanical treatment of nickel-titanium instruments.

INTRODUCTION: The performance and mechanical properties of nickel-titanium (NiTi) instruments are influenced by factors such as cross-section, flute design, raw material, and manufacturing processes. Many improvements have been proposed by manufacturers during the past decade to provide clinicians with safer and more efficient instruments. METHODS: The mechanical performance of NiTi alloys is sensitive to their microstructure and associated thermomechanical treatment history. Heat treatment or thermal processing is one of the most fundamental approaches toward adjusting the transition temperature in NiTi alloy, which affects the fatigue resistance of NiTi endodontic files. The newly developed NiTi instruments made from controlled memory wire, M-Wire (Dentsply Tulsa Dental Specialties, Tulsa, OK), or R-phase wire represent the next generation of NiTi alloys with improved flexibility and fatigue resistance. The advantages of NiTi files for canal cleaning and shaping are decreased canal transportation and ledging, a reduced risk of file fracture, and faster and more efficient instrumentation. The clinician must understand the nature of different NiTi raw materials and their impact on instrument performance because many new instruments are introduced on a regular basis. RESULTS: This review summarizes the metallurgical properties of next-generation NiTi instruments, the impact of thermomechanical treatment on instrument flexibility, and the resistance to cyclic fatigue and torsion. CONCLUSIONS: The aim of this review was to provide clinicians with the knowledge necessary for evidence-based practices, maximizing the benefits from the selection and application of NiTi rotary instruments for root canal treatment.

Phase transformation behavior and mechanical properties of thermomechanically treated K3XF nickel-titanium instruments.

INTRODUCTION: The bending and torsional properties of thermomechanically treated K3XF (SybronEndo, Orange, CA) nickel-titanium instruments in relation to their phase transformation behavior were evaluated. METHODS: NiTi instruments K3 (SybronEndo) and K3XF, both in sizes 25/.04 and 40/.04, were examined by differential scanning calorimetry and X-ray diffraction. The metal composition was determined by scanning electron microscopy with X-ray energy-dispersive spectrometric analyses. The bending property of K3 and K3XF instruments was measured in a cantilever-bending test with a maximum deflection of 4.00 mm. A torsional test of the instruments was evaluated according to the American National Standards Institute/American Dental Association Specification No. 28. RESULTS: K3 and K3XF instruments had approximately the same chemical composition with a nickel content of 48-49 atomic %. The differential scanning calorimetry analyses showed that each segment of the K3XF instruments (24.89°C ± 1.98°C) had a higher austenite finish temperature than the K3 instruments (17.63°C ± 1.76°C) (P < .05). The bending load values were significantly lower for K3XF than for K3 in the superelastic ranges (P < .05). There was no statistically significant difference between K3 and K3XF in the maximum torque or maximum angular deflection before failure. The torque at fracture values of K3 and K3XF increased significantly with the diameter (P < .05). CONCLUSIONS: K3XF exhibited different phase transformation behavior and flexibility when compared with K3, which may be attributed to the special heat treatment history of K3XF instruments.

Physical properties of 5 root canal sealers.

INTRODUCTION: The aim of this study was to evaluate the pH change, viscosity and other physical properties of 2 novel root canal sealers (MTA Fillapex and Endosequence BC) in comparison with 2 epoxy resin-based sealers (AH Plus and ThermaSeal), a silicone-based sealer (GuttaFlow), and a zinc oxide-eugenol-based sealer (Pulp Canal Sealer). METHODS: ISO 6876/2001 specifications were followed. The pH change of freshly mixed and set sealers was evaluated during periods of 1 day and 5 weeks, respectively. The viscosity was investigated at different injection rates (72, 10, and 5 mm/min) at room temperature by using a syringe-based system that was based on the Instron 3360 series universal testing system. RESULTS: The flow, dimensional change, solubility, and film thickness of all the tested sealers were in agreement with ISO 6876/2001 recommendations. The MTA Fillapex sealer exhibited a higher flow than the Endosequence BC sealer (P < .05). The MTA Fillapex and Endosequence BC sealers showed the highest film thicknesses among the tested samples. The Endosequence BC sealer exhibited the highest value of solubility, which was in accordance with 3% mass fraction recommended by the ISO 6876/2001, and showed an acceptable dimensional change. The MTA Fillapex and Endosequence BC sealers presented an alkaline pH at all times. The pH of fresh samples of the AH Plus and ThermaSeal sealers was alkaline at first but decreased significantly after 24 hours. The viscosity of the tested sealers increased with the decreased injection rates. CONCLUSIONS: The tested sealers were pseudoplastic according to their viscosities as determined in this study. The MTA Fillapex and Endosequence BC sealers each possessed comparable flow and dimensional stability but higher film thickness and solubility than the other sealers tested.

In vitro cytotoxicity evaluation of a novel root repair material.

INTRODUCTION: This study examined the effect of a new bioactive dentin substitute material (Biodentine) on the viability of human gingival fibroblasts. METHODS: Biodentine, White ProRoot mineral trioxide aggregate (MTA), and glass ionomer cement were evaluated. Human gingival fibroblasts were incubated for 1, 3, and 7 days both in the extracts from immersion of set materials in culture medium and directly on the surface of the set materials immersed in culture medium. Fibroblasts cultured in Dulbecco modified Eagle medium were used as a control group. Cytotoxicity was evaluated by flow cytometry, and the adhesion of human gingival fibroblasts to the surface of the set materials was assessed by using scanning electron microscopy. The data of cell cytotoxicity were analyzed statistically by using a one-way analysis of variance test at a significance level of P< .05. RESULTS: Cells exposed to extracts from Biodentine and MTA showed the highest viabilities at all extract concentrations, whereas cells exposed to glass ionomer cement extracts displayed the lowest viabilities (P< .05). There was no significant difference in cell viabilities between Biodentine and MTA during the entire experimental period (P> .05). Human gingival fibroblasts in contact with Biodentine and MTA attached to and spread over the material surface after an overnight culture and increased in numbers after 3 and 7 days of culture. CONCLUSIONS: Biodentine caused gingival fibroblast reaction similar to that by MTA. Both materials were less cytotoxic than glass ionomer cement.

Mechanical properties of controlled memory and superelastic nickel-titanium wires used in the manufacture of rotary endodontic instruments.

INTRODUCTION: The aim of this study was to investigate the structure and mechanical properties of newly developed controlled memory (CM) nickel-titanium wires used in the manufacture of rotary endodontic instruments. METHODS: The composition and the phase transformation behavior of both types of wires were examined by x-ray energy dispersive spectroscopy and differential scanning calorimetry, respectively. Conventional superelastic (SE) nickel-titanium wire was used as a control. The mechanical properties of the wires at selected temperatures (room temperature, 37°C, and 60°C) were evaluated with tensile, cyclic tensile, and cantilever bending tests by using an Instron 3365 universal testing machine. The data of austenitic transformation finishing temperature (A(f)) were analyzed statistically by using 1-way analysis of variance test at a significance level of P < .05. RESULTS: The raw CM wires contained a nickel content of 50.7% ± 0.5% and possessed a relatively higher A(f) than SE wires (P < .05). The critical plateau stress and ultimate tensile strength of the CM wires were lower than they were for the SE wires, but the maximum strain before fracture of the CM wires (58.4% ± 7.5% to 84.7% ± 6.8%) was more than 3 times higher than it was for SE wires (16.7% ± 3.8% to 27.5% ± 5.4%). The maximum strain of the CM wires with a diameter of 1.22 mm tested at room temperature (23°C ± 2°C) was up to 84% ± 6.4%. CM wires were not SE at either room temperature or 37°C; however, they exhibited superelasticity when heated to 60°C. CONCLUSIONS: The raw CM wires exhibited different phase transformation behavior and mechanical properties when compared with SE wires, attributing to the special heat treatment history of CM wires. This study suggested greater flexibility of endodontic instruments manufactured with CM wires than similar instruments made of conventional SE wires.

ProFile Vortex instruments after clinical use: a metallurgical properties study.

INTRODUCTION: The aim of the study was to analyze the incidence and mode of ProFile Vortex instrument (Dentsply Tulsa Dental Specialties, Tulsa, OK) defects during a predefined schedule of clinical use by the undergraduate students in a dental school setting and to examine the metallurgical characteristics of unused and clinically used Vortex instruments. METHODS: A total of 2,203 ProFile Vortex instruments discarded after single use from the undergraduate students program over 24 months were collected and examined for defects using a stereomicrosocpe at 10× magnification. The incidence and type of instrument defects or separation were analyzed. The lateral surfaces of part of the defected instruments and fracture surfaces of fractured files were examined using scanning electron microscopy. Unused and clinically used files were examined by differential scanning calorimetry and X-ray diffraction. Vickers hardness of the files was measured with a 200-g load. RESULTS: Only 1 of the 2,203 files fractured during clinical use. The cause of fracture was shear stress, and the file also showed unwinding of the helix structure. None of the remaining 2,202 files exhibited unwinding after clinical use. Blunt apicals were detected in 86 used files (3.9%). Austenite-finish temperatures were very similar for as-received, used files with defects and used files without defects, all exceeding 50°C. No difference in microhardness was detected among these 3 instrument groups. X-ray diffraction results showed that NiTi files had austenite structure at room temperature. CONCLUSIONS: The risk of ProFile Vortex fracture is very low when files are used 1 time by undergraduate students. Unwinding of the files was not detected except for the fractured file. Clinical single use had no detectable effect on austenite-martensite phase transformation of the files. Unused and clinical single-use files contain a similar phase structure at body temperature.

Ti-Ge binary alloy system developed as potential dental materials.

As-cast Ti-xGe (x = 2, 5, 10, 20 wt %) binary alloys were produced in this work, and various experiments were carried out to investigate the microstructure, mechanical properties, in vitro electrochemical and immersion corrosion behaviors as well as cytotoxicity with as-cast pure Ti as control, aiming to study the feasibility of Ti-xGe alloy system as potential dental materials. The microstructure of Ti-xGe alloys changes from single α-Ti phase to α-Ti + Ti(5)Ge(3) precipitation phase with the increase of Ge content. Mechanical tests show that Ti-5Ge alloy has the best comprehensive mechanical properties. The corrosion behavior of Ti-xGe alloys in artificial saliva with different NaF and lactic acid addition at 37°C indicates that Ti-2Ge and Ti-5Ge alloys show better corrosion resistance to fluorine-containing solution. The cytotoxicity test indicates that Ti-xGe alloy extracts show no obvious reduction of cell viability to L-929 fibroblasts and MG-63 osteosarcoma cells, similar to pure Ti which is generally acknowledged to be biocompatible. Considering all these results, Ti-2Ge and Ti-5Ge alloys possess the optimal comprehensive performance and might be used as potential dental materials.

Metallurgical characterization of controlled memory wire nickel-titanium rotary instruments.

INTRODUCTION: To improve the fracture resistance of nickel-titanium (NiTi) files, manufacturers have introduced new alloys and developed new manufacturing processes for the fabrication of NiTi files. This study aimed to examine the phase transformation behavior and microstructure of NiTi instruments from a novel controlled memory NiTi wire (CM wire). METHODS: Instruments of EndoSequence (ES), ProFile (PF), ProFile Vortex (Vortex), Twisted Files (TF), Typhoon (TYP), and Typhoon™ CM (TYP CM), all size 25/.04, were examined by differential scanning calorimetry (DSC) and x-ray diffraction (XRD). Microstructures of etched instruments were observed by optical microscopy and scanning electron microscopy with x-ray energy-dispersive spectrometric (EDS) analyses. RESULTS: The DSC analyses showed that each segment of the TYP CM and Vortex instruments had an austenite transformation completion or austenite-finish (A(f)) temperature exceeding 37°C, whereas the NiTi instruments made from conventional superelastic NiTi wire (ES, PF, and TYP) and TF had A(f) temperatures substantially below mouth temperature. The higher A(f) temperature of TYP CM instruments was consistent with a mixture of austenite and martensite structure, which was observed at room temperature with XRD. All NiTi instruments had room temperature martensite microstructures consisting of colonies of lenticular features with substantial twinning. EDS analysis indicated that the precipitates in all NiTi instruments were titanium-rich, with an approximate composition of Ti(2)Ni. CONCLUSIONS: The TYP CM and Vortex instruments with heat treatment contribute to increase austenite transformation temperature. The CM instrument has significant changes in the phase transformation behavior, compared with conventional superelastic NiTi instruments.

Influence of cross-sectional design and dimension on mechanical behavior of nickel-titanium instruments under torsion and bending: a numerical analysis.

INTRODUCTION: The aim of this study was to examine the influence of the cross-sectional configuration and dimensions (size and taper) on the torsional and bending behavior of nickel-titanium rotary instruments, taking into account the nonlinear mechanical properties of material. METHODS: Ten cross-sectional configurations, square, triangular, U-type, S-type (large and small), convex-triangle, and 4 proprietary ones (Mani NRT and RT2, Quantec, and Mtwo), were analyzed under torsion or bending by using a 3-dimensional finite element method. The von Mises stresses were correlated with the critical values for various phases of the nickel-titanium material. RESULTS: Different loading conditions led to unequal patterns of stress distribution. Increasing the applied torque or bending angle resulted in a rise in the corresponding stresses in the instrument. Favorable stress distribution without dangerous stress concentration was observed if the material was undergoing superelastic transformation at that applied load. The ultimate strength of the material was not exceeded when the instrument was bent up to a 50-degree curvature. On the other hand, when a torsional moment of greater than 1.0 N*mm was applied, the maximum stresses developed in some designs would exceed the ultimate strength of the material. Little variation in the von Mises stresses was observed for instruments of different nominal sizes and tapers on bending to similar extent. CONCLUSIONS: The cross-sectional design has a greater impact than taper or size of the instrument on the stresses developed in the instrument under either torsion or bending. Certain cross-sectional configurations are prone to fracture by excess torsional stresses.

The application of poly (glycerol-sebacate) as biodegradable drug carrier.

Poly (glycerol-sebacate) (PGS) is an elastomeric biodegradable polymer which possesses the ideal properties of drug carriers. In the present study, we prepared a series of PGS implants (5-FU-PGSs) loaded with different weight percent of 5-fluorouracil (2, 5, 7.5 and 10%). We studied the infrared spectrum properties, in vitro degradation and drug release, in vivo degradation and tissue biocompatibility of 5-FU-PGSs, in order to provide detailed information for the application of PGS as biodegradable drug carrier in cancer therapy. Macroscopically, all 5-FU-PGS wafers in phosphate buffer solution (PBS) kept their geometries during the degradation period of 30 days. The in vitro degradation rates of 5-FU-PGSs were accelerated when higher concentration of 5-FU was doped. Scanning electron microscopy observation showed that the surfaces of 5-FU-PGSs with higher concentration of 5-FU had irregular pits. The cumulative drug release profiles of 5-FU-PGSs exhibited a biphasic release with an initial burst release in the first day. After 7 days, almost 100% cumulative release of 5-FU was found for all 5-FU-PGSs.The degradation rate of 5-FU-PGSs in vivo was much quicker than that in vitro. Hematoxylin and eosin staining showed that no remarkable inflammations were observed in the tissue surrounding 5-FU-PGS implants, suggesting 5-FU-PGSs had good biocompatibility and no tissue toxicity. In vitro anti-tumor activity assay suggested that 5-FU-PGSs exhibited anti-tumor activity through sustained-release drug mode. These results demonstrate that PGS is a candidate of biodegradable drug carriers.