Translucent multi-layered zirconia: Sandblasting effect on optical and mechanical properties.

OBJECTIVE: The aim of this study was to evaluate the influence of the sandblasting treatment on the microstructure, optical and mechanical properties of multi-layered translucent zirconia. METHODS: Samples of yttria-stabilized zirconia were prepared by stratifying four layers (L1, L2, L3 and L4) of ML-type KATANA multi-layered monolithic discs, whose surfaces were then sandblasted with alumina particles (110 µm and 0.2 MPa) in order to evaluate its effect on the presence of different crystalline phases as well as on the optical and mechanical properties of each of the four layers. The optical characterization was carried out by measuring the reflectance spectrum and colorimetric parameters by UV-Vis spectrophotometric analysis and the transmittance curves were indirectly obtained using the Kubelka-Munk model (KM). Microstructural, structural, mechanical and roughness characterizations were also performed using SEM, XRD, biaxial flexural strength B3B, and light interferometry, respectively RESULTS: According to the KM model there are different degrees of translucency between the upper and lower layers of the monolithic discs, but there was no influence of the Al2O3-sandblasting treatment on this optical property. The disk pigmentation causes greater absorption of light below 600 nm, decreasing the transmittance rate to values below 25% in this region of the spectrum. The yellowing index presented higher values for inner disk layers L3 and L4, in agreement with the highest values of the light absorption coefficient K observed for these layers. The roughness of the samples did not change significantly with the surface treatment performed and the sandblasting did not result in new crystalline phases. SEM analysis showed the presence of different grain sizes in all layers analyzed, being related to the co-occurring presence of cubic (c-ZrO2) and tetragonal (t-ZrO2) phases in similar contents (∼ 50 wt%). The Weibull statistical analysis, in turn, showed an increase in the Weibull characteristic stress value (σ0) for most layers subjected to sandblasting, except for the second layer (central region of the disk). It was also verified an increase in the value of the structural reliability of the material (m), referring to the samples of the central region of the disc (L2 and L3 layers) after sandblasting. SIGNIFICANCE: The pigmentation in the disk causes a decrease of the transmittance rate to values well below 25% in the region of the spectrum 400-600 nm and the inner layers (L3 and L4) have even lower transmittance than the outer layers in this spectrum range. Although the CR index indicates variation related to the Al2O3-sandblasting treatment, the transmittance spectra of KM model show that the sandblasting did not cause a significant change in the transmittance rate of the four analyzed layers. Also, there is no significant difference in the light scattering of the different layers of the disc, either before or after Al2O3-sandblasting treatment.

Enhanced bone tissue regeneration with hydrogel-based scaffolds by embedding parathyroid hormone in mesoporous bioactive glass.

OBJECTIVES: To evaluate hydrogel-based scaffolds embedded with parathyroid hormone (PTH)-loaded mesoporous bioactive glass (MBG) on the enhancement of bone tissue regeneration in vitro. MATERIALS AND METHODS: MBG was produced via sol-gel technique followed by PTH solution imbibition. PTH-loaded MBG was blended into the hydrogels and submitted to a lyophilisation process associated with a chemical crosslinking reaction to the production of the scaffolds. Characterisation of the MBG and PTH-loaded MBG scaffolds, including the scanning electron microscope (SEM) connected with an X-ray detector (EDX), Fourier transform infrared (FTIR), compression strength, rheological measurements, swelling and degradation rates, and PTH release analysis, were performed. Also, bioactivity using simulated-body fluid (SBF), biocompatibility (MTT), and osteogenic differentiation analyses (von Kossa and Alizarin Red stainings, and µ-computed tomography, µCT) of the scaffolds were carried out. RESULTS: SEM images demonstrated MBG particles dispersed into the hydrogel-based scaffold structure, which was homogeneously porous and well interconnected. EDX and FTIR revealed large amounts of carbon, oxygen, sodium, and silica in the scaffold composition. Bioactivity experiments revealed changes on sample surfaces over the analysed period, indicating the formation of carbonated hydroxyapatite; however, the chemical composition remained stable. PTH-loaded hydrogel-based scaffolds were biocompatible for stem cells from human-exfoliated deciduous teeth (SHED). A high quantity of calcium deposits on the extracellular matrix of SHED was found for PTH-loaded hydrogel-based scaffolds. µCT images showed MBG particles dispersed into the scaffolds' structure, and a porous, lamellar, and interconnected hydrogel architecture. CONCLUSIONS: PTH-loaded hydrogel-based scaffolds demonstrated consistent morphology and physicochemical properties for bone tissue regeneration, as well as bioactivity, biocompatibility, and osteoinductivity in vitro. Thus, the scaffolds presented here are recommended for future studies on 3D printing. CLINICAL RELEVANCE: Bone tissue regeneration is still a challenge for several approaches to oral and maxillofacial surgeries, though tissue engineering applying SHED, scaffolds, and osteoinductive mediators might help to overcome this clinical issue.

In vitro evaluation of bilayer membranes of PLGA/hydroxyapatite/ß-tricalcium phosphate for guided bone regeneration.

Membranes for guided bone regeneration represent valuable resources, preventing fibroblast infiltration and aiding anatomical bone reconstruction. Nonetheless, available membranes lack bone regenerative capacity, suitable mechanical behavior, or adequate degradation profile. Therefore, to overcome these limitations, this study developed bilayer membranes with a dense layer (dry phase inversion) of PLGA (poly(lactic-co-glycolic acid)):HAp (hydroxyapatite) - 95:05 (wt%) - and an electrospun layer of PLGA and HAp:ß-TCP (ß-tricalcium phosphate) with ratios of 60:40, 70:30 and 85:15 (wt%), evaluating its mechanical, morphological and in vitro properties. The bilayer membranes displayed adequate interlayer adhesion, dense layer pore size of 4.20 µm and electrospun layer with porosity degree of 38.2%, thus capable of preventing fibroblast infiltration while allowing osteoblast migration and nutrient permeation. They also showed Tg of 82 °C and higher storage modulus, which was constant up to 54.6 °C, characteristics important for membrane implantation and use with no mechanical compromise. In vitro degradation mass loss was only 10% after 60 days, a profile suitable for the application requirement. Membranes with calcium phosphates had better osteoblast attachment, proliferation and migration. Taken together, results indicate the great potential of PLGA/HAp/ß-TCP bilayer membranes on bone reconstruction with proper degradation profile, morphology, mechanical behavior and bone regenerative capacity.

Manufacturing and characterization of plates for fracture fixation of bone with biocomposites of poly (lactic acid-co-glycolic acid) (PLGA) with calcium phosphates bioceramics.

Commercially, there are several plates and screws for bone fracture fixation made with PLA, however, its long degradation time and lack of integration with bone structure, provides interest in research using polymers with faster degradation, such as PLGA, and together with bioceramics, in order to improve bioactivity in bone regeneration. Based on this, in this study, bone fracture fixation plates composed of PLGA polymer matrix and combinations of 5 and 10%wt. of bioceramics were processed by microinjection. The bioceramics used comprehend nanostructured hydroxyapatite (n-HA), ß-tricalcium phosphate (ß-TCP) and calcium phosphate with ion substitution of magnesium (Mg-Ca/P) and strontium (Sr-Ca/P). The introduction of bioceramics modified thermal and mechanical properties of the polymer. The TGA analysis showed that there was a variation on the ceramic's mass inserted in relation to the expected values (5% and 10%wt.) in all groups of biocomposites. In general, Tg values obtained by DMA were slightly increased in almost all the biocomposites. The storage modulus (E') of biocomposites was higher for almost all groups of inserted ceramics, with exception of 5%n-HA. In the flexural tests, the biocomposites obtained a great dispersion in average values of fracture loading, presented lower values in relation to pure PLGA. There were difficulties in the processing of biocomposites with Mg-Ca/P and Sr-Ca/P, a factor that can be attributed to lack of homogeneity in the material mixing process. The results suggest modifications in thermal and mechanical properties of the PLGA plates with the bioceramics insertion and provide improvement understanding about of manufactured composites with PLGA and bioceramics.

Avaliação funcional do desenho de três brocas de preparo para colocação do implante dentário / Functional evaluation of three different drill designs for dental implant osteotomy: an in vitro study

Objetivos: avaliar o desempenho de furação de brocas. Material e métodos: três sistemas de implantes brasileiros foram testados: A (FGM, Joinville); B (Neodent, Curitiba); e C (SIN, São Paulo). A força de furação foi mantida constante e igual a 35 N. A rotação das brocas foi de 800 rpm e os corpos-de-prova foram mantidos em temperatura de 36°C ± 2°C, sendo a água destilada como fluido refrigerante. Dados sobre a temperatura e torque de furação foram adquiridos, e o desgaste das brocas foi avaliado por MEV. Os testes Anova e Tukey (α=5%) foram utilizados na análise estatística. Resultados: as brocas são eficazes, não ultrapassando a temperatura de limite biológico (47°C). Conclusão: de acordo com os ensaios realizados, a broca do grupo A reúne características que a habilitam como broca de perfuração única no preparo do leito do implante dentário. A análise em MEV mostrou que os grupos A e B mantiveram os gumes de corte bem defi nidos e sem desgaste aparente.

Objectives: to evaluate the osteotomy performance of implant drills. Material and methods: three different Brazilian dental implant systems were tested: A (FGM, Joinville), B (Neodent, Curitiba), and C (SIN, São Paulo). Drilling force was kept at 35 N. Drill rotation was set at 800 RPM and samples were kept at 36 ± 2°C under water coolant. Data regarding temperature and torque were acquired and drill wear evaluated under SEM. The Anova and Tukey tests (α=5%) were applied for statistical analyses. Results: all drills were effi cient and remained below the biologic limit level (47°C). Conclusion: according to the tests, drills of the A group had characteristics for a single osteotomy at the bone bed for implant placement. The SEM analysis demonstrated that groups A and B still had sharp, well-defi ned cutting edges with no visible wear.

Synthesis and characterization of calcium phosphate compounds with strontium and magnesium ionic substitutions / Síntetis y caracterización del compuestos de fosfato de calcio con substituto iónico de estroncio y magnesio

Bioceramics offer advantages in the repair and regeneration of hard tissues and are used as bone void fillers and particulate fillers in bone cements with surgical applications. Regeneration and osteosynthesis stimulation via the release of essential ions such as strontium (Sr2+) and magnesium (Mg2+) is a relatively new field. Therefore, there is great interest in investigating various ionic substitutions on crystallographic structure and characteristics for use in osteoporosis prevent and increase bone formation and decrease bone resorption. In this study, we synthesize calcium phosphate samples with Sr2+ and Mg2+ ionic substitutions. The samples are characterized using X-ray diffraction, Fourier transform infrared spectroscopy, and inductively coupled plasma mass spectroscopy. Hydroxyapatite, beta tricalcium phosphate, and amorphous phases were observed. Depending on the ionic substitution, the crystal size and crystallinity varied from 22 nm to 130 nm and from 84% to 99.6%, respectively. The Ca/P ratio ranged from 0.72 to 1.82. The results demonstrated the effect of Sr2+ and Mg2+ inclusions in calcium phosphate on important parameters used in several bioceramic applications.

Los biocerámicos ofrecen ventajas en la reparación y regeneración de tejidos duros utilizándose como relleno en cavidades óseas y como relleno particulado en cementos óseos de aplicaciones quirúrgicas. Regeneración y estimulación de la osteosíntesis a través de la liberación de iones esenciales, como el estroncio (Sr) y magnesio (Mg) es un campo relativamente nuevo. Por lo tanto, existe un gran interés en la investigación de diversas sustituciones iónicos sobre la estructura cristalográfica y las características para su uso en la prevención de osteoporosis y aumento de la formación ósea con disminuir la resorción ósea. En este estudio, se sintetizó muestras de fosfato de calcio con sustituciones iónicos Sr y Mg. Las muestras se caracterizaron usando difracción de rayos X, espectroscopia infrarroja por transformada de Fourier, y la espectroscopia de masas con plasma acoplado inductivamente. Se observó hidroxiapatita, fosfato tricálcico beta, y las fases amorfas. Dependiendo de la sustitución iónica, el tamaño del cristal y cristalinidad variaron de 22 nm a 130 nm y de 84% a 99,6%, respectivamente. La relación Ca/P varió desde 0,72 hasta 1,82. Los resultados demostraron el efecto de las inclusiones de Sr y Mg en fosfato de calcio en parámetros importantes que se utilizan en varias aplicaciones de biocerámicos.

Zircônia na prótese dentária / Zirconia in prosthetic dentistry

Na tentativa de substituir as infraestruturas metálicas das próteses dentárias, cerâmicas de alto desempenho têm sido aprimoradas e cada vez mais utilizadas na odontologia. Dentre as cerâmicas odontológicas, a zircônia tem surgido como material versátil e promissor, em função de suas propriedades biológicas, mecânicas e ópticas, o que certamente tem acelerado o uso rotineiro da tecnologia CAD/CAM em coroas unitárias, próteses fixas, pilares e próteses sobre implantes, por técnicos e cirurgiões-dentistas. Este artigo apresenta um relato de caso clínico em que uma cerâmica à base de zircônia foi associada à tecnologia CAD/CAM, considerando-se suas indicações e contra-indicações, em função da microestrutura e propriedades desse material

In an attempt to replace metal infrastructure of crowns and bridges, high-strength ceramics have been developed and are increasingly used. The zirconia has been introduced as a promising, versatile material because of its biological, mechanical, and optical properties. This definitely boosted the use of CAD / CAM technology by dentists and dental technicians. This article presents a case report where a zirconia based ceramic has been associated to a CAD / CAM system, and to present the indications and contraindications according to the features of the material

Optical influence of the type of illuminant, substrates and thickness of ceramic materials.

OBJECTIVES: The present study is an instrumental evaluation of the optical influence of the type of illuminant, substrate and different thickness on the color of dental ceramics. METHODS: Thirty ceramic disks were prepared from IPS-Empress and IPS-Empress2 in three different thicknesses (1.5, 2.0 and 2.5mm). Disks made of composite resin; silver-palladium alloy and gold were used as substrates. The disks with a 1.5mm thickness were placed on a neutral gray photographic paper and measured with a spectrophotometer under three illuminants: daylight (D65), incandescent light (A) and fluorescent light (F6). All ceramic disks were combined with the substrate disks and a spectrophotometer was used to measure the coordinates of lightness (L*) and chromaticity (a* and b*). Two-way ANOVA (p<0.05) was used to analyze the combinations of ceramics, substrates and illuminants tested considering the coordinates of lightness (L*) and chromaticity (a* and b*), and also differences of color (DeltaE), lightness (DeltaL*), chromaticity values (Deltaa* and Deltab*). RESULTS: For the illuminants tested, the results present significant differences for coordinates of chromaticity a* and b*, suggesting a metamerism effect. In combination with the substrates, the results present statistical differences in all the tested conditions, especially where there is no ceramic substructure. SIGNIFICANCE: The presence of discolored tooth remnants or metallic posts and cores can interfere with the desired aesthetic result, based on the selection of color aided by a single luminous source. Thus, the substrate color effect, thickness of the ceramic materials and type of illuminant are important factors to be considered during the clinical application of the ceramic systems.

Influence of Nd:YAG laser irradiation on an adhesive restorative procedure.

Hard tissue modification by means of laser irradiation is becoming popular in dentistry, since it promotes assorted responses between the tooth and the restorative material. Some studies on the bond strength of adhesive systems to Nd:YAG irradiated teeth have shown distinctive behaviors when irradiation was applied before or after the adhesive agent. This study evaluated the microtensile bond strength of a commercial adhesive system to dentin irradiated with Nd:YAG laser after adhesive application but prior to polymerization. The experiment was conducted in vitro, using freshly extracted human teeth as samples. For the microtensile test, the teeth were separated into 4 different groups according to the energy density of laser irradiation: 0, 5, 10 and 50 J/cm2. The data was analyzed with analysis of variance (ANOVA) and LSD tests, and the results indicated that the group that was irradiated with 5 J/cm2 had significantly higher bond strength values. Adhesive penetration on the etched dentin was observed by scanning electron microscopy, where the images showed better adhesive penetration on dentinal tubules after dentin irradiation with 5 J/cm2. Based on the results of this study, it is possible to conclude that irradiation of dentin with the Nd:YAG laser at low energy densities after application of the adhesive but prior to polymerization might be positive for the adhesive restorative process.