Effect of cement type, luting protocol, and ceramic abutment material on the shade of cemented titanium-based lithium disilicate crowns and surrounding peri-implant soft tissue: a spectrophotometric analysis.

PURPOSE: The objective of the study was to analyze the impact of cement, bonding pretreatment, and ceramic abutment material on the overall color results of CAD-CAM ceramic crowns bonded to titanium-based hybrid abutments. MATERIALS AND METHODS: For single implant restoration of a maxillary lateral incisor a total of 51 CAD-CAM-fabricated monolithic lithium disilicate crowns were fabricated and subsequently bonded onto 24 lithium disilicate Ti-base abutments, 24 zirconia Ti-base abutments and 3 resin abutment replicas as a control group. The 48 copings were cemented with three definitive and one provisional cement on both grit-blasted and non-blasted Ti-bases. The color of each restoration and surrounding artificial gingiva was measured spectrophotometrically at predefined measuring points and the CIELAB (ΔEab) color scale values were recorded. RESULTS: The color outcome of ceramic crowns bonded to hybrid abutments and soft tissues was affected differently by cements of different brands. Grit-blasting of Ti-bases prior to cementing CAD-CAM copings affected the color results of all-ceramic crowns. There was a significant difference (P = .038) for the median ΔE value between blasted and non-blasted reconstructions at the cervical aspect of the crown. Full-ceramic crowns on zirconia Ti-base abutments exhibited significantly lower ΔE values below the threshold of visibility (ΔE 1.8). In all subcategories tested, the use of a highly opaque temporary cement demonstrated the lowest median ΔE for both the crown and the artificial gingiva. CONCLUSION: Various cements, core ceramic materials and airborne particle abrasion prior to bonding can adversely affect the color of Ti-base supported ceramic crowns and peri-implant soft tissue. However, zirconia CAD-CAM copings and an opaque cement can effectively mask this darkening.

Head size in Delta ceramic-on-ceramic total hip arthroplasty: a comparative registry study.

INTRODUCTION: Optimal bearing size in total hip arthroplasty (THA) has not been clearly ascertained, but large diameter ceramic balls may improve function and implant stability, with minimal concerns for wear. Delta ceramic-on-ceramic (COC) THA were stratified based on head diameter (32, 36 and 40 mm), aiming to assess: 1) survival rates, reasons for revision and hazard ratios for failure; 2) survival rates and hazard ratios for aseptic loosening, dislocation/primary instability, liner failure. MATERIALS AND METHODS: A regional arthroplasty registry was enquired about Delta COC THA performed for primary osteoarthritis, stratified by head size. 13,161 primary cementless THAs were included in the study, with a mean follow-up of 5.7 years (range: 0-17): 3980 (30.2%) 32 mm balls, 8327 (63.3%) 36 mm heads, 854 (6.5%) 40 mm heads. RESULTS: The three cohorts achieved similar survival rates (p = 0.99) and adjusted hazard ratios (p > 0.05). No revisions for head breakage or metallosis occurred. When revision for cup aseptic loosening was the endpoint, the survival rates of three cohorts (p = 0.08) and the adjusted hazard ratios (p > 0.05) were similar. The three cohorts achieved comparable survival rates when revision for dislocation/primary instability was the endpoint (p = 0.08). When the endpoint was revision for liner breakage, 32 mm cohort showed higher rates of revision (p = 0.01). No liner failure was detected in the 40 mm cohort. CONCLUSIONS: 32 mm, 36 mm and 40 mm provided similar 10-year survival rates in Delta COC THA. 40 mm heads emerged as safe options but did not lower the revisions for dislocations/primary instability. LEVEL OF EVIDENCE: IV (therapeutic study).

Ultra-short laser processing of 3D bioceramic, porous scaffolds designed by freeze foaming method for orthopedic applications.

Bone substitutes are widely employed for applications in orthopedic surgery for the replacement of injured bone. Among the diverse methods that are used to design 3D bioceramic matrices, Freeze Foaming has gained attention, since it provides the ability to tune the shape of the created structures. One of the major problems related to these constructs is the lack of porosity at the outwards sides (holder) of the scaffold, thus reducing the cellular affinity and creating a rejection of the implant. In this research, we aimed to develop a bone scaffold with enhanced surface properties and improved cellular affinity. The main aim was to alter the biocompatibility characteristics of the 3D bioceramic constructs. We have produced three-dimensional, complex-shaped hollow shell structures, manufactured by Additive Manufacturing processes and as a second step, filled with a ceramic suspension by the Freeze-Foaming process. 3D constructs from HAP-derived TCP and TCP/ZrO2 were synthesized by freeze-foaming method and subsequently irradiated with a fs-laser (λ = 800 nm) spanning a range of parameters for achievement of optimal surface processing conditions. The designed scaffolds demonstrated enhanced topographical properties with improved porosity examined by SEM, EDX, and 3D profilometry after laser treatment. Wettability and computer tomography (CT) evaluation was also performed. The results from X-ray diffraction (XRD) and micro-Raman analysis did not show photochemical and surface or volume defects and changes after laser processing of the ceramic samples. Preliminary results from MG-63 osteoblast-like cell tests showed good cell affinity on the processed surfaces and no cytotoxic effect on the cells.

Clinical Success Evaluation of Ultrathin Ceramic Veneers Bonded to Nonprepared Teeth: An Observational Prospective Cohort Study.

BACKGROUND: Patients' increasing interest in achieving optimal cosmetic outcomes and the widespread use of ultrathin ceramic veneers offer advantages such as high esthetic results and long-term durability. Several issues related to tooth preparation have been raised, including dental sensitivity, periodontal diseases, and increased treatment phases, in addition to complications associated with previous procedures, the treatment of which remains controversial to date. With the advancement of dental ceramic and its manufacturing techniques, it was widely used to manufacture ultrathin ceramic veneers with minimal preparation. Issues such as fracture and abfraction are the most common in ceramic veneers made of feldspathic ceramic due to their weak mechanical properties against various forces, which led to the emergence of lithium disilicate glass-ceramic manufactured using the heat-press technique. This has resulted in ultrathin ceramic veneers with a thickness of up to 0.1-0.2 mm easily bonded and finished as they have high mechanical properties and esthetic qualities that mimic natural tooth color and shape. The current cohort study aimed to evaluate the success rates of this kind of treatment for patients treated at our department. MATERIALS AND METHODS: This observational cohort study's sample comprised 60 ultrathin ceramic veneers manufactured from lithium disilicate glass-ceramic bonded to nonprepared upper teeth. The clinical performance of the studied sample was evaluated and monitored at monthly intervals (one month, three months, six months, and one year) using the clinical success evaluation based on Walton's principles adopted for evaluating the success and failure of fixed restorations. RESULTS: Ultrathin ceramic veneers made from lithium disilicate glass-ceramic, bonded to nonprepared teeth, proved to be a successful clinical and esthetic treatment option, with a clinical success rate of 100% during the entire follow-up period. CONCLUSIONS: This study's findings indicate that ultrathin ceramic veneers made from lithium disilicate glass-ceramic, bonded to nonprepared teeth, are a successful clinical and esthetic treatment option, with a clinical success rate of 100% during the entire follow-up period.

Vertical marginal gap and internal fit of virgilite-based lithium disilicate glass ceramic veneers with different preparation designs.

PURPOSE: To evaluate and compare internal fit and marginal adaptation of conventional lithium disilicate (LDS) glass ceramics and LDS containing virgilite computer-aided design and manufacturing (CAD-CAM) blocks before and after aging. MATERIALS AND METHODS: Seventy-two epoxy replicated dies from two prepared maxillary right central incisors acrylic typodont were divided into two groups of different preparation designs (n = 36): Group I, incisal butt-joint, and Group P, incisal overlap. Each group was further subdivided into two equal groups according to ceramic material (n = 18): Group E, IPS e.max CAD, and Group T, Tessera advanced lithium disilicate (ALD) CAD-CAM blocks. The replica technique was used to assess the internal fit using a stereomicroscope at 45× magnification. Laminate veneers were cemented to their corresponding epoxy dies, then the vertical marginal gap was evaluated before and after thermal cycling. Repeated measures analysis of variance (ANOVA) were used for marginal fit data and 2-way ANOVA for internal fit measurements (α = 0.05). RESULTS: For internal fit, there were no significant differences between tested groups. For vertical marginal gap results, two-way ANOVA showed that only aging had a significant effect on the vertical marginal gap (p < 0.001), while different CAD-CAM materials and preparation designs did not affect the vertical marginal gap. CONCLUSIONS: The vertical marginal gap and internal fits of IPS e.max CAD and CEREC Tessera CAD for both preparation designs were comparable. Aging significantly affected the vertical marginal gap of the laminate veneers of both materials and both preparation designs; however, all were within clinically acceptable ranges before and after aging.

Why Are Contemporary Primary Ceramic-on-Highly Crosslinked Polyethylene Total Hip Arthroplasties Failing? An Analysis of Over 5,500 Cases.

INTRODUCTION: Ceramic-on-highly crosslinked polyethylene (HXLPE) has become the most common bearing surface utilized in primary total hip arthroplasty (THA). The purpose of this study was to determine the implant survivorship and clinical outcomes of THAs with ceramic-on-HXLPE in a large, single institutional, series. METHODS: We identified 5,536 primary THAs performed from 2007 to 2017 using a ceramic-on-HXLPE bearing through our total joint registry. The mean age was 60 years, 51% were women, and the mean body mass index (BMI) was 30. A cementless femoral component was used in 98% of cases, and a head size of ≥ 36 was used in 75%. Kaplan-Meier survivorship analyses were completed to assess survivorship free of any revision or reoperation. Clinical outcomes were assessed via Harris Hip Scores (HHS). The mean follow-up was 4 years. RESULTS: The 5-year survivorship free of any revision was 97%. The most common indications for revision were dislocation (41 hips), periprosthetic joint infection (PJI) (39 hips), and periprosthetic femur fracture (18 hips). The 5-year survivorship free of any reoperation was 96%. There were an additional 70 reoperations, with the most common indications being wound dehiscence (32 hips), iliopsoas impingement (11 hips), and periprosthetic femur fracture (11 hips). There were only two bearing surface failures: one HXLPE liner fractured and one dissociated. There were no ceramic head fractures or failures. The mean HHS increased from 57 to 92 (P < 0.0001). CONCLUSION: In over 5,500 THAs completed with modern ceramic-on-HXLPE bearings, failures of the bearing surface were nearly eliminated at midterm follow-up, and overall 5-year survivorship free of revision was excellent. Dislocation, PJI, and periprosthetic femur fracture were the most common causes of failure. As bearing surfaces have evolved, traditional failure mechanisms such as polyethylene wear, corrosion and metal reactions, and ceramic fractures have become nearly extinct.

Prospective applications of bioactive materials in orthopedic therapies: A review.

The biomedical application of biodegradable polymers for addressing bone-related diseases has garnered considerable attention in recent years. Advances in material technology have expanded the repertoire of materials suitable for orthopedic implants, with nanomaterials playing a pivotal role in replicating crucial surface properties akin to natural tissues. This comprehensive review explores the evaluation of bioactive glass ceramics, shedding light on their properties and applications. The synthesis of composites through composite manufacturing has emerged as a strategy to enhance biocompatibility and biomechanical characteristics. They are addressing challenges associated with conventional implants and nanomaterials, whether in the form of functional nano coatings or nanostructured surfaces, present opportunities to refine implant techniques. Novel developments in orthopedic biomaterials, such as smart biomaterials, porous structures, and 3D implants, offer stimuli-responsive behavior to achieve desired implant shapes and characteristics. Bioactive and biodegradable porous polymer/inorganic composite materials are explored for bone tissue engineering scaffolds, aiming to promote bone formation and regeneration. As a prospective direction, the integration of stem cells into scaffolds hints at the creation of next-generation synthetic/living hybrid biomaterials, displaying high adaptability in biological settings. This review establishes a foundation for nanotechnology-driven biomaterials by elucidating fundamental design factors crucial for orthopedic implant performance and their response to cell differentiation, proliferation, and adhesion.

Improvement of Hydrogen-Resistant Gas Turbine Engine Blades: Single-Crystal Superalloy Manufacturing Technology.

This paper presents the results of an analysis of resistance to hydrogen embrittlement and offers solutions and technologies for manufacturing castings of components for critical applications, such as blades for gas turbine engines (GTEs). The values of the technological parameters for directional crystallization (DC) are determined, allowing the production of castings with a regular dendritic structure of the crystallization front in the range of 10 to 12 mm/min and a temperature gradient at the crystallization front in the range of 165-175 °C/cm. The technological process of making GTE blades has been improved by using a scheme for obtaining disposable models of complex profile castings with the use of 3D printing for the manufacture of ceramic molds. The ceramic mold is obtained through an environmentally friendly technology using water-based binders. Short-term tensile testing of the samples in gaseous hydrogen revealed high hydrogen resistance of the CM-88 alloy produced by directed crystallization technology: the relative elongation in hydrogen at a pressure of 30 MPa increased from 2% for the commercial alloy to 8% for the experimental single-crystal alloy.

Preparation and Properties of Nb5+-Doped BCZT-Based Ceramic Thick Films by Scraping Process.

A bottleneck characterized by high strain and low hysteresis has constantly existed in the design process of piezoelectric actuators. In order to solve the problem that actuator materials cannot simultaneously exhibit large strain and low hysteresis under relatively high electric fields, Nb5+-doped 0.975(Ba0.85Ca0.15)[(Zr0.1Ti0.9)0.999Nb0.001]O3-0.025(Bi0.5Na0.5)ZrO3 (BCZTNb0.001-0.025BiNZ) ceramic thick films were prepared by a film scraping process combined with a solid-state twin crystal method, and the influence of sintering temperature was studied systematically. All BCZTNb0.001-0.025BiNZ ceramic thick films sintered at different sintering temperatures have a pure perovskite structure with multiphase coexistence, dense microstructure and typical dielectric relaxation behavior. The conduction mechanism of all samples at high temperatures is dominated by oxygen vacancies confirmed by linear fitting using the Arrhenius law. As the sintering temperature elevates, the grain size increases, inducing the improvement of dielectric, ferroelectric and field-induced strain performance. The 1325 °C sintered BCZTNb0.001-0.025BiNZ ceramic thick film has the lowest hysteresis (1.34%) and relatively large unipolar strain (0.104%) at 60 kV/cm, showing relatively large strain and nearly zero strain hysteresis compared with most previously reported lead-free piezoelectric ceramics and presenting favorable application prospects in the actuator field.

Numerical Analysis of Cavitation Erosion in 316L Steel with CrN PVD Coating.

The erosion process of a 4 µm monolayer CrN coating deposited on 316L stainless steel due to cavitation was investigated using finite element analysis (FEA). To estimate load parameters from cavitation pit geometry resulting from high impact velocity and high strain rate, the explicit dynamic solver was employed. Water microjet impacts at velocities of 100, 200 and 500 m/s were simulated to recreate different cavitation erosion intensities observed in the experiment. The resulting damage characteristics were compared to previous studies on uncoated 316L steel. The relationship between impact velocity and postimpact geometry was examined. Simulations revealed that only impact at 500 m/s can exceed the maximum yield stress of the substrate without penetrating the coating. Subsequent impacts on the same zone deepen the impact pit and penetrate the coating, leading to direct substrate degradation. The influence of impact velocity on the coating degradation process is discussed.

Thin-Layer TiO2 Membrane Fabrication by Condensed Layer Deposition.

A novel approach to the fabrication of thin-film supported metal oxide membranes was investigated. Nanocoatings were obtained by the condensed layer deposition of TiO2 on tubular microporous supports, applying multiple consecutive layers of TiO2/polyaniline. The surface, cross-sectional structure, and morphology of the materials were investigated by electron microscopy. Their membrane-related properties were explored by permeability measurements, rejection, and fouling analysis, using polyethylene glycol (PEG) as test molecules. The SEM images showed that TiO2 was successfully deposited on the surface, creating a layer with partial coverage of the support after each layer was deposited; consequently, the permeability of the membranes decreased gradually. Overall, the results of the flux and permeability of the membranes confirmed the coating. The transmembrane pressure (TMP) increased with each coating layer, while the rejection of the membrane showed gradual improvement.

Advancements in Inorganic Membrane Filtration Coupled with Advanced Oxidation Processes for Wastewater Treatment.

Membrane filtration is an effective water recycling and purification technology to remove various pollutants in water. Inorganic membrane filtration (IMF) technology has received widespread attention because of its unique high temperature and corrosion resistance. Commonly used inorganic membranes include ceramic membranes and carbon-based membranes. As novel catalytic inorganic membrane processes, IMF coupled with advanced oxidation processes (AOPs), can realize the separation and in situ degradation of pollutants, thus mitigating membrane contamination. In this paper, the types and performance of IMF are discussed. The influencing factors of inorganic membranes in practical wastewater treatment are summarized. The applications, advantages, and disadvantages of the coupled process of IMF and AOPs are summarized and outlined. Finally, the challenges and prospects of IMF and IMF coupled with AOPs are presented, respectively. This contributes to the design and development of coupled systems of membrane filtration with inorganic materials and IMF coupled with AOPs for practical wastewater treatment.

Experimental Analysis of IPMC Optical-Controlled Flexible Driving Performance under PLZT Ceramic Configuration.

Ionic polymer metal composite (IPMC) is regarded as the mainstream application material for achieving flexible driving technology in various engineering fields. In this article, aiming at the non-independence of the current IPMC electric driving method, an IPMC optical-controlled flexible driving method based on the photoinduced effects of lanthanum-modified lead zirconate titanate (PLZT) ceramic is proposed. To this end, a mathematical model for IPMC optical controlled flexible driving is built on the basis of the photovoltaic characteristic of PLZT ceramic, and the driving performance is experimentally analyzed through different lengths of IPMC under the excitation of different direct currents and light intensities. From the analysis and experimental results, when PLZT ceramic is irradiated by different light intensities, the output deformation of IPMC increases with increases in light intensity, and finally reaches a stable state. Moreover, the actuation curves obtained by light excitation and direct current excitation are consistent, and the motion coefficient reflects the driving performance more accurately. In addition, using light energy as an excitation source to drive IPMC not only provides new ideas for its development in the flexible driving field, but also provides a theoretical basis for its practical application.

An efficient electrode for reversible oxygen reduction/evolution and ethylene electro-production on protonic ceramic electrochemical cells.

Protonic ceramic electrochemical cells (PCECs) have demonstrated great promise for applications in the generation of electricity, and the synthesis of chemicals (for example, ethylene). However, enhancing the electrochemical reactions kinetics and stability of PCECs electrodes is one grand challenge. Here, we present a novel electrode material via a co-doping of cesium (Cs) and niobium (Nb) on PrBaCo2O6-δ with the composition of PrBa0.9Cs0.1Co1.9Nb0.1O6-δ (PBCCN), which naturally decomposes into dual phases of a double-perovskite PBCCN (DP-PBCCN, ∼92.3 wt%) and a single-perovskite Ba0.9Cs0.1Co0.95Nb0.05O3-δ (SP-BCCN, ∼7.7 wt%) under typical powder processing conditions. PBCCN exhibits a low area-specific resistance (ASR) value of 0.107 Ω cm2, an outstanding performance of 2.04 W cm-2 in fuel cell (FC) mode, a current density of -2.84 A cm-2 at 1.3 V in electrolysis cell (EC) mode, and promising reversible operational durability of 53 cycles in ∼212 h at +/- 0.5 A cm-2 and 650 °C. Cs doping generates more oxygen vacancies and accelerates the oxygen exchange kinetics, while Nb doping effectively enhances the stability, as illustrated by the analyses of X-ray photoelectron spectroscopy, and electrical conductivity relaxations. When applied as the positrode for electrochemical non-oxidative dehydrogenation of ethane (C2H6) to ethylene (C2H4) on PCECs, it displays an encouraging C2H6 conversion of 12.75% and a C2H4 selectivity of 98.4% at 1.2 V.

Perspective on Water-Soluble Two-Photon Initiator for Two-Photon Polymerization.

Two-photon polymerization (TPP) as an unparalleled technology empowers the rapid prototyping of customized three-dimensional (3D) micro/nanostructures, garnering noticeable interest in tissue engineering, drug delivery, and regenerative medicine. These applications have a high requirement on the biocompatibility and integrity of 3D structures. Therefore, it is important to develop two-photon initiator with good water-solubility, initiation efficiency, and biocompatibility. Here, we share our insights into the development of a water-soluble two-photon initiator (WTPI) and applications from the material and manufacturing perspective. We highlight the nonlinear optical properties and the synthesis of WTPI through three pathways. Then we further demonstrate the applications of the TPP technique in the aqueous phase in the fields of tissue engineering, 4D printing, and ceramic manufacturing. Finally, a general conclusion and outlook are provided for the future development and application of WTPI.

Direct Precursor Route for the Fabrication of LLZO Composite Cathodes for Solid-State Batteries.

Solid-state batteries based on Li7La3Zr2O12 (LLZO) garnet electrolyte are a robust and safe alternative to conventional lithium-ion batteries. However, the large-scale implementation of ceramic composite cathodes is still challenging due to a complex multistep manufacturing process. A new one-step route for the direct synthesis of LLZO during the manufacturing of LLZO/LiCoO2 (LCO) composite cathodes based on cheap precursors and utilizing the industrially established tape casting process is presented. It is shown that Al, Ta:LLZO can be formed directly in the presence of LCO from metal oxide precursors (LiOH, La2O3, ZrO2, Al2O3, and Ta2O5) by heating to 1050 °C, eliminating the time- and energy-consuming synthesis of preformed LLZO powders. In addition, performance-optimized gradient microstructures can be produced by sequential casting of slurries with different compositions, resulting in dense and flat phase-pure cathodes without unwanted ion interdiffusion or secondary phase formation. Freestanding cathodes with a thickness of 85 µm, a relative density of 95%, and an industrial relevant LCO loading of 15 mg show an initial capacity of 82 mAh g-1 (63% of the theoretical capacity of LCO) in a solid-state cell with Li metal anodes, which is comparable to conventional LCO/LLZO cathodes and can be further improved in the future.

Effect of artificial aging on fracture toughness and hardness of 3D-printed and milled 3Y-TZP zirconia.

PURPOSE: This study aimed to evaluate the impact of artificial aging on the fracture toughness and hardness of three-dimensional (3D)-printed and computer-aided design and computer-aided manufacturing (CAD-CAM) milled 3 mol% yttria-stabilized tetragonal zirconia polycrystals (3Y-TZP). MATERIALS AND METHODS: Forty bar-shaped specimens (45 × 4 × 3 mm) were prepared using two manufacturing technologies: 3D printing (LithaCon 3Y 210, Lithoz GmbH, Vienna, Austria; n = 20) and milling (Initial Zirconia ST, GC, Japan; n = 20) of 3Y-TZP. The chevron-notch beam method was used to assess the fracture toughness according to ISO 24370. Specimens from each 3Y-TZP group were divided into two subgroups (n = 10) based on the artificial aging process (autoclaving): nonaged and aged. Nonaged specimens were stored at room temperature, while aged specimens underwent autoclave aging at 134°C under 2 bar-pressure for 5 h. Subsequently, the specimens were immersed in absolute 99% ethanol using an ultrasonic cleaner for 5 min. Each specimen was preloaded by subjecting it to a 4-point loading test, with a force of up to 200 N applied for three cycles. Further 4-point loading was conducted at a rate of 0.5 mm/min under controlled temperature and humidity conditions until fracture occurred. The maximum force (Fmax) was recorded and the chevron notch was examined at 30 × magnification under an optical microscope for measurements before the fracture toughness (KIc) was calculated. Microhardness testing was also performed to measure the Vickers hardness number (VHN). A scanning electron microscope (SEM) coupled with an energy dispersive X-ray unit (EDX) was used to examine surface topography and chemical composition. X-ray diffraction (XRD) was conducted to identify crystalline structure. Data were statistically analyzed using two-way ANOVA and Student's t-test with a significance level of 0.05. RESULTS: The nonaged 3D-printed 3Y-TZP group exhibited a significantly higher fracture toughness value (6.07 MPa m1/2) than the milled 3Y-TZP groups (p < 0.001). After autoclave aging, the 3D-printed 3Y-TZP group maintained significantly higher fracture toughness (p < 0.001) compared to the milled 3Y-TZP group. However, no significant differences in hardness values (p = 0.096) were observed between the aged and nonaged groups within each manufacturing process (3D-printed and milled) independently. CONCLUSION: The findings revealed that the new 3D-printed 3Y-TZP produced by the lithography-based ceramic manufacturing (LCM) technology exhibited superior fracture toughness after autoclave aging compared to the milled 3Y-TZP. While no significant differences in hardness were observed between the aged groups, the 3D-printed material demonstrated greater resistance to fracture, indicating enhanced mechanical stability.

Effect of carbamide peroxide treatment on the ion release of different dental restorative materials.

BACKGROUND: To predict the long-term performance of restorative materials in the oral environment, it is important to evaluate their resistance to chemical and mechanical degradation and to know the toxic potential of the type and amount of ions eluted from the filling material. In this study, home bleaching was applied to dental materials with different contents and it was aimed to determine the type and amount of ions released from these materials. METHODS: In this study, amalgam, posterior composite resin, anterior composite resin, bulk fill composite resin, indirect composite resin, hybrid ceramic and all-ceramic were used as restorative materials. 10 specimens of each material were prepared according to the manufacturer's instructions. Each material group was divided into two subgroups as the bleached group and the control group. After bleaching, all specimens were stored in 1 ml of 75% ethanol/water solution. Solutions were renewed after 1, 14 and 28 days. The type and amount of ions released from the materials were determined using Inductively Coupled Plasma-Mass Spectrometer (ICP-MS). Data were analyzed using the Friedman, Wilcoxon Signed Ranks, and Mann-Whitney U tests (α = 0.05). RESULTS: It was determined that the amount of ions release from the restorative materials decreased over time (p < 0.05). According to the results of the Mann-Whitney U test, there was no difference between the bleaching and control groups in most of the restorative materials (p > 0.05). CONCLUSION: Within the limits of this study, home bleaching system does not have a significant effect on ion release from restorative materials.

Three-Dimensionally Printed Biphasic Calcium Phosphate Ceramic Substrates as the Sole Inducer of Osteogenic Differentiation in Stromal Vascular Fraction Cells.

The stromal vascular fraction (SVF) is a derivate of fat tissue comprising both adipose-derived mesenchymal stem cells and endothelial cells and serves as a promising cell source for engineering vascularized bone tissues. Its combination with osteoconductive biphasic calcium phosphate (BCP) ceramic may represent a point-of-care agent for bone reconstruction. Here we assessed the proliferation and osteogenic differentiation capacities of SVF on 3D printed BCP implants, in comparison with isolated adipose-derived mesenchymal stem cells (AD-MSCs). AD-MSCs and SVF isolated from human donors were seeded on plastic or 3D printed BCP ceramics with sinusoidal or gyroid macrotopography and cultured in the presence or absence of osteogenic factors. Vascular, hematopoietic and MSC surface markers were assessed by flow cytometry whereas osteogenic activity was investigated through alizarin red staining and alkaline phosphatase activity. Osteogenic factors were necessary to trigger osteogenic activity when cells were cultured on plastic, without significant difference observed between the two cell populations. Interestingly, osteogenic activity was observed on BCP implants in the absence of differentiation factors, without significant difference in level activity between the two cell populations and macrotopography. This study offers supportive data for the use of combined BCP scaffolds with SVF in a perspective of a one-step surgical procedure for bone regeneration.

Enhancing the Opacity of Glass Ceramics by Applying Opaque Stains to the Intaglio Surface.

OBJECTIVE: The aim of this study was to assess the effect of opaque stain application to the intaglio surface of lithium disilicate glass ceramics on the masking ability of discolored substrates and bond strength to a resin-based luting agent (depending on etching time); the stain film-thickness was also assessed. MATERIALS AND METHODS: Ceramic specimens were produced with CAD-CAM blocks of lithium disilicate (IPS e.max CAD). Two opaque stains were tested at ceramic intaglio surface: opaque glassy stain for titanium frameworks (OP-ti) and low-fusion glassy stain for ceramic characterization (LFG-iv). Non-stained ceramic specimens served as controls. For optical and colorimetric analyses, A2-shaded ceramics of medium and low-translucencies were tested, in thicknesses of 1.0- and 1.5-mm (n = 10), with two coupling agents (non-shaded-glycerin and A2-shaded try-in paste). CIEDE2000 formula was used for calculation of translucency parameter (TP00) and color differences (ΔE00). Whiteness index for dentistry (WID) was also reported. ΔE00 were assessed over discolored substrates (tooth-shaded A2-reference, A4, C3, and C4; coppery metal, silvery metal, white zirconia, and PEEK). Microshear bond strength of stained and non-stained ceramic specimens to a resin-based luting agent was evaluated. Film-thickness of stains was assessed by scanning electron microscopy. RESULTS: The application of opaque stains to the intaglio surface of lithium disilicate ceramics resulted in significant reduction of TP00 (p < 0.001) and WID (p < 0.001) and differences in L*, C*, and ho color coordinates (especially with OP-ti) (p < 0.001). ΔE00 was significantly reduced in stained ceramic groups in comparison with the control, for all discolored substrates (p < 0.001). Acceptable color matching was obtained with stained ceramic specimens for all discolored substrates, depending on the type of stain, ceramic thickness, ceramic translucency, and coupling agent. The application of stains to the ceramic intaglio surface was not detrimental to bond strength to a resin-based luting agent, but depended on the time of hydrofluoric acid-etching (20 s for OP-ti and 60 s for LFG-iv) (p < 0.001). Film-thickness of stains presented mean values <70 µm. CONCLUSION: The application of opaque stains to the intaglio surface of lithium disilicate glass ceramics was effective to mask severely discolored substrates, presenting adequate bond strength to the luting agent and thin film-thicknesses. CLINICAL SIGNIFICANCE: For indirect restorations over severely discolored substrates, the application of opaque stain to the intaglio surface of lithium disilicate glass ceramic ensures acceptable color matching, with adequate bond strength to resin-based luting agents and clinically acceptable stain film-thickness.