Biodegradable electrospun poly(L-lactide-co-ε-caprolactone)/polyethylene glycol/bioactive glass composite scaffold for bone tissue engineering.

The field of tissue engineering has witnessed significant advancements in recent years, driven by the pursuit of innovative solutions to address the challenges of bone regeneration. In this study, we developed an electrospun composite scaffold for bone tissue engineering. The composite scaffold is made of a blend of poly(L-lactide-co-ε-caprolactone) (PLCL) and polyethylene glycol (PEG), with the incorporation of calcined and lyophilized silicate-chlorinated bioactive glass (BG) particles. Our investigation involved a comprehensive characterization of the scaffold's physical, chemical, and mechanical properties, alongside an evaluation of its biological efficacy employing alveolar bone-derived mesenchymal stem cells. The incorporation of PEG and BG resulted in elevated swelling ratios, consequently enhancing hydrophilicity. Thermal gravimetric analysis confirmed the efficient incorporation of BG, with the scaffolds demonstrating thermal stability up to 250°C. Mechanical testing revealed enhanced tensile strength and Young's modulus in the presence of BG; however, the elongation at break decreased. Cell viability assays demonstrated improved cytocompatibility, especially in the PLCL/PEG+BG group. Alizarin red staining indicated enhanced osteoinductive potential, and fluorescence analysis confirmed increased cell adhesion in the PLCL/PEG+BG group. Our findings suggest that the PLCL/PEG/BG composite scaffold holds promise as an advanced biomaterial for bone tissue engineering.

Stepwise stress testing of different CAD-CAM lithium disilicate veneer application methods applied to lithium disilicate substructures.

STATEMENT OF PROBLEM: Whether a computer-aided design and computer-aided manufacture (CAD-CAM) fabricated high-translucency lithium disilicate veneer on a lithium disilicate substructure would increase the strength of the restoration compared with a traditional feldspathic porcelain veneer is unclear. PURPOSE: The purpose of this in vitro study was to evaluate the effect of different lithium disilicate veneer application methods on a lithium disilicate substructure on their biaxial flexural stress (BFS). MATERIAL AND METHODS: Lithium disilicate disks were fabricated so that when combined with the veneering disks, they had a dimension of 12×1.2 mm. Experimental groups were as follows (n=15): resin-bonded lithium disilicate veneer, lithium disilicate veneer adhesively cemented to lithium disilicate; sintered lithium disilicate veneer, lithium disilicate veneer sintered to lithium disilicate; sintered feldspathic veneer, feldspathic porcelain applied to lithium disilicate; and monolithic lithium disilicate, the control group. Weibull distribution survival analysis was used to compare the differences in the resistance to fracture after fatigue. The total number of cycles was analyzed by using 1-way ANOVA (α=.05). A finite element analysis (FEA) was also performed. The maximum principal stress (MPS) was used as the failure criterion. RESULTS: The sintered feldspathic veneer group had significantly lower fatigue resistance than sintered lithium disilicate veneer or resin-bonded lithium disilicate veneer (P<.05). The resin-bonded lithium disilicate veneer group showed significantly more fractured fragments than the other groups. No statistical difference was observed in the number of cycles. The lithium disilicate veneered groups presented similar resistance to fatigue as the monolithic specimens of the same overall dimensions. Higher peaks of MPS were observed for groups monolithic lithium disilicate, sintered lithium disilicate veneer, and sintered feldspathic veneer than for resin-bonded lithium disilicate veneer. CONCLUSIONS: Veneering a lithium disilicate substructure with a lithium disilicate veneer, bonded or sintered, increased resistance to fatigue compared with a feldspathic porcelain veneer. The lithium disilicate veneer groups had similar fatigue resistance to that of the monolithic group.

The role of nanohydroxyapatite on the morphological, physical, and biological properties of chitosan nanofibers.

OBJECTIVES: This study aimed to evaluate the effects of nanohydroxyapatite (nHAp) particles on the morphological, chemical, physical, and biological properties of chitosan electrospun nanofibers. MATERIALS AND METHODS: nHAp particles with a 1.67 Ca/P ratio were synthesized via the aqueous precipitation method, incorporated into chitosan polymer solution (0.5 wt%), and electrospun into nHAp-loaded fibers (ChHa fibers). Neat chitosan fibers (nHAp-free, Ch fibers) were used as the control. The electrospun fiber mats were characterized using morphological, topographical, chemical, thermal, and a range of biological (antibacterial, antibiofilm, cell viability, and alkaline phosphatase [ALP] activity) analyses. Data were analyzed using ANOVA and Tukey's test (α = 0.05). RESULTS: ChHa fibers demonstrated a bead-like morphology, with thinner (331 ± 110 nm) and smoother (Ra = 2.9 ± 0.3 µm) distribution as compared to the control fibers. Despite showing similar cell viability and ALP activity to Ch fibers, the ChHa fibers demonstrated greater antibacterial potential against most tested bacteria (except for P. intermedia), and higher antibiofilm activity against P. gingivalis biofilm. CONCLUSIONS: The incorporation of nHAp particles did not jeopardize the overall morphology, topography, physical, and biological characteristics of the chitosan nanofibers. CLINICAL RELEVANCE: The combination of nHAp particles with chitosan can be used to engineer bioactive, electrospun composite nanofibers with potential applications in regenerative dentistry.

The role of polymeric nanofibers on the mechanical behavior of polymethyl methacrylate resin.

This study aimed to synthesize and characterize non-woven acrylonitrile butadiene styrene (ABS), polyamide-6 (P6), and polystyrene (PS) nanofibers, and evaluate their effects on the flexural strength and fracture resistance of fiber-modified polymethyl methacrylate (PMMA) resin. ABS, P6, and PS polymer solutions were prepared and electrospun into fiber mats, which were characterized by means of morphological, chemical, physical, and mechanical analyses. The fiber mats were then used to modify a thermally-activated PMMA resin, resulting in four testing groups: one unmodified group (control) and three fiber-modified groups incorporated with ABS, P6, or PS fiber mats. Flexural strength, work of fracture, and fractographic analysis were performed for all groups. Data were analyzed using Kruskal-Wallis or ANOVA tests (α = 0.05). The fiber diameter decreased, respectively, as follows: ABS > P6 > PS. Only the P6 fiber mats demonstrated a crystalline structure. Wettability was similar among the distinct fiber mats, although tensile strength was significantly greater for P6, followed by ABS, and then PS mats. Flexural strength of the fiber-modified PMMA resins was similar to the control, except for the weaker P6-based material. The work of fracture seemed to be greater and lower when the P6 and PS fibers were used, respectively. The fiber-modified groups exhibited a rougher pattern in the fractured surfaces when compared to the control, which may suggest that the presence of fibers deviates the direction of crack propagation, making the fracture mechanism of the PMMA resin more dynamic. While the neat PMMA showed a typical brittle response, the fiber-modified PMMA resins demonstrated a ductile response, combined with voids, suggesting large shear deformation during fracture. Altogether, despite the lack of direct reinforcement in the mechanical strength of the PMMA resin, the use of electrospun fibers showed promising application for the improvement of fracture behavior of PMMA resins, turning them into more compliant materials, although this effect may depend on the fiber composition.

Survival Probability, Weibull Characteristics, Stress Distribution, and Fractographic Analysis of Polymer-Infiltrated Ceramic Network Restorations Cemented on a Chairside Titanium Base: An In Vitro and In Silico Study.

Different techniques are available to manufacture polymer-infiltrated ceramic restorations cemented on a chairside titanium base. To compare the influence of these techniques in the mechanical response, 75 implant-supported crowns were divided in three groups: CME (crown cemented on a mesostructure), a two-piece prosthetic solution consisting of a crown and hybrid abutment; MC (monolithic crown), a one-piece prosthetic solution consisting of a crown; and MP (monolithic crown with perforation), a one-piece prosthetic solution consisting of a crown with a screw access hole. All specimens were stepwise fatigued (50 N in each 20,000 cycles until 1200 N and 350,000 cycles). The failed crowns were inspected under scanning electron microscopy. The finite element method was applied to analyze mechanical behavior under 300 N axial load. Log-Rank (p = 0.17) and Wilcoxon (p = 0.11) tests revealed similar survival probability at 300 and 900 N. Higher stress concentration was observed in the crowns' emergence profiles. The MP and CME techniques showed similar survival and can be applied to manufacture an implant-supported crown. In all groups, the stress concentration associated with fractographic analysis suggests that the region of the emergence profile should always be evaluated due to the high prevalence of failures in this area.

Mechanical performance of monolithic materials cemented to a dentin-like substrate.

STATEMENT OF PROBLEM: Studies on the mechanical behavior of restorative materials bonded to tooth structure and considering the properties of the material and the bonding between both substrates are lacking. PURPOSE: The purpose of this in vitro study was to evaluate the hardness, fracture toughness, load-to-failure, cyclic fatigue, and stress distribution of 4 computer-aided design and computer-aided manufacturing (CAD-CAM) materials when bonded to a substrate similar to dentin (G10). MATERIAL AND METHODS: Disks (11×1.2 mm) of lithium disilicate (LD), feldspathic ceramic (FC), polymer-infiltrated ceramic (PC), and a nanohybrid composite resin (NC) were fabricated (n=45) and had their surfaces polished. Microhardness was measured by the Knoop indentation (19.61 N, 12 seconds, n=5). Indented specimens were subjected to biaxial flexural strength testing, and the fracture origin defect was measured to calculate fracture toughness (n=5). Forty disks from each material were adhesively bonded to G10. Half of the specimens were subjected to load-to-failure testing, and remaining specimens (n=20) were subjected to cyclic fatigue (400 N, 106 cycles). The test was suspended every 200 000 cycles, and specimens were examined for cracks, debonding, or catastrophic failure. Obtained data were evaluated by analysis of variance and the Tukey post hoc test (α=.05). Weibull analysis was also performed. A 3D model of the tested specimens was constructed in a design software program, and the stress distribution was evaluated by finite element analysis, with the application of a 100-N load normal to the restoration surface. RESULTS: Hardness values with statistically significant differences were LD (540.4)>FC (474.6)>PC (176.6)>NC (58.26). Fracture toughness vales (MPa.m1/2) and statistical significance were as follows: LD (2.25)=NC (2.46)>FC (1.14)=PC (1.18). Load-to-failure values (N) were LD (2881.6)=FC (2881.6)=PC (3200.6)>NC (2367.5). A specimen each of LD and NC fractured during the fatigue test, and LD and PC had a high percentage of subsurface cracks (55% and 75%, respectively). The FC had the lowest debonding rate after load-to-failure testing and no catastrophic fractures or cracks during fatigue. CONCLUSIONS: The materials tested had different mechanical behaviors depending on the tests performed. Feldspathic ceramic had the best fatigue behavior when cemented to a dentin-like substrate.

Short communication: Influence of retainer configuration and loading direction on the stress distribution of lithium disilicate resin-bonded fixed dental prostheses: 3D finite element analysis.

The present study elucidates the mechanical performance of different designs of resin-bonded fixed dental prostheses made of lithium disilicate simulating masticatory loads of anterior or canine guidance. A three-dimensional model of maxilla was constructed containing central incisor and canine teeth, with edentulous space of the lateral incisor. Three designs of prosthesis were created: retained in central incisor (1-I), retained in canine (1-C) and fixed in both teeth (2-IC). The computational analysis was performed for load in canine and central incisor separately (100N, 45°). The tensile and shear stresses were calculated for the resin-bonded fixed dental prosthesis, bonding surface of each retainer and cement layer using 3D finite element analysis. The 20 highest stress values were analyzed using two-way ANOVA and post-hoc Tukey test, all with α = 5%. The computational analysis showed that 2-retainer resin-bonded fixed dental prosthesis presented the worst prognosis regardless of the mandibular movement. ANOVA showed that Mandibular movement*Retainer interaction influenced on the tensile and shear stresses values (p < 0.01). Higher stresses were observed in the connector region for all groups (13-82.2 MPa; 11-70.2 MPa). In order to reduce the stress concentration in the resin-bonded fixed dental prosthesis and the retainer made of lithium disilicate, the occlusion may serve as the selection criteria of the unitary abutment for better sustainability.

Influence of resin cement rigidity on the stress distribution of resin-bonded fixed partial dentures.

The mechanical properties of the adhesive cement used in resin-bonded fixed partial dentures (RBFPD) can modify the clinical performance of the rehabilitation. The goal of this study was to evaluate the influence of the elastic modulus of different cements on the stress distribution in RBFPD using finite element analysis. For that an anterior 3-unit prosthesis was modeled based in a stereolithography file. The model was meshed with tetrahedral elements and materials considered isotropic, linearly elastic and homogeneous. The force applied to the palatal area of the lateral incisor (pontic) at 45° was 100 N. The cements used presented 7 different elastic modulus (E): 2, 6, 10, 14, 18, 22 or 26 GPa. The total deformation, von-Mises stress and maximum principal stress criteria were used to calculate the results. The lower tensile stress occurred in the cement layer with E = 2 GPa [25.6 (canine) and 16.32 MPa (incisor)]. For the prosthesis, the model with the lower tensile stress [287 (canine) and 248 MPa (incisor)] occurred when the cement presented E = 26 GPa. In this way, the stress concentration may have its magnitude modified depending on the stiffness of the cement. Since more flexible cements concentrate less tensile stress in its structure, but allow an increased displacement of the prosthesis, which is friable and rigid and ends up concentrating more tensile stress at its connector. In that way the clinician should avoid the use of adhesive cement with lower elastic modulus due to it increases the stress concentration in the ceramic.

Short communication: Influence of restorative material and cement on the stress distribution of posterior resin-bonded fixed dental prostheses: 3D finite element analysis.

The goal of this study was to compare the mechanical response of resin-bonded fixed dental prosthesis (RBFDP) made in zirconia, metal, lithium disilicate and composite resin cemented using resin cements with different elastic modulus. For the finite element analysis, a three-dimensional model of partial right maxilla was used to create a model with edentulous space in the second premolar and the cavity's preparation on the first pre-molar and first molar to receive a RBFDP. The model was imported to the analysis software in which they were divided into mesh composed by nodes (371,101) and tetrahedral elements (213,673). Each material was considered isotropic, elastic and homogeneous. No-separation contacts were considered between restoration/resin cement and resin cement/tooth. For all other structures the contacts were considered ideal. The model fixation occurred at the base of the bone and an axial load of 300 N was applied on the pontic occlusal surface. To simulate polymerization shrinkage effects on the cement, the thermal expansion approach was used. The displacement and maximum principal stress (in MPa) were selected as failure criteria. The prosthesis made in composite resin showed higher displacement, while in zirconia showed higher stress concentration. Tensile stress between restoration/cement, cement and cement/cavity was directly proportional to the restorative material's elastic modulus. The more rigid cement increases the tensile zones in the cement layer but decreases the stress between prosthesis and cement. The molar cavity showed higher stress concentration between restoration/cement than the preparation in the pre-molar tooth. The use of composite resin for the manufacturing of RBFDP increases the displacement of the set during the loading. However, it reduces the amount of stress concentration at the adhesive interface in comparison with the other materials.

Can Cleansing Regimens Effectively Eliminate Saliva Contamination from Lithium Disilicate Ceramic Surface?

This study evaluated the effect of cleaning protocols on the bond strength of resin cement to glass-ceramic. Ceramic specimens (N=120, n=12 per group) were etched with hydrofluoric acid and rinsed with water. After saliva contamination, specimens were cleaned as follows: water, 37% H3PO4, cleaning-paste (Ivoclean), or isopropanol. Non-contaminated specimens acted as the control. Resin cement was bonded to the specimens, and tested either after 24 h or x5000 thermocycling. Both the cleaning method (p=0.001) and the storage conditions (p=0.005) significantly affected the bond strength results. In dry conditions, the groups PA and IV showed no significant difference, being also similar to the non-saliva contaminated control group (p⟩0.05). In dry conditions, no significant difference was observed between the mean DW and IS being significantly lower than those of other groups (p⟨0.05). Except for the group IV, thermocycling decreased the results significantly in all groups (p⟨0.05). Predominantly mixed failure type was observed in both dry and aged conditions. SEM micrographs of ceramic surfaces after cleaning agents showed no major differences but on the specimens from the IV group, small, rounded-zirconia particles were observed. In case of saliva contamination of acid-etched glass-ceramics, mechanical cleaning can restore adhesion to the baseline situation.

Effect of random/aligned nylon-6/MWCNT fibers on dental resin composite reinforcement.

The aims of this study were (1) to synthesize and characterize random and aligned nanocomposite fibers of multi-walled carbon nanotubes (MWCNT)/nylon-6 and (2) to determine their reinforcing effects on the flexural strength of a dental resin composite. Nylon-6 was dissolved in hexafluoropropanol (10 wt%), followed by the addition of MWCNT (hereafter referred to as nanotubes) at two distinct concentrations (i.e., 0.5 or 1.5 wt%). Neat nylon-6 fibers (without nanotubes) were also prepared. The solutions were electrospun using parameters under low- (120 rpm) or high-speed (6000 rpm) mandrel rotation to collect random and aligned fibers, respectively. The processed fiber mats were characterized by scanning (SEM) and transmission (TEM) electron microscopies, as well as by uni-axial tensile testing. To determine the reinforcing effects on the flexural strength of a dental resin composite, bar-shaped (20×2×2 mm(3)) resin composite specimens were prepared by first placing one increment of the composite, followed by one strip of the mat, and one last increment of composite. Non-reinforced composite specimens were used as the control. The specimens were then evaluated using flexural strength testing. SEM was done on the fractured surfaces. The data were analyzed using ANOVA and the Tukey׳s test (α=5%). Nanotubes were successfully incorporated into the nylon-6 fibers. Aligned and random fibers were obtained using high- and low-speed electrospinning, respectively, where the former were significantly (p<0.001) stronger than the latter, regardless of the nanotubes׳ presence. Indeed, the dental resin composite tested was significantly reinforced when combined with nylon-6 fibrous mats composed of aligned fibers (with or without nanotubes) or random fibers incorporated with nanotubes at 0.5 wt%.

Color stability of composites: effect of immersion media.

Coloring in drinks decreases the color stability of composite restorations, reducing their longevity. The purpose of this in vitro study was to evaluate the effect of immersion media on color stability of seven different composite resins (Solidex - Shofu, Resilab-Wilcos, Signum - Heraeus, Epricord - Tokuyama, Adoro - Ivoclar Vivadent, Admira - Voco and Sinfony - 3MESPE). Seven resin-based composite specimens were prepared using a cylindrical teflon mold 2 mm thick and 10 mm in diameter Fifteen specimens of each resin were light-cured according to manufacturers' instructions and randomized into 3 groups (n= 5) according to immersion media: coffee, cola beverage and water A digital spectrophotometer Easy Shade (VITA) was used to evaluate the color changes at baseline and 7 days after immersion in each solution. Specimens were stored in the different staining media for 24 h/day during one week. The color differences were analyzed by two-way ANOVA and Tukey 's test (p< 0.05). Color change was observed after one week of immersion and there were statistical differences in staining, composite and interaction factors. The least staining was observed in Admira (deltaE= 3.934+/-0.814) and Resilab (deltaE= 3.993+/-0.735), followed by Adoro (deltaE= 4.044+/-1.001), Epri-cord (deltaE= 4.049+/-1.234), Signum (deltaE= 4.260+/-1.785), Solidex (deltaE=5,122+/-0.534) and Sinfony (deltaE=5.126+/-0.838). All of the composites tested except Adoro were susceptible to staining by substances present in coffee and cola, when stored in beverage for seven days. The lowest deltaE means were obtained with Admira.