The role of extracellular vesicles in periodontitis: pathogenesis, diagnosis, and therapy.

Periodontitis is a prevalent disease and one of the leading causes of tooth loss. Biofilms are initiating factor of periodontitis, which can destroy periodontal tissue by producing virulence factors. The overactivated host immune response is the primary cause of periodontitis. The clinical examination of periodontal tissues and the patient's medical history are the mainstays of periodontitis diagnosis. However, there is a lack of molecular biomarkers that can be used to identify and predict periodontitis activity precisely. Non-surgical and surgical treatments are currently available for periodontitis, although both have drawbacks. In clinical practice, achieving the ideal therapeutic effect remains a challenge. Studies have revealed that bacteria produce extracellular vesicles (EVs) to export virulence proteins to host cells. Meanwhile, periodontal tissue cells and immune cells produce EVs that have pro- or anti-inflammatory effects. Accordingly, EVs play a critical role in the pathogenesis of periodontitis. Recent studies have also presented that the content and composition of EVs in saliva and gingival crevicular fluid (GCF) can serve as possible periodontitis diagnostic indicators. In addition, studies have indicated that stem cell EVs may encourage periodontal regeneration. In this article, we mainly review the role of EVs in the pathogenesis of periodontitis and discuss their diagnostic and therapeutic potential.

Nanostructure Mediated Piezoelectric Effect of Tetragonal BaTiO3 Coatings on Bone Mesenchymal Stem Cell Shape and Osteogenic Differentiation.

In recent years, porous titanium (Ti) scaffolds with BaTiO3 coatings have been designed to promote bone regeneration. However, the phase transitions of BaTiO3 have been understudied, and their coatings have yielded low effective piezoelectric coefficients (EPCs < 1 pm/V). In addition, piezoelectric nanomaterials bring many advantages in eliciting cell-specific responses. However, no study has attempted to design a nanostructured BaTiO3 coating with high EPCs. Herein, nanoparticulate tetragonal phase BaTiO3 coatings with cube-like nanoparticles but different effective piezoelectric coefficients were fabricated via anodization combining two hydrothermal processes. The effects of nanostructure-mediated piezoelectricity on the spreading, proliferation, and osteogenic differentiation of human jaw bone marrow mesenchymal stem cells (hJBMSCs) were explored. We found that the nanostructured tetragonal BaTiO3 coatings exhibited good biocompatibility and an EPC-dependent inhibitory effect on hJBMSC proliferation. The nanostructured tetragonal BaTiO3 coatings of relatively smaller EPCs (<10 pm/V) exhibited hJBMSC elongation and reorientation, broad lamellipodia extension, strong intercellular connection and osteogenic differentiation enhancement. Overall, the improved hJBMSC characteristics make the nanostructured tetragonal BaTiO3 coatings promising for application on implant surfaces to promote osseointegration.

In vivo evaluation of the reliability and validity of three digital occlusion analysis methods.

OBJECTIVES: The reliability and validity of three digital occlusion analysis methods was evaluated in vivo. METHODS: The three method evalueated were:scanning of articulating paper marks (SA), dental prescale occlusal analysis system (DP) and a virtual occlusion constructed method (VO). A conventional silicone transmission method (ST) was used as the standard for comparison. Each of the 20 enroled human subjects was tested with the four methods. Retest of each method was performed at 2-week intervals. Occlusal contact area (OCA) and occlusal contact numbers (OCN) were calculated for analyses. For reliability evaluation, intraclass correlation coefficients (ICC) of the OCA and OCN values obtained from each method were compared. For validity evaluation, Pearson correlations coefficients, paired t-tests, regression analysis and Bland-Altman analysis were examined. RESULTS: The ICC values of OCA and OCN were in the order: ST>SA>DP>VO. The highest OCA and OCN values were found ST while the lowest values were obtained from DP. Paired t-test identified a significant difference when OCA values obtained from the three digital methods were compared with ST, and between the OCN values of DP and ST. Pearson correlation showed high coefficients between ST and three digital methods (0.583-0.885 for OCA; 0.779-0.836 for OCN). A significant linear correlation was found between the results from ST and those from SA or VO. Bland-Altman analysis showed good agreement between OCN values of SA and ST, and between those of VO and ST. CONCLUSIONS: The three digital occlusal analysis methods showed good reliability and validity for in vivo clinical application. CLINICAL SIGNIFICANCE: The three digital occlusion analysis systems examined demonstrate good potential in in vivo quantitative analysis, with good reliability and validity. The use of these analytical methods should facilitate digital workflow in clinical practice.

Laminin 332-functionalized coating to regulate the behavior of keratinocytes and gingival mesenchymal stem cells to enhance implant soft tissue sealing.

Peri-implant epithelial sealing is the first line of defense against external pathogens or stimuli; hence, an essential process to prevent peri-implantitis. Laminin 332 (LN332) is the main component of the internal basal lamina and participates in peri-implant epithelial sealing by forming hemidesmosomes (HDs) with integrin α6ß4. In this work, poly (D, L-lactide) (PDLLA)-LN332 composite coating was successfully constructed by a method similar to layer-by-layer assembly, displaying staged LN332 release for as long as 28 days. The PDLLA-LN332 composite coating can activate the intracellular PI3K-Akt pathway via binding to cellular integrin α6ß4, which can promote adhesion, migration and proliferation of HaCaT cells and further enhance the expression of keratinocyte HD-related molecules, including integrin α6ß4, LN332 and plectin. Furthermore, the PDLLA-LN332 composite coating can promote the adhesion, spreading and proliferation of gingival mesenchymal stem cells and accelerate their epithelial differentiation. Therefore, the PDLLA-LN332 composite coating can enhance implant soft tissue sealing, warranting further in vivo study.

Polyetheretherketone versus titanium CAD-CAM framework for implant-supported fixed complete dentures: a retrospective study with up to 5-year follow-up.

PURPOSE: To evaluate the performance of polyetheretherketone (PEEK) versus titanium computer-aided designed and manufactured (CAD-CAM) framework for implant-supported fixed complete dentures (ISFCDs) with a follow-up for a duration of up to 5 years. METHODS: Consecutively edentulous patients who underwent ISFCDs with a PEEK framework or titanium framework at one dental specialist center were included in this retrospective study. Implant/prosthesis survival rates, mechanical/biological complications, and bone and soft tissue parameters were analyzed. Overall survival was analyzed using Kaplan-Meier survival curves and the log-rank test. RESULTS: Sixty ISFCDs (29 PEEK, 31 titanium) performed on 43 edentulous patients (331 implants) were included. An implant survival rate of 100% was obtained. There was no significant difference in the cumulative prosthesis survival rate between the PEEK (93.1%) and titanium groups (93.5%). The most common mechanical complications were fracture of the artificial veneer in both the PEEK (13.8%) and titanium (16.7%) groups. Bruxers had a higher prevalence of mechanical complications than non-bruxers (p<0.05). The biological complications included bleeding upon probing (13.8% for the PEEK group; 16.1% for the titanium group), soft tissue inflammation (3.4% for the PEEK group; 3.2% for the titanium group), and temporomandibular disorders (6.5% for the titanium group). The vertical bone loss was significantly lower in the PEEK group (0.70 mm) than in the titanium group (0.96 mm). Smokers had a significantly higher prevalence of biological complications than non-smokers. CONCLUSION: Within the limitations of this study, ISFCDs with PEEK frameworks can provide good prognosis for edentulous patients, still requiring longer-term validation.

Use of a digitally guided triple technique for bone reduction, implant placement, and immediate interim prostheses in complete-arch implant surgery.

A digitally guided triple technique for bone reduction, implant placement, and immediate interim prostheses in complete-arch implant surgery is presented. This technique integrates bone reduction and implant placement information into a dual-function surgical template and introduces a digital approach to fabricating immediate interim implant-supported fixed dental prostheses with the same occlusal relationship as the one evaluated with diagnostic removable prostheses.

Antibacterial Peptide HHC-36 Sustained-Release Coating Promotes Antibacterial Property of Percutaneous Implant.

Percutaneous implants are widely used in clinical practice. However, infection is the main clinical problem of percutaneous implants. Titanium dioxide nanotubes are suitable for forming coatings on complex surfaces such as implants. HHC-36, a cationic antimicrobial peptide, has been identified to have a strong broad-spectrum antibacterial effect. In the present study, we use poly D,L-lactic acid (PDLLA) and poly lactic-co-glycolic acid (PLGA) coating to build HHC-36 sustained-release system on the surface of titanium dioxide nanotubes. The titanium specimens were anodized coated with HHC-36-PDLLA/PLGA. The morphology and surface elemental distribution of the specimens were evaluated. Besides, results in the present study demonstrated that with antibacterial peptide HHC-36 sustained-release coating, titanium dioxide nanotubes maintain effective drug release for 15 days in vitro, and show significant antibacterial activity. The proliferation of Staphylococcus aureus can be effectively inhibited by PDLLA/PLGA-HHC-36 coated titanium dioxide nanotube. In addition, PDLLA-HHC-36 and PLGA-HHC-36 coating was demonstrated to be biocompatible and antibacterial in vivo. These findings demonstrated that HHC-36 coated titanium nanotube could improve antibacterial potential of percutaneous implants, and indicated a novel and efficient strategy in preventing bacterial infection of percutaneous implants.

Mandibular residual ridge morphology in relation to complete dentures and implant overdentures-Part I: Predictors for perceived conventional denture stability.

BACKGROUND: There is lack of reliable predictors for success of conventional complete denture (CCD) therapy, which in turn might affect the effectiveness of subsequent implant-retained overdenture (IOD) therapy. PURPOSE: To investigate relationships between digitally obtained geometrical mandibular residual ridge measures and perceived CCD-stability. MATERIALS AND METHODS: 30 CCD wearing patients (67.9 ± 7.0 years) for whom a new set of CCDs was advised, were treated with new CCDs. Digitalized mandibular gypsum models were measured using the Geomagic Studio 2013 software. Data were obtained for (1) height, width, and cross-section surface area of the residual ridge at different locations (midline, premolar, and anterior edge of retromolar pad) and (2) denture base surface area. Scatter plots and multivariate regression analyses were used to investigate associations between the geometric data and denture base surface area, and correlated with denture stability scores (Spearman rank test). RESULTS: Scatter plots showed that best model fit for denture base surface area was mean ridge height (R2 = 0.906). Multivariate regression showed that height at premolar location (p = 0.001) had largest effect on denture base surface area (R2 = 0.796). Ridge morphology variables, except width at midline location, were significantly correlated with CCD-stability (p-values <0.05). CCD-stability was significantly correlated with denture base surface area (p ≤ 0.001). CONCLUSION: Residual ridge height at premolar location was most predictive for denture base surface area and perceived CCD-stability.

Mandibular residual ridge morphology in relation to complete dentures and implant overdentures-Part II: Predictors for effectiveness of implant overdenture therapy.

BACKGROUND: The significance of mandibular residual ridge height and satisfaction with conventional complete dentures (CCD) as predictors for the added value of implant-overdenture (IOD) therapy is unknown. PURPOSE: To investigate the predictive value of thresholds for (1) residual ridge height at premolar location (PRH), and (2) satisfaction with CCD-stability for the added value of two intraforaminal implants supporting the mandibular CCD. METHODS: Thirty CCD wearing patients (67.9 ± 7.0 years) for whom a new CCD was advised, received a new CCD. Mandibular gypsum models were digitally measured. After 3 months free of complaints (T1), perceived CCD-stability was evaluated, and participants received two intraforaminal implants. At T1 and T2 (3 months free of complaints after IOD therapy) participants completed OHIP14-CN, and denture satisfaction (VAS) questionnaires, and performed mixing ability tests. Participants were grouped according to PRH of ≥6.15 mm versus < 6.15 mm, and perceived CCD-stability satisfied vs. dissatisfied. Scores at T2 were compared to T1 (paired t-tests). Predictive values of PRH and CCD-stability were analyzed with logistic multivariate regression models. RESULTS: At T2, only participants with PRH of <6.15 mm or dissatisfied with CCD-stability had significant lower OHIP-total and domain scores for 'physical pain' and 'physical disability' and significantly higher VAS scores for perceived chewing function, denture retention and oral comfort. Regression analyses showed that participants with PRH of <6.15 mm, or dissatisfied with CCD-stability had significantly higher chance for lower OHIP-total and domain scores 'physical pain' and 'physical disability', and for higher VAS scores for perceived chewing function, denture retention and oral comfort at T2. Masticatory performance improved significantly after IOD therapy, but independent of PRH and CCD-stability. CONCLUSION: PRH and satisfaction with CCD-stability were adequate prognostic indicators for improvement of oral health-related quality of life and denture satisfaction by mandibular IOD therapy.

Clinical outcomes of implant-retained mandibular overdentures using the bar and magnetic attachment systems: an up to 5-year retrospective study.

BACKGROUND: Implant-retained mandibular overdentures (IODs) represent an effective and reliable treatment modality for edentulous patients. The present retrospective study compared the clinical outcomes of IODs using bar attachment (BA) system with those using magnetic attachment (MA) system after functioning for up to 5 years. METHODS: Human subjects treated with IODs between 01-01-2010 and 12-31-2014 were identified from patient records. Of the 54 subjects who met the inclusion criteria, 48 subjects including 26 treated with BA-IODs and 22 with MA-IODs (96 mandibular implants) were recruited for the study. The implant units and prostheses were evaluated individually for peri-implant health. Prosthetic complications and maintenance during follow-up were recorded. The subjects responded to the visual analog scale (VAS) and the Oral Health Impact Profile questionnaires for evaluation of patient satisfaction and oral health-related quality of life (OHRQoL). RESULTS: The survival rates of the implants and prostheses were 96.9% and 95.8%, respectively, over a mean observation period of 48±11.3 (range, 13-64) months. Peri-implant probing depth (PPD) and plaque index (PI) were significantly better for the MA group compared with the BA group (P<0.05), while marginal bone loss (MBL) and sulcus bleeding index (SBI) showed no significant differences (P>0.05). Prosthetic complications and maintenance were attachment-dependent. Most recruited subjects were satisfied with their prostheses. There was no statistically significant difference regarding general patient satisfaction or OHRQoL between the two groups (P>0.05). Nevertheless, patients complained that the BA-IODs were significantly more difficult to clean than the MA-IODs (P<0.05). CONCLUSIONS: IODs have an ideal medium-term outcome irrespective of the attachment design. It is recommended that oral hygiene instructions and regular clinical examination be given to subjects wearing IODs.

Minimal invasive microscopic tooth preparation in esthetic restoration: a specialist consensus.

By removing a part of the structure, the tooth preparation provides restorative space, bonding surface, and finish line for various restorations on abutment. Preparation technique plays critical role in achieving the optimal result of tooth preparation. With successful application of microscope in endodontics for >30 years, there is a full expectation of microscopic dentistry. However, as relatively little progress has been made in the application of microscopic dentistry in prosthodontics, the following assumptions have been proposed: Is it suitable to choose the tooth preparation technique under the naked eye in the microscopic vision? Is there a more accurate preparation technology intended for the microscope? To obtain long-term stable therapeutic effects, is it much easier to achieve maximum tooth preservation and retinal protection and maintain periodontal tissue and oral function health under microscopic vision? Whether the microscopic prosthodontics is a gimmick or a breakthrough in obtaining an ideal tooth preparation should be resolved in microscopic tooth preparation. This article attempts to illustrate the concept, core elements, and indications of microscopic minimally invasive tooth preparation, physiological basis of dental pulp, periodontium and functions involved in tool preparation, position ergonomics and visual basis for dentists, comparison of tooth preparation by naked eyes and a microscope, and comparison of different designs of microscopic minimally invasive tooth preparation techniques. Furthermore, a clinical protocol for microscopic minimally invasive tooth preparation based on target restorative space guide plate has been put forward and new insights on the quantity and shape of microscopic minimally invasive tooth preparation has been provided.

[Minimal invasive microscopic tooth preparation based on endodontic, periodontal and functional health].

Tooth preparation is the primary and core operation technique for dental esthetic restoration treatment, due to its effect of providing restoration space, bonding interfaces and marginal lines for dental rehabilitation after tooth tissue reduction. The concept of microscopic minimal invasive dentistry put forward the issue of conducting high-quality tooth preparation, conserve tooth-structure, protect vital pulp and periodontal tissue simultaneously. This study reviewed the concepts, physiology background, design and minimal invasive microscopic tooth preparation, and in the meantime, individualized strategies and the two core elements of tooth preparation (quantity and shape) are listed.

Intrafibrillar silicified collagen scaffold promotes in-situ bone regeneration by activating the monocyte p38 signaling pathway.

Intrafibrillar silicified collagen scaffold (SCS) is a promising biomaterial for bone regeneration because it promotes cell homing and angiogenesis in bone defects via monocyte modulation. In the present study, a rat femoral defect model was used to examine the contribution of monocyte signaling pathways to SCS modulation. Activation of the monocyte p38 signaling pathway by SCS resulted in monocyte differentiation into TRAP-positive mononuclear cells. These cells demonstrated increased secretion of SDF-1α, VEGFa and PDGF-BB, which, in turn, promoted homing of bone marrow stromal cells (BMSCs) and endothelial progenitor cells (EPCs), as well as local vascularization. Monocyte differentiation and secretion were blocked after inhibition of the p38 pathway, which resulted in reduction in cell homing and angiogenesis. Taken together, these novel findings indicate that the p38 signaling pathway is crucial in SCS-modulated monocyte differentiation and secretion, which has a direct impact on SCS-induced bone regeneration. STATEMENT OF SIGNIFICANCE: Intrafibrillar silicified collagen scaffold (SCS) is a promising biomaterial for bone regeneration. The present work demonstrates that SCS possesses favorable bone regeneration potential in a rat femoral defect model. The degrading scaffold modulates monocyte differentiation and release of certain cytokines to recruit MSCs and EPCs, as well as enhances local vascularization by activating the p38 MAPK signaling pathway. These findings indicate that SCS contributes to bone defect regeneration by stimulating host cell homing and promoting local angiogenesis and osteogenesis without the need for loading cytokines or xenogenous stem cells.

[Investigation of sagittal root position in relation to the anterior maxillary alveolar bone: a cone-beam CT study in 300 cases with normal occlusion].

Objective: To investigate the sagittal root position and apical bone height of the maxillary anterior teeth in order to provide anatomical information for immediate implant placement in the esthetic region. Methods: Cone-beam CT (CBCT) data from 300 randomly selected patients who met the inclusion criteria were included in this study. After three-dimensional reconstruction, the sagittal plane (the sagittal plane through the long axis of the tooth) was determined. The positions and angulations of the tooth roots were classified with reference to the alveolar process. By comparing the buccal and palatal bone thickness at the mid-root level, the toot positions with reference to the mid-alveolar line were defined and classified as follows, type B (closer to the buccal alveolar surface), type M (midway between the buccal and palatal alveolar surface) and type P (closer to the palatal alveolar surface). By comparing the angulations of the alveolar process with the long axis of the roots, the angulations were classified as follows, type 1 (root apex angulated toward the palatal side or parallel to the alveolus), type 2 (root apex angulated toward the buccal side with the long axis passing posterior to point A) and type 3 (root apex angulated toward the buccal side with the long axis passing anterior to point A). The frequency of each category was counted and the apical bone height was measured. The subjects were divided into three age groups, 19-30 years, 31-50 years and 51-75 years. Results: The overall mean apical bone height of the healthy maxillary central incisors was (9.2±3.0) mm, the lateral incisors was (10.0±2.9) mm and the canine was (8.1±3.1) mm. There was no significant difference in the height of apical bone between central incisors and lateral incisors (P>0.05). There was no significant difference in the height of apical bone between male and female (P>0.05). The height of apical bone in group 31-50 years and 51-75 years were greater than that in group 19-30 years (P<0.05), respectively. The proportion of the maxillary anterior teeth type B, M, P was 98.5% (1 774/1 800), 0.3% (5/1 800) and 1.2% (21/1 800) respectively. The proportion of type 1, 2, 3 was 2.6% (46/1 800), 58.6% (1 055/1 800) and 38.8% (699/1 800) respectively. Conclusions: There was enough apical bone height in the area of maxillary anterior teeth, but the majority of roots positioned more buccally.

Effect of plasma nitriding and titanium nitride coating on the corrosion resistance of titanium.

STATEMENT OF PROBLEM: The passive film on the surface of titanium can be destroyed by immersion in a fluoridated acidic medium. Coating with titanium nitride (TiN) may improve the corrosion resistance of titanium. PURPOSE: The purpose of this in vitro study was to investigate the effect of duplex treatment with plasma nitriding and TiN coating on the corrosion resistance of cast titanium. MATERIAL AND METHODS: Cast titanium was treated with plasma nitriding and TiN coating. The corrosion resistance of the duplex-treated titanium in fluoride-containing artificial saliva was then investigated through electrochemical and immersion tests. The corroded surface was characterized by scanning electron microscopy (SEM) with energy-dispersive spectroscopy surface scan analysis. The data were analyzed using ANOVA (α=.05) RESULTS: Duplex treatment generated a dense and uniform TiN film with a thickness of 4.5 µm. Compared with untreated titanium, the duplex-treated titanium displayed higher corrosion potential (Ecorr) values (P<.001) and lower corrosion current density (Icorr) values (P<.001). SEM results showed that the surface of untreated titanium was more heavily corroded than that of duplex-treated titanium. Surface scan analysis of duplex-treated titanium that had been immersed in artificial saliva containing 2 g/L fluoride revealed fluorine on the titanium surface, whereas fluorine was not observed on the surface of untreated titanium after immersion in fluoride-containing artificial saliva. The concentration of titanium ions released from the treated titanium was less than the amount released from untreated titanium (P<.001). CONCLUSIONS: Duplex treatment by plasma nitriding and TiN coating significantly improved the corrosion resistance of cast titanium in a fluoride-containing environment.

Occlusal tooth wear in patients of a dental school's prosthodontic department in Xi'an, China.

PURPOSE: To assess the relationships between occlusal tooth wear and occlusal conditions, chewing side preference, and occlusal guidance scheme. MATERIALS AND METHODS: A total of 257 Chinese adult dental school patients were categorized according to a hierarchical functional classification system. Occlusal tooth wear was assessed using a modified Smith and Knight index. Occlusal tooth wear index (OTWI) scores were analyzed using multivariate regression models, including four specific occlusal conditions (≥10 teeth in each arch, complete anterior regions, sufficient premolar regions, and sufficient molar regions) adjusted for age and sex. RESULTS: Occlusal tooth wear was observed in all participants; older participants and men had significantly higher mean OTWI scores. The occlusal condition of having fewer than 10 teeth in each arch was significantly associated with occlusal tooth wear; participants with fewer than 10 teeth in each arch had higher mean OTWI scores in anterior and premolar teeth. OTWI scores for the different tooth types were highly correlated with chewing side preference. OTWI scores for the molar region (including third molars) were significantly higher at the preferred chewing side. The same effect was seen for OTWI scores of all teeth combined. OTWI scores were not associated with occlusal guidance scheme. CONCLUSIONS: The occlusal condition of having fewer than 10 teeth in each arch appears to be a risk factor for increased occlusal tooth wear. Occlusal wear was more severe at the chewing side. Occlusal tooth wear was significantly associated with the nondental factors of age and sex.

The effects of pulsed electromagnetic field on the functions of osteoblasts on implant surfaces with different topographies.

The use of pulsed electromagnetic fields (PEMFs) is a promising approach to promote osteogenesis. However, few studies have reported the effects of this technique on the osseointegration of endosseous implants, especially with regard to different implant topographies. We focused on how the initial interaction between cells and the titanium surface is enhanced by a PEMF and the possible regulatory mechanisms in this study. Rat osteoblasts were cultured on three types of titanium surfaces (Flat, Micro and Nano) under PEMF stimulation or control conditions. Protein adsorption was significantly increased by the PEMF. The number of osteoblasts attached to the surfaces in the PEMF group was substantially greater than that in the control group after 1.5h incubation. PEMF stimulation oriented the osteoblasts perpendicular to the electromagnetic field lines and increased the number of microfilaments and pseudopodia formed by the osteoblasts. The cell proliferation on the implant surfaces was significantly promoted by the PEMF. Significantly increased extracellular matrix mineralization nodules were observed under PEMF stimulation. The expression of osteogenesis-related genes, including BMP-2, OCN, Col-1,ALP, Runx2 and OSX, were up-regulated on all the surfaces by PEMF stimulation. Our findings suggest that PEMFs enhance the osteoblast compatibility on titanium surfaces but to different extents with regard to implant surface topographies. The use of PEMFs might be a potential adjuvant treatment for improving the osseointegration process.

The effect of different titanium nitride coatings on the adhesion of Candida albicans to titanium.

OBJECTIVES: The aim of the present study was an in vitro evaluation of the effects of different titanium nitride (TiNx) coatings on Candida albicans (C. albicans) adhesion to titanium and to correlate these findings to differences in specific surface characteristics (surface topography, roughness, chemical component, and surface free energy). METHODS: TiNx coatings were prepared by physical vapour deposition (PVD), a plasma nitriding process or a dual nitriding process. Surface properties were analysed by the optical stereoscopic microscopy, scanning electron microscopy, roughmeter, and drop shape methods. Quantity comparisons of C. albicans on the four surfaces were assessed by cell count and XTT reduction assays. Types of adhesive C. albicans were explored by SEM and confocal laser scanning microscope. RESULTS: The nitrided modifications were found to influence the surface properties and fungal susceptivity of flat titanium. Compared to flat titanium, fewer adhered C. albicans in yeast form were observed on the TiN-coated surface, whereas the plasma nitrided surface did not show any reduced potential to adhere C. albicans in hyphal or yeast form. The dual nitrided coating showed anti-fungal characteristics, although a small quantity of hyphae were identified. Our findings indicate that the Ti2N phase is prone to C. albicans hyphae, while the TiN phase inhibits their adhesion. CONCLUSIONS: Different TiNx phases could influence the characteristics of C. albicans adhesion. TiN coating by PVD could be a potential modification to inhibit C. albicans.

Electrically polarized micro-arc oxidized TiO2 coatings with enhanced surface hydrophilicity.

The use of micro-arc oxidation titania (MAO TiO2) coatings to modify titanium surfaces improves the biocompatibility of implant surfaces. To obtain hydrophilic MAO TiO2 coating surfaces electric polarization, which induces surface electric fields in the materials and produces surface charges, was performed in this study. Electric polarization of the MAO TiO2 coatings was confirmed by measuring the thermally stimulated depolarization current. After electric polarization treatment the MAO TiO2 coatings did not exhibit any obvious changes in surface roughness, morphology, or phase components. X-ray photoelectron spectroscopy results indicated that electric polarization resulted in oxidation of the cathodic-faced surfaces and reduction of the anodic-faced surfaces. This result suggests that the existence of a concentration gradient of oxide ions/oxygen vacancies produced the stored space charge in the coatings. Reduction of the deionized water contact angle on the polarized MAO TiO2 surfaces was maintained for longer periods compared with the non-polarized surface. Our study demonstrated that metastable electric fields across the MAO TiO2 coating produced by electric polarization made it durably wettable by reducing the interfacial surface tension between the material and water.

[An 8-year follow-up study of Cerec2 computer aided design and computer aided manufacture of all-ceramic crowns].

OBJECTIVE: To evaluate the clinical performance of the crowns made by Cerec2 computer aided design and computer aided manufacture (CAD/CAM) system. METHODS: Twenty four teeth were restored with Cerec2 CAD/CAM crowns. Eight years after delivery of the prostheses, the all-ceramic crowns were evaluated using modified standard of California Dental Association quality evaluation system. Patients filled out a satisfaction questionnaire at the same time. And Kaplan-Meier analysis was carried out. RESULTS: Three out of 24 restorations were rated as failure. Kaplan-Meier analysis showed that the success rate of Cerec2 crowns eight year following delivery was 88%. CONCLUSIONS: Crowns made by Cerec2 CAD/CAM system can survive in oral condition and function well for 8 years.