Investigation of a new implant surface modification using phosphorylated pullulan.

Various implant surface treatment methods have been developed to achieve good osseointegration in implant treatment. However, some cases remain impossible to treat with implants because osseointegration is not obtained after implantation, and the implants fail. Thus, this study focused on phosphorylated pullulan because of its adhesiveness to titanium (Ti) and bone, high biocompatibility, and early replacement with bone. In this study, the response of bone-related cells to phosphorylated pullulan was evaluated to develop a new surface treatment method. Saos-2 (human osteosarcoma-derived osteoblast-like cells), MC3T3-E1 (mouse calvaria-derived osteoblast-like cells), and RAW264.7 (mouse macrophage-like cells) were used. In evaluating cellular responses, phosphorylated pullulan was added to the culture medium, and cell proliferation and calcification induction tests were performed. The proliferation and calcification of cells on the surface of Ti disks coated with phosphorylated pullulan were also evaluated. In addition, bone morphogenetic protein-2 (BMP-2), an osteogenic factor, was used to evaluate the role of phosphorylated pullulan as a drug carrier in inducing calcification on Ti disks. Phosphorylated pullulan tended to promote the proliferation of osteoblast-like cells and the formation of calcification on Ti disks coated with phosphorylated pullulan. Ti disks coated with phosphorylated pullulan loaded with BMP-2 enhanced calcification. Phosphorylated pullulan inhibited osteoclast-like cell formation. These results are due to the properties of phosphorylated pullulan, such as adhesiveness to titanium and drug-loading function. Therefore, phosphorylated pullulan effectively promotes bone regeneration when coated on titanium implants and is useful for developing a new surface treatment method.

Does dental material type influence bacterial adhesion under the same polishing conditions? Direct observation using a fluorescent staining technique: An in vitro study.

Highly polished 3, 4, and 5 mol% yttria-stabilized zirconia and CAD/CAM composite resin samples were prepared, and the influence of surface roughness (Ra and Sa, 21 areas/group), wettability (contact angle and surface energy, 3 samples/group), and surface chemical composition (2 samples/group) on single-strain bacterial adhesion models (Porphyromonas gingivalis, Streptococcus oralis, Streptococcus sanguinis, Streptococcus gordonii, and Streptococcus mutans) were compared via fluorescent staining with graphical analysis (21 areas/group). Statistical analysis was performed using the Shapiro-Wilk test followed by one-way analysis of variance with Tukey's test or the Kruskal-Wallis test with Dunn's test (α=0.05) and linear regression. For dental zirconia with the same surface roughness, the yttria content did not significantly influence the initial bacterial adhesion. However, higher bacterial adhesion was detected for the composite resin owing to its high C, O, and Si contents. There was no correlation between surface energy and bacterial adhesion for any bacterial strain (p<0.005).

Does the universal adhesive's film thickness affect dentin-bonding effectiveness?

OBJECTIVES: To investigate the influence of adhesive resin application modalities on the film thickness of the adhesive resin and the effectiveness of a two-step universal adhesive (UA) bonded in self-etch (SE) bonding mode to high C-factor class-I cavity-bottom dentin. MATERIALS AND METHODS: After application of the primer of G2-Bond Universal (G2B, GC), the adhesive resin was applied into standard class-I cavities (human molars) following four application modalities: (1) one layer, strongly air-blown; (2) one layer, gently air-blown; (3) two layers, each gently air-blown; (4) one layer, not air-blown. After being restored with composite, each tooth was sectioned to obtain one micro-specimen (n = 10), of which the adhesive resin film thickness was measured using optical microscopy. The micro-tensile bond strength (µTBS) was tested immediately or upon 100,000 thermocycles. Statistical analyses involved Kruskal-Wallis and Mann-Whitney U testing (p < 0.05). RESULTS: G2B's µTBS was significantly affected by the adhesive resin application modality and aging. Gently air-blowing the adhesive resin resulted in significantly higher immediate µTBS than strong air-blowing or no air-blowing. No significant difference in µTBS was found between single or double gently air-blown adhesive resin applications. The adhesive resin film thickness significantly varied with the application modalities. CONCLUSIONS: A too thin or too thick adhesive resin film thickness adversely affected bond strength of the two-step UA applied in SE mode and high C-factor condition. CLINICAL RELEVANCE: The adhesive resin layer thickness can affect the bonding performance of two-step UAs in high C-factor cavities. Dental clinicians remain advised to avoid improper air-blowing of UAs and strictly follow the application instructions.

Multi-Parameter Characterization of HEMA/BPA-free 1- and 2-step Universal Adhesives Bonded to Dentin.

PURPOSE: This study aimed to investigate the bonding effectiveness of two HEMA/BPA-free universal adhesives (UAs) to flat dentin, to characterize their adhesive-dentin interfacial ultrastructure, and to measure their water sorption (Wsp), water solubility (Wsl), and hydrophobicity. MATERIALS AND METHODS: The immediate and aged (50,000 thermocycles) microtensile bond strength (µTBS) to flat dentin of the HEMA/BPA-free UAs Healbond Max (HbMax; Elsodent) and Healbond MP (HbMP; Elsodent) as well as the reference adhesives OptiBond FL (Opti-FL; Kerr), Clearfil SE Bond 2 (C-SE2; Kuraray Noritake), and Scotchbond Universal (SBU; 3M Oral Care) was measured. The adhesive-dentin interfaces of HbMax and HbMP were characterized by TEM. Wsp and Wsl of all adhesive resins and of the primer/adhesive resin mixtures of HbMax, Opti-FL, and C-SE2 were measured. Hydrophobicity was determined by measuring the contact angle of water dropped on adhesive-treated dentin. RESULTS: In terms of µTBS, HbMax and HbMP performed statistically similarly to Opti-FL and C-SE2, but outperformed SBU. Aging only significantly reduced the µTBS of SBU when applied in E&R bonding mode. TEM revealed typical E&R and SE hybrid-layer ultrastructures at dentin, while electron-lucent globules of unknown origin, differing in size and shape, were observed within the adhesive resin of HbMP and even more frequently in that of HbMax. Higher Wsp was measured for the primer/adhesive resin mixtures than for the adhesive resins. Opti-FL was more hydrophobic than all other adhesives tested. CONCLUSION: The HEMA/BPA-free UAs bonded durably to flat dentin with bond strengths comparable to those of the gold-standard E&R/SE adhesives and superior to that of the HEMA/BPA-containing 1-step UA.

Adhesive Performance Assessment of Universal Adhesives and Universal Adhesive/Composite Cement Combinations.

PURPOSE: To investigate the bonding performance of three universal adhesives (UAs) to dentin and the effect of different curing modes and hydrofluoric-acid (HF) etching of lithium-disilicate glass-ceramic on the adhesive performance of two UA/composite cement (CC) combinations. MATERIALS AND METHODS: In the first project part, the immediate and aged (25k and 50k thermocycles) microtensile bond strength (µTBS) of the two light-curing UAs G2-Bond Universal (G2B; GC) and Scotchbond Universal Plus (SBUp; 3M Oral Care), and the self-curing UA Tokuyama Universal Bond II (TUBII; Tokuyama) to flat dentin was measured, when applied in both E&R and SE bonding mode using a split-tooth design (n = 10). The resultant adhesive-dentin interfaces were characterized using TEM. In the second project part, CAD/CAM composite blocks were luted to flat dentin with either Scotchbond Universal Plus/RelyX Universal (SBUp/RxU; 3M Oral Care) or Tokuyama Universal Bond II/Estecem II Plus (TUBII/ECIIp; Tokuyama Dental) using different curing modes (AA mode: auto-curing of both adhesive and cement; AL mode: auto-curing of adhesive and light-curing of cement), upon which their immediate and aged (25k and 50k thermocycles) µTBS was measured. In the third project part, the same UA/CC combinations were luted to CAD/CAM glass-ceramic to measure their immediate and aged (6-month water storage) shear bond strength (SBS). RESULTS: In E&R bonding mode, the performance of G2B, SBUp and TUBII was not significantly different in terms of µTBS, while G2B and SBUp significantly outperformed TUBII in SE bonding mode. No significant difference in µTBS was found between the SBUp/RxU and TUBII/ECIIp UA/CC combinations, regardless of bonding mode, aging time, or curing mode. The cement-curing mode did not significantly influence µTBS, while a significantly higher µTBS was recorded for the UA/CC combinations applied in E&R bonding mode. HF significantly improved the SBS of the UA/CC combinations to glass-ceramic. CONCLUSION: The self-curing adhesive performed better when applied in E&R than in SE bonding mode. The curing mode did not influence the adhesive performance of the composite cements, while an E&R bonding mode rendered more favorable adhesion in a self-curing luting protocol. When bonding to glass-ceramic, the adhesive performance of the universal adhesive/composite cement combinations benefited from HF etching.

Phosphorylated pullulan promotes calcification during bone regeneration in the bone defects of rat tibiae.

The current study aimed to evaluate bone tissue regeneration using a combination of ß-tricalcium phosphate (ßTCP) and phosphorylated pullulan (PPL, a phosphate-rich polysaccharide polymer consisting of maltotriose units). Round defects of 2 mm diameter were created in the arterial center of rat tibiae, which were further treated with vehicle (control group), ßTCP (ßTCP group), or ßTCP + PPL (ßTCP + PPL group) grafts. The control specimens without bone grafts exhibited rapid bone formation after 1 week; however, the regenerated bone was not resorbed until 4 weeks. In contrast, ßTCP-grafted specimens exhibited fewer but thicker trabeculae, whereas the ßTCP + PPL group displayed many fine trabeculae at 4 weeks. In the ßTCP + PPL group, new bone was associated with the ßTCP granules and PPL. Similarly, PHOSPHO1-positive osteoblasts were localized on the ßTCP granules as well as the PPL. On the other hand, TRAP-reactive osteoclasts predominantly localized on newly-formed bone and ßTCP granules rather than on the PPL. No significant differences were observed in the expression of Alp, Integrin αv, Osteopontin, Osteocalcin, and Dmp-1 in PPL-treated MC3T3-E1 osteoblastic cells, suggesting that PPL did not facilitate osteoblastic differentiation. However, von Kossa staining identified abundant needle-like calcified structures extending inside the PPL. Furthermore, transmission electron microscopy (TEM) revealed many globular structures identical to calcified nodules. In addition, calcified collagen fibrils were observed in the superficial layer of the PPL. Thus, PPL may serve as a scaffold for osteoblastic bone formation and promotes calcification on its surface. In conclusion, we speculated that ßTCP and PPL might promote bone regeneration and could be integrated into promising osteoconductive materials.

Long-Term Antibacterial Efficacy of Cetylpyridinium Chloride-Montmorillonite Containing PMMA Resin Cement.

Despite being able to adhesively restore teeth, adhesives and cement do not possess any anticariogenic protection potential, by which caries recurrence may still occur and reduce the clinical lifetime of adhesive restorations. Several antibacterial agents have been incorporated into dental adhesives and cement to render them anticariogenic. Due to an additional therapeutic effect, such materials are classified as 'dental combination products' with more strict market regulations. We incorporated cetylpyridinium chloride (CPC), often used for oral hygiene applications, into montmorillonite (CPC-Mont), the latter to serve as a carrier for controlled CPC release. CPC-Mont incorporated into tissue conditioner has been approved by the Pharmaceuticals and Medical Devices Agency (PmontMDA) in Japan. To produce a clinically effective dental cement with the antibacterial potential to prevent secondary caries, we incorporated CPC-Mont into PMMA resin cement. We measured the flexural strength, shear bond strength onto dentin, CPC release, and the biofilm-inhibition potential of the experimental CPC-Mont-containing PMMA cement. An 8 and 10 wt% CPC-Mont concentration revealed the antibacterial potential without reducing the mechanical properties of the PMMA cement.

Layer characteristics in strength-gradient multilayered yttria-stabilized zirconia.

OBJECTIVES: To investigate crystallography, translucency, phase content, microstructure and flexural strength of two commercial strength-gradient multilayered dental zirconia grades. METHODS: Two zirconia grades, i.e., KATANA Zirconia YML (Kuraray Noritake; referred to as "YML"; composed of four layers: enamel, body 1-3) and IPS e.max ZirCAD Prime (Ivoclar Vivadent; referred to as "Prime"; composed of three layers: enamel, transition, body) were investigated. Fully sintered square-shaped zirconia specimens from each layer were prepared. Microstructure, chemical composition, translucency parameter and zirconia-phase composition of each layer were characterized. Four-point and biaxial flexural strength of each layer was measured using fully sintered bar- and square-shaped specimens. Square-shaped samples were used to measure strength across the layers. RESULTS: For both multilayer zirconia grades, the 'enamel' layer contains a higher amount of c-ZrO2, which resulted in higher translucency but lower flexural strength than the 'body' layers. The characteristic 4-point flexural strength of the YML 'body 2' (923 MPa) and 'body 3' (911 MPa) layers, and of the Prime 'body' (989 MPa) layer were comparable and higher than for the YML 'enamel' (634 MPa), Prime 'transition' (693 MPa) and 'enamel' (535 MPa) layers. The biaxial strength of specimens sectioned across the layers was in-between that of the 'enamel' and 'body' layers for both YML and Prime, implying the interfaces did not form a weak link. SIGNIFICANCE: The difference in yttria content affects the phase composition and mechanical properties of each layer of the multi-layer zirconia. The strength-gradient approach allowed to integrate monoliths with irreconcilable properties.

Prevention of Root Caries Using Oxalic Acid.

Certain dentin hypersensitivity treatment materials include oxalic acid to coat dentin surfaces with minerals, while certain organic acids possess a remineralization effect. Herein, an organic acid that inhibits the demineralization and coating of root surfaces was evaluated. Specimens were produced using five non-carious extracted bovines. Four different acids were used: oxalic acid (OA), malonic acid (MA), polyacrylic acid (PA), and succinic acid (SA). Each acid was applied to the root surface and washed using distilled water or a remineralization solution, and the surface was observed using scanning electron microscopy (SEM). All the surfaces of each specimen, barring the polished surface, were covered with wax and immersed in an automatic pH cycling system for two weeks. Dentin demineralization was analyzed using transverse microradiography (TMR) before and after pH cycling. SEM analysis demonstrated that the three acid groups demineralized the dentin surface, whereas the OA group generated crystals covering the dentin surface, even in a distilled water environment. TMR analysis revealed that the OA groups showed significantly lower integrated mineral loss compared with the other groups, even in the distilled water environment. The results suggest that OA generates insoluble calcium oxalate crystals on the dentin and suppresses demineralization even under low saliva conditions.

Development of Autopolymerizing Resin Material with Antimicrobial Properties Using Montmorillonite and Nanoporous Silica.

Although autopolymerizing resin offers numerous applications in orthodontic treatment, plaque tends to accumulate between the appliance and the mucosa, which increases the number of microorganisms present. In this study, we added cetylpyridinium chloride (CPC) loaded montmorillonite (Mont) and nanoporous silica (NPS) to autopolymerizing resin (resin-Mont, resin-NPS) and evaluated their drug release capacity, antimicrobial capacity, drug reuptake capacity, mechanical strength, and color tone for the devolvement of autopolymerizing resin with antimicrobial properties. As observed, resin-Mont and resin-NPS were capable of the sustained release of CPC for 14 d, and a higher amount of CPC was released compared to that of resin-CPC. Additionally, resin-Mont and resin-NPS could reuptake CPC. Moreover, the antimicrobial studies demonstrated that resin-Mont and resin-NPS could release effective amounts of CPC against Streptococcus mutans for 14 d and 7 d after reuptake, respectively. Compared to resin-CPC, resin-Mont exhibited a higher sustained release of CPC in all periods, both in the initial sustained release and after reuptake. However, the mechanical strength decreased with the addition of Mont and NPS, with a 36% reduction observed in flexural strength for resin-Mont and 25% for resin-NPS. The application of these results to the resin portion of the orthodontic appliances can prevent bacterial growth on the surface, as well as on the interior, of the appliances and mitigate the inflammation of the mucosa.

Dentine Mineral Changes Induced by Polyalkenoate Cements after Different Selective Caries Removal Techniques: An in vitro Study.

This study aimed at evaluating the mineral variation induced by polyalkenoate cements in residual dentine after different caries removal methods. Ten extracted sound molars were selected, and five cavities were prepared on the occlusal surface of each specimen. Carious lesions were generated using a microbial protocol, while the caries removal was performed using bur, hand excavator, or two papain-based chemo-mechanical agents. One cavity was left unexcavated in each tooth. Cavities were restored using a zinc polycarboxylate cement (ZPC; n = 25), or a glass ionomer cement (GIC) was used (n = 25). Subsequently, the specimens were stored under simulated pulpal pressure for 45 days. Micro-CT scanning was performed after caries formation, removal, and restoration. Cavity volumes (mm3) and mineral density (MD) changes were calculated. Remineralisation ability was investigated by scanning electron microscopy (SEM) and Fourier-transformed infrared spectroscopy (FTIR). Statistical analysis was performed (5% significance level). Baseline caries, cavity volume, and MD increase after caries removal were similar to all excavation groups (p > 0.05). MD was higher in ZPC compared to GIC (p < 0.05). SEM revealed that the chemo-mechanical techniques produced a smoother dentine surface compared to mechanical methods. FTIR showed silicon-based minerals in GIC-treated dentine, while ZPC-treated presented mineral deposits characterised by amorphous calcium phosphate. In both cases, the presence of carbonates was detected on dentine surfaces. All caries removal techniques performed similarly in terms of carious dentine excavation. ZPC can be used as dentine replacement material after caries removal as it may induce higher MD increase in residual dentine via deposition of calcium phosphates, compared to GIC.

Antimicrobial adhesive polyurethane gel sheet with cetylpyridinium chloride-montmorillonite for facial and somato prosthesis fastening.

Purpose Existing options for attaching facial and somato prostheses, such as skin adhesives, are problematic because of microbial colonization and skin irritation. This study aims to evaluate the suitability of adhesive polyurethane gel sheets containing cetylpyridinium chloride (CPC)-montmorillonite (Mont) for prosthesis fastening.Methods Adhesive gel sheets were fabricated as mixtures of base resin (99.6 wt% polyol) and hardening agent at a ratio of 3:1 with 0 (control), 2, 5, 10, or 15 wt% CPC-Mont. The controlled release of CPC, antimicrobial activity, in vitro skin irritation, and adhesive force against silicone and human skin at different blending ratios were determined. Statistical analyses of the data were performed using one-way analysis of variance (ANOVA), analysis of covariance (ANCOVA), Tukey's test, or single regression analysis, as appropriate.Results The amount of CPC released increased with the CPC-Mont blending ratio and was linearly proportional to the surface occupation area ratio of CPC-Mont. The samples with >5 wt% CPC-Mont exhibited antimicrobial activity against Staphylococcus aureus at an exposure time of 0 d, and samples with >2 wt% CPC-Mont exhibited antimicrobial activity against Candida albicans at an exposure time of 1 d. All samples were classified as non-irritant based on an in vitro skin irritation test. The adhesive force on the silicone material and human skin decreased with increasing CPC-Mont blending ratio.Conclusions Samples with 5 wt% CPC-Mont are potential candidates as antimicrobial adhesive polyurethane gel sheets for fastening facial and somato prostheses.

Experimental two-step universal adhesives bond durably in a challenging high C-factor cavity model.

OBJECTIVES: To determine the bonding effectiveness of experimental 2-step universal adhesives (UAs) to high C-factor class-I cavity-bottom dentin and to assess the potential bond-strength contribution of an additional flowable composite layer. METHODS: Three experimental 2-step UA formulations, involving the application of a 10-MDP-based primer followed by a hydrophobic adhesive resin with a 15-to-20-µm film thickness and differing only for filler, referred to as BZF-21 (silica and bioglass filler), BZF-29 (silica filler) and BZF-29_hv (higher silica-filler loading resulting in a higher viscosity), all prepared by GC, along with three representative commercial adhesives, Clearfil SE Bond 2 (C-SE2, Kuraray Noritake), G-Premio Bond (G-PrB, GC) and OptiBond FL (Opti-FL, Kerr), were comparatively investigated for their 'immediate' and 'aged' (50,000 thermocycles) micro-tensile bond strength (µTBS), when applied either in etch-and-rinse (E&R) or self-etch (SE) mode, to high C-factor class-I cavity-bottom dentin (n = 10; 10 experimental groups). Four additional experimental groups involved the extra application of the flowable composite G-ænial Universal Flo (GC), employed as an intermediate liner in combination with the adhesives BZF-29 and G-PrB and again applied both in E&R or SE mode. Statistical analysis was performed using linear mixed-effects (LME) modelling and linear regression analysis (p < 0.05). RESULTS: All 2-step UAs performed similarly when compared to the gold-standard E&R Opti-FL and SE C-SE2 adhesives, except for the aged µTBS of BZF-29_hv applied in E&R mode, and significantly outperformed the 1-step UA G-PrB. Significant reduction in µTBS upon aging was only recorded for 2-step UAs applied in E&R mode. The extra flowable composite layer significantly improved G-PrB's µTBS. SIGNIFICANCE: The experimental 2-step UAs revealed favorable bonding performance in the challenging high C-factor class-I cavity model, comparable to that of the multi-step gold-standard E&R and SE adhesives and superior to that of the 1-step UA investigated. An additionally applied flowable composite layer compensated for the lower bonding effectiveness of the 1-step UA in the high C-factor cavity model.

Osteoblast Response of Additively Manufactured Zirconia and Alumina-Toughened Zirconia.

Zirconia ceramics have been widely used in dentistry. Herein, we assess the surface morphology, surface texture, and osteoblast response of additively manufactured zirconia and alumina-toughened zirconia (ATZ) in comparison with titanium. The surface roughness, contact angle, and surface microstructure of titanium sandblasted with large-grit alumina and subsequently acid-etched using 18% HCl and 49% H2SO4 (SLA-titanium), uniaxially pressed zirconia (UP zirconia), additively manufactured zirconia (AM zirconia), and additively manufactured ATZ (AM ATZ) were investigated. Moreover, the cell viability, alkaline phosphatase (ALP) activity, and gene expression of type I collagen on these materials were evaluated. The data were statistically analyzed using one-way ANOVA with Tukey's post hoc test. SLA-titanium showed the highest surface roughness and contact angle. The other three materials showed comparable surface roughness and contact angles. Micro- and nanoroughness were observed on the surface of SLA-titanium. UP zirconia and AM zirconia had similar surface morphologies. The cell viability, ALP activity, and gene expression of type I collagen on AM zirconia were comparable to or better than those on SLA-titanium. Our results indicate that AM zirconia is a promising material for zirconia dental implants.

Does Multifunctional Acrylate's Addition to Methacrylate Improve Its Flexural Properties and Bond Ability to CAD/CAM PMMA Block?

This study investigated the effects of a multifunctional acrylate copolymer-Trimethylolpropane Triacrylate (TMPTA) and Di-pentaerythritol Polyacrylate (A-DPH)-on the mechanical properties of chemically polymerized acrylic resin and its bond strength to a CAD/CAM polymethyl methacrylate (PMMA) disk. The methyl methacrylate (MMA) samples were doped with one of the following comonomers: TMPTA, A-DPH, or Trimethylolpropane Trimethacrylate (TMPTMA). The doping ratio ranged from 10 wt% to 50 wt% in 10 wt% increments. The flexural strength (FS) and modulus (FM) of PMMA with and without comonomer doping, as well as the shear bond strength (SBS) between the comonomer-doped PMMA and CAD/CAM PMMA disk, were evaluated. The highest FS (93.2 ± 4.2 MPa) was obtained when doped with 20 wt% of TMPTA. For TMPTMA, the FS decreased with the increase in the doping ratio. For SBS, TMPTA showed almost constant values (ranging from 7.0 to 8.2 MPa) regardless of the doping amount, and A-DPH peaked at 10 wt% doping (8.7 ± 2.2 MPa). TMPTMA showed two peaks at 10 wt% (7.2 ± 2.6 MPa) and 40 wt% (6.5 ± 2.3 MPa). Regarding the failure mode, TMPTMA showed mostly adhesive failure between the CAD/CAM PMMA disk and acrylic resin while TMPTA and A-DPH showed an increased rate of cohesive or mixed failures. Acrylate's addition as a comonomer to PMMA provided improved mechanical properties and bond strength to the CAD/CAM PMMA disk.

Preliminary Study on the Optimization of Femtosecond Laser Treatment on the Surface Morphology of Lithium Disilicate Glass-Ceramics and Highly Translucent Zirconia Ceramics.

All-ceramic restorations have become increasingly popular in dentistry. Toward ensuring that these restorations adhere to the tooth structure, this study determines the optimal femtosecond laser (FL) treatment parameters for lithium disilicate glass-ceramics and highly translucent zirconia ceramics with respect to surface morphology. For both the ceramics, the following surface conditions were investigated: (1) as-sintered; (2) Al2O3 sandblasted; (3) FL treatment (dot pattern with line distances of 14, 20, and 40 µm); (4) FL treatment (crossed-line pattern with a line distance of 20 and 40 µm). Surface roughness parameters were estimated using a 3D confocal laser microscope; microstructures were analyzed using a scanning electron microscope. Peak fluence (Fpeak) values of 4 and 8 J/cm2 and irradiation numbers (N) of 20 and 10 shots were selected to create dot patterns in highly translucent zirconia and lithium disilicate glass-ceramics, respectively. Furthermore, Fpeak = 8 J/cm2 and N = 20 shots were chosen to obtain crossed-line patterns in both ceramics. Our results show that lithium disilicate glass-ceramics and highly translucent zirconia exhibit a similar surface morphology under each of the surface treatment conditions. Therefore, FL irradiation of dot or crossed-line patterns (at a distance of 20 and 40 µm) are potential candidates for future investigations.

Kinematic characteristics during gait in frail older women identified by principal component analysis.

Frailty is associated with gait variability in several quantitative parameters, including high stride time variability. However, the associations between joint kinematics during walking and increased gait variability with frailty remain unclear. In the current study, principal component analysis was used to identify the key joint kinematics characteristics of gait related to frailty. We analyzed whole kinematic waveforms during the entire gait cycle obtained from the pelvis and lower limb joint angle in 30 older women (frail/prefrail: 15 participants; non-frail: 15 participants). Principal component analysis was conducted using a 60 × 1224 input matrix constructed from participants' time-normalized pelvic and lower-limb-joint angles along three axes (each leg of 30 participants, 51 time points, four angles, three axes, and two variables). Statistical analyses revealed that only principal component vectors 6 and 9 were related to frailty. Recombining the joint kinematics corresponding to these principal component vectors revealed that frail older women tended to exhibit greater variability of knee- and ankle-joint angles in the sagittal plane while walking compared with non-frail older women. We concluded that greater variability of knee- and ankle-joint angles in the sagittal plane are joint kinematic characteristics of gait related to frailty.

Effect of Air-Particle Abrasion Protocol and Primer on The Topography and Bond Strength of a High-Translucent Zirconia Ceramic.

PURPOSE: To evaluate effect of air-particle abrasion protocol and primer on surface topography and bond strength of resin cement to high-translucent zirconia ceramics. MATERIALS AND METHODS: Two hundred disk-shaped high-translucent zirconia specimens of 5Y-PSZ were prepared. The specimens were assigned to 5 groups in terms of particle type and air-particle abrasion pressure: (1) control, (2) alumina with 0.2 MPa-air pressure [AB-0.2], (3) alumina with 0.4 MPa-air pressure [AB-0.4], (4) glass beads with 0.2 MPa-air pressure [GB-0.2], and (5) glass beads with 0.4 MPa-air pressure [GB-0.4]. Two different primers 1% MDP (Experimental) and MDP-silane primer (Clearfil Ceramic Primer Plus) was also tested. Stainless steel rods were bonded to the 5Y-PSZ specimens with PANAVIA V5. For each group, the tensile bond strength (TBS) was measured after 24-hour water storage (n = 10) and after 5000 thermal-cycling (n = 10) at crosshead speed of 2 mm/min. The data were statistically analyzed using Weibull analysis. Surface roughness (Sa) was measured using a 3D-Laser Scanning Confocal Microscope (n = 5) and analyzed by t-test with Bonferroni correction. Surface topography using scanning electron microscopy (SEM) and surface elemental analysis using energy dispersion spectroscopy (EDX), and cross-section SEM at the interface with composite cement were also investigated. RESULTS: In MDP-silane groups, the highest TBS was observed in AB-0.4 after 24 hours and GB-0.4 after thermal-cycling (p < 0.05). In MDP groups, AB groups resulted in the significantly higher TBS than GB groups (p < 0.05). AB-0.4 group showed the highest Sa value compared to all groups (p < 0.005), meanwhile GB groups did not show different Sa compared to control (p > 0.005). CONCLUSION: Air-abrasion with different particle and blasting pressure can improve bonding to zirconia with proper primer selection. Particularly, glass beads abrasion followed by MDP-silane primer and alumina abrasion followed by MDP primer alone provided stable bond strength of resin cement to high-translucent zirconia after aging. High-translucent zirconia abraded with glass beads achieves a desirable bonding performance without creating surface microcracks which may hinder zirconia's mechanical properties.

Novel composite cement containing the anti-microbial compound CPC-Montmorillonite.

OBJECTIVES: The aim of this study was to evaluate the mechanical properties, bonding performance and anti-microbial activity of a novel composite cement containing cetylpyridinium chloride (CPC) modified montmorillonite ('CPC-Mont'), and using these parameters to determine the optimal particle size and concentration of CPC-Mont the composite cement can be loaded with. METHODS: CPC-Mont particles with a median diameter of 30 and 7 µm were prepared and added to a composite cement at a concentration of 2, 3, 4, 5 and 7.5 wt%. Mechanical properties and bonding performance of the experimental composite cements were evaluated by 3-point bending and micro-tensile bond-strength testing. The amount of CPC released from the cement disks was quantified using a UV-vis recording spectrophotometer. The anti-biofilm activity was studied using scanning electron microscopy (SEM). RESULTS: Adding 30-µm CPC-Mont decreased the mechanical properties and bonding performance of the composite cement, while no reduction was observed for the 7-µm CPC-Mont loaded cement formulation. Although CPC release substantially decreased during the 7-day period assessed, 5- and 7.5-wt% CPC-Mont loaded composite cement inhibited biofilm formation for 30 days. SIGNIFICANCE: Loading composite cement with CPC-Mont with a median diameter of 7 µm at concentrations of 5-7.5 wt% was effective in achieving continuous anti-biofilm activity, while maintaining mechanical strength and bonding performance.

Development of 4-META/MMA-TBB resin with added benzalkonium chloride or cetylpyridinium chloride as antimicrobial restorative materials for root caries.

To develop antimicrobial restorative materials for root caries, we assessed a 4-META/MMA-TBB resin (Bondfill SB Plus, Sun Medical) containing benzalkonium chloride (BAC) or cetylpyridinium chloride (CPC) at 1.25, 2.5, and 5.0 wt%. The same resin without antibacterial agent was used as control. The degree of conversion was measured by attenuated total reflectance-Fourier transform infrared spectroscopy. The 3-point flexural strength test was conducted according to ISO 4049. The antimicrobial effect against three oral bacteria (Streptococcus mutans, S. sobrinus, and Actinomyces naeslundii) was assessed using agar diffusion tests. The shear bond strength to root dentin was assessed after 24 h of storage in water with or without 10,000 thermal cycles. The shear bond strength data were statistically compared using a linear mixed-effects model (α = 0.05). The specimen with 5.0 wt% BAC showed a significantly higher degree of conversion than the control, but it also had significantly lower flexural strength and lower shear bond strength after thermal cycling than the other specimens. When BAC or CPC was added at ≥ 2.5 wt%, the resins inhibited the growth of the three investigated microbes. In conclusion, both BAC and CPC showed significant antimicrobial effects when added at 5.0 wt% to the 4-META/MMA-TBB resin. Up to 2.5 wt%, neither antimicrobial agent affected the degree of conversion, flexural strength, or shear bond strength of the resin.