The Influence of Eggshell on Bone Regeneration in Preclinical In Vivo Studies.

The aim of this study is to systemically review the available evidence on the in vivo behavior of eggshell as a guided bone regeneration substitute material. Five databases (PubMed, Cochrane, Web of Science, Scopus, EMBASE) were searched up to October 2020. In vivo animal studies with a bone defect model using eggshell as a grafting material were included. Risk of bias was assessed using SYRCLE tool and the quality assessment using the ARRIVE guidelines. Overall, a total of 581 studies were included in the study, 187 after duplicate removal. Using the inclusion and exclusion criteria 167 records were further excluded. The full text of the remaining 20 articles was assessed for eligibility and included in the qualitative and quantitative assessment synthesis. There were different methods of obtaining eggshell grafting materials. Eggshell is a biocompatible grafting material, with osteoconduction proprieties. It forms new bone similar to Bio-Oss and demineralized freeze-dried bone matrix. It can be combined with other materials to enhance its proprieties. Due to the high variability of the procedures, animals, production and assessment methods, no meta-analysis could be performed. Eggshell might be considered a promising biomaterial to be used in bone grafting procedures, though further research is needed.

Clinical applications of avian eggshell-derived hydroxyapatite.

The search for bone reconstruction materials and methods is an ongoing challenge. The aim of this review is to systemically search the available literature concerning the clinical performance of eggshell as a substitute material in guided bone regeneration in oral surgery. Five databases (PubMed, Cochrane, Web of Science, Scopus, and Embase) were searched up to February 2020. Clinical trials that used eggshell as a bone substitute material were included in the review. Animal and in vivo studies were excluded from the review. ROBINS-I was used to evaluate the risk of bias. A total of 840 studies were retrieved, out of which 55 full-text articles were screened. Five studies were finally included: one study showed critical and four serious risk of bias. A total of 74 patients and 88 intervention sites were included in the five studies. Clinical and radiological evaluation showed complete healing during the follow-ups. Statistically significant radiological and clinical evidence of new bone formation was achieved for socket preservation, grafting after third molar extraction, and cystic/apicectomy grafting. One patient with complications was reported. Histological analysis and micro computed tomography confirmed that it promotes bone regeneration. A comparison with synthetic hydroxyapatite showed similar healing characteristics. Within the limitations of the included studies, the eggshell can be safely and efficiently used in guided bone regeneration procedures, but more research is needed to completely evaluate the full potential of this material.

Influence of opacity on the color stability of a nanocomposite.

OBJECTIVE: The aim of this study was to evaluate the color stability in relation to the opacity of the nanocomposite Filtek Ultimate (3M ESPE), by immersing the specimens in different types of natural and artificial staining solutions. MATERIAL AND METHODS: Eighty disks of the shades A1 body (A1B), A1 dentine (A1D), A1 enamel (A1E), and white enamel (WE) (n = 4) of the nanocomposite Filtek Ultimate (3M ESPE) were immersed in staining solutions Orange II, Amaranth, coffee, tea, and artificial saliva. Color coordinates Commission Internationale de l'éclairage (CIE) L*a*b* were collected before and after immersion at 4, 6, 12, 24 h and 7 days. Two-way repeated measurements ANOVA was used in order to assess the effect of immersion time, staining solutions, and materials on CIE L*a*b* parameters, translucency parameter (TP), and color difference (ΔE*). For comparisons between staining solutions and materials, pairwise contrasts adjusted by Bonferroni method were used. RESULTS: The color difference (ΔE*) after 7 days of immersing in staining solution ranged between 0.9 and 15.8. The highest ΔE* after 7 days was obtained for WE, followed by A1E, A1B, and A1D (for all of the immersion solutions, except coffee). There were differences among staining solutions regarding the induced color changes. Coffee induced the most pronounced color differences. However, Orange II, Amaranth, and artificial saliva generated similar behavior in time, for all tested materials. CONCLUSIONS: No statistically significant differences were found among various opacities of Filtek Ultimate regarding the ΔE*, TP, ΔL*, and Δb* overtime. In contrast, Δa* was significantly affected by the type of material. CLINICAL RELEVANCE: The purpose of this study was to predict the color change of different layers of composites, in cases of complex stratified dental restorations.