Effects of multiple firings on the translucency, crystalline phase, and mechanical strength of highly translucent zirconia.

This study aimed to clarify the effects of multiple firings on the translucency, crystal structure, and mechanical strength of highly translucent zirconia. Four types of highly translucent zirconia (LAVA Esthetic, LAVA Plus, KATANA Zirconia STML, and KATANA Zirconia HTML) were fired three times at three different temperatures, and the translucency, crystal structure, and flexural strength were evaluated before and after firing. The translucency was statistically compared using repeated-measures analysis of variance; the zirconia phase composition was assessed using X-ray diffraction followed by Rietveld analysis; and the biaxial flexural strength was assessed using Weibull analysis. The translucency of LAVA Esthetic and KATANA Zirconia HTML decreased significantly after firing, and the crystal composition of LAVA Plus and KATANA Zirconia HTML changed after multiple firings, whereas multiple firings did not affect the biaxial flexural strength of any samples. Thus, multiple firings may affect the optical properties of highly translucent zirconia.

Fracture strength of porcelain veneer on surface-treated zirconia.

In this study, we investigated the effects of surface treatment on the fracture strength of porcelain-veneered zirconia. Highly translucent 4 mol% yttria-stabilized zirconia disks (KATANA HT, Kuraray Noritake Dental) were divided into three surface-treatment groups: 1)as-sintered, 2) alumina sandblasted, and 3) ground. Crystallographic and surface-roughness analyses were conducted for each group. Veneering ceramics (Cerabien ZR, Kuraray Noritake Dental) were applied to the zirconia surfaces. The fracture strengths of the porcelain-veneered zirconia disks were measured using biaxial flexural-strength tests. Crystallographic analysis revealed that grinding and sandblasting increased the fractions of the monoclinic and rhombohedral zirconia phases. The ground specimens had a higher surface roughness than the sandblasted specimens. Weibull analysis showed no significant differences in biaxial flexural strength among the three groups. The results suggest that these surface treatments do not affect the fracture strength of porcelain-veneered zirconia.

UV-Curing Assisted Direct Ink Writing of Dense, Crack-Free, and High-Performance Zirconia-Based Composites With Aligned Alumina Platelets.

Additive manufacturing (AM) of high-performance structural ceramic components with comparative strength and toughness as conventionally manufactured ceramics remains challenging. Here, a UV-curing approach is integrated in direct ink writing (DIW), taking advantage from DIW to enable an easy use of high solid-loading pastes and multi-layered materials with compositional changes; while, avoiding drying problems. UV-curable opaque zirconia-based slurries with a solid loading of 51 vol% are developed to fabricate dense and crack-free alumina-toughened zirconia (ATZ) containing 3 wt% alumina platelets. Importantly, a non-reactive diluent is added to relieve polymerization-induced internal stresses, avoid subsequent warping and cracking, and facilitate the de-binding. For the first time, UV-curing assisted DIW-printed ceramic after sintering reveals even better mechanical properties than that processed by a conventional pressing. This is attributed to the aligned alumina platelets, enhancing crack deflection and improving the fracture toughness from 6.8 ± 0.3 MPa m0.5 (compacted) to 7.4 ± 0.3 MPa m0.5 (DIW). The four-point bending strength of the DIW ATZ (1009 ± 93 MPa) is also higher than that of the conventionally manufactured equivalent (861 ± 68 MPa). Besides homogeneous ceramic, laminate structures are demonstrated. This work provides a valuable hybrid approach to additively manufacture tough and strong ceramic components.

Factors influencing postoperative bleeding after dental extraction in older adult patients receiving anticoagulation therapy.

OBJECTIVES: To investigate factors influencing postoperative bleeding occurrence after dental extraction in older patients receiving anticoagulation therapy. MATERIALS AND METHODS: This retrospective study included patients aged ≥ 65 years receiving one of the following anticoagulants: apixaban, edoxaban, rivaroxaban, and warfarin. Patients who underwent one to multiple tooth extractions in the geriatric dentistry clinic at Tokyo Medical and Dental University Hospital between August 1, 2016, and November 30, 2020, were included. The outcome variable was postoperative bleeding occurrence. Logistic regression analysis was performed with the following ten factors as explanatory variables: age, sex, maximum systolic blood pressure during the extraction, type of local anesthesia, vertical incision, osteotomy, usage of surgical splints, the mesiodistal width of the extracted tooth on a radiograph, use of antiplatelet agents, and history of diabetes requiring medication. RESULTS: Among 395 participants (mean age, 82.3 ± 6.5 years) included in this study, 75 patients experienced postoperative bleeding after tooth extraction. Logistic regression analysis revealed that the odds ratios for the vertical incision (18.400, p < 0.001), osteotomy (3.630, p = 0.00558), usage of surgical splints (1.860, p = 0.0395), and the mesiodistal width of the extracted tooth on a radiograph (1.060, p = 0.0261) were statistically significant. CONCLUSIONS: For dental extraction in older patients receiving anticoagulants, postoperative bleeding is more likely to occur in patients with vertical incision, osteotomy, and posterior or multiple tooth extractions. CLINICAL RELEVANCE: Dentists should consider suturing and adjunctive hemostatic procedures for patients undergoing vertical incision, osteotomy, and multiple tooth extractions while receiving anticoagulation therapy to minimize the risk of postoperative bleeding.

Smoothed particle hydrodynamics method applied to oral region: A narrative review.

Traditionally, simulation studies in dentistry have relied on the finite element method (FEM). However, the smoothed particle hydrodynamics (SPH) method, which represents objects as particle collections without the use of meshes, has gained recent attention. Despite its application in dentistry, there is currently a lack of comprehensive literature summarizing the specific applications of the SPH method in the oral region. This review aims to provide a summary of studies that have utilized the SPH method in dentistry, focusing on its applications in analyzing large deformations, such as dental ceramic collisions, soft material analysis (e.g., denture adhesive), and virtual training simulations for dental treatments. By combining the advantages of the SPH and FEM methods, more accurate simulations can be achieved, and further applications of the SPH method in dentistry are anticipated.

Does speed-sintering affect the optical and mechanical properties of yttria-stabilized zirconia? A systematic review and meta-analysis of in-vitro studies.

Zirconia restorations are increasingly popular in dental treatment. Yttria-stabilized zirconia (YSZ) needs to be sintered for clinical applications and novel speed-sintering protocols are being developed for chairside treatments. Whether the properties of speed-sintered YSZ meet clinical requirements, however, remains unclear. Therefore, we conducted a systematic review and meta-analysis on the influence of speed-sintering on the optical and mechanical properties of dental YSZ according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A literature search was conducted using PubMed, Embase, and Web of Science databases for relevant articles published between January 1, 2010 and February 28, 2022 in English, Chinese, or Japanese. After full-text evaluation and quality assessment, 26 articles were selected. Meta-analysis revealed that speed-sintering does not significantly affect the CIEDE2000-based translucency parameter, contrast ratio, three-point flexural strength, biaxial flexural strength, or fracture toughness of YSZ (p < 0.01) compared to conventional sintering. However, the CIELab-based translucency parameter of conventionally sintered YSZ is higher than that of speed-sintered YSZ. The descriptive analysis indicated that speed-sintering does not affect the hardness of YSZ compared to that of conventionally sintered YSZ. The results indicate that speed-sintering is suitable for preparing YSZ for dental restorations.

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.

Impact of surface pre-reacted glass ionomer filler eluate on lipase gene expression in Candida albicans: An in vitro study.

Although a surface pre-reacted glass ionomer (S-PRG) exerts a suppressive effect on Candida albicans (C. albicans) activity and growth, its influence on the expression of the lipase gene (LIP) family including LIP1-LIP10, an indicator of clinical infection, has not yet been investigated. Therefore, in this study, we evaluated the effect of S-PRG filler eluates on LIP expression in C. albicans using real-time reverse-transcription polymerase chain reaction. Candida albicans was treated with an S-PRG filler diluted at ratios of 1:32 and 1:64 for 24 h at 37°C. The diluted S-PRG filler eluates (1:32) suppressed lipase activity in C. albicans by downregulating LIP5 (0.54±0.25 relative to that of the control) and LIP8 (0.35±0.074) expression after 24 h, which corresponded with decreased lipase activity. At a dilution factor of 1:64, there was no significant difference in LIP expression. Thus, the S-PRG filler eluate has potential to suppress fungal activity by downregulating LIP expression.

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.

Fully Digital Workflow for the Fabrication of Three-Dimensionally Printed Surgical Splints for Preventing Postoperative Bleeding: A Case Report.

The management of postoperative bleeding is mandatory in patients receiving anticoagulants. In this case report, we introduce a fully digital workflow for surgical splint fabrication to prevent postoperative bleeding in patients receiving anticoagulants and/or at risk of inadvertent extraction of a mobile tooth during impression making. An 87-year-old woman using apixaban had a left mandibular canine that required extraction due to chronic apical periodontitis. A digital impression was obtained using an intraoral scanner. First, the tooth to be extracted was deleted using three-dimensional (3D) computer-aided design (CAD) software (Geomagic Freeform, 3D Systems) and a stereolithography (STL) file was exported. This modified STL file was imported into another CAD software (3Shape Dental System, 3Shape) and a surgical splint was designed. The splint was fabricated using a 3D printer (Form 3; Formlabs) and light-curable resin (Dental LT Clear, Formlabs) and was delivered after the tooth extraction. The patient was followed-up 2 days after the extraction; no postoperative bleeding was detected and the surgical splint was removed. The additively manufactured surgical splint fabricated using a fully digital workflow was efficacious for managing postoperative bleeding after a dental extraction.

3D printed zirconia dental implants with integrated directional surface pores combine mechanical strength with favorable osteoblast response.

Dental implants need to combine mechanical strength with promoted osseointegration. Currently used subtractive manufacturing techniques require a multi-step process to obtain a rough surface topography that stimulates osseointegration. Advantageously, additive manufacturing (AM) enables direct implant shaping with unique geometries and surface topographies. In this study, zirconia implants with integrated lamellar surface topography were additively manufactured by nano-particle ink-jetting. The ISO-14801 fracture load of as-sintered implants (516±39 N) resisted fatigue in 5-55 °C water thermo-cycling (631±134 N). Remarkably, simultaneous mechanical fatigue and hydrothermal aging at 90 °C significantly increased the implant strength to 909±280 N due to compressive stress generated at the seamless transition of the 30-40 µm thick, rough and porous surface layer to the dense implant core. This unique surface structure induced an elongated osteoblast morphology with uniform cell orientation and allowed for osteoblast proliferation, long-term attachment and matrix mineralization. In conclusion, the developed AM zirconia implants not only provided high long-term mechanical resistance thanks to the dense core along with compressive stress induced at the transition zone, but also generated a favorable osteoblast response owing to the integrated directional surface pores. STATEMENT OF SIGNIFICANCE: Zirconia ceramics are becoming the material of choice for metal-free dental implants, however significant efforts are required to obtain a rough/porous surface for enhanced osseointegration, along with the risk of surface delamination and/or microstructure variation. In this study, we addressed the challenge by additively manufacturing implants that seamlessly combine dense core with a porous surface layer. For the first time, a unique surface with a directional lamellar pore morphology was additively obtained. This AM implant also provided strength as strong as conventionally manufactured zirconia implants before and after long-term fatigue. Favorable osteoblast response was proved by in-vitro cell investigation. This work demonstrated the opportunity to AM fabricate novel ceramic implants that can simultaneously meet the mechanical and biological functionality requirements.

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.

Mechanical properties-translucency-microstructure relationships in commercial monolayer and multilayer monolithic zirconia ceramics.

OBJECTIVES: To evaluate the phase composition, microstructure, optical properties and mechanical properties of eight commercially available multilayer and monolayer monolithic dental zirconias. METHODS: Five commercial 3Y-TZP (GC ST, GC HT [GC, Tokyo Japan]; Katana ML, Katana HT [Kuraray Noritake] and Lava Plus [3M Oral Care]) and three Y-PSZ (Katana STML, Katana UTML [Kuraray Noritake]; GC UHT [GC, Tokyo Japan]) zirconia ceramic grades were cut in plate-shaped specimens, sintered according to the manufacturer's instructions and mirror polished. The zirconia chemical composition was determined using X-ray fluorescence (XRF), phase composition was characterized using X-ray diffraction (XRD), while the grain size was measured using scanning electron microscopy (SEM). The translucency Parameter (TP) and Contrast Ratio (CR) were measured with a spectrophotometer (n = 10/group). The indentation fracture toughness (n = 10), Vickers hardness (n = 10) and biaxial strength (n = 20) of the sintered ceramics were assessed. The stress distribution during biaxial testing was assessed by Finite element analysis (FEA). Statistical analysis involved one-way ANOVA and post-hoc Tukey's HSD test and Pearson correlation test (α = 0.05). RESULTS: FEA showed that the stress distribution in plate shape specimens was the same as for disks, rationalizing the use of plates for biaxial strength testing. As expected, higher quantities of Y2O3 were related to a higher cubic ZrO2 phase content and lower tetragonality t-ZrO2, which improved translucency but diminished flexural strength and toughness. While there was no significant correlation between grain size and other material properties, addition of pigments to the zirconia grade statistically negatively affected hardness. CONCLUSION: Even though an improvement in strength and translucency could be recorded for the last Y-TZP generation, future research still needs to strive for combined improvement of optical properties and mechanical reliability of zirconia ceramics.

Impact of direct restorative dental materials on surface root caries treatment. Evidence based and current materials development: A systematic review.

This systematic review provides an update on the development and efficacy of direct restorative dental materials for root caries interventions from in vitro and clinical studies. PubMed, Embase, and Web of Science were searched using specific MeSH keywords. Full articles from September 1990 to October 2021 were collected. Additional articles were identified by reference retrieval and manual searching. Studies not related to restorative materials for root caries treatment, case reports, non-original articles, and/or articles not written in English were excluded. Bias risk assessment was performed for the clinical studies. Forty-two articles (eleven clinical studies and thirty-one in vitro studies) were included for analysis. Most in vitro studies indicated an excellent cariostatic effect of glass ionomer cement. Resin-modified glass ionomer restorations also presented reduced recurrent caries activity but had a lower efficacy than glass ionomer cement restorations. For composite resin restorations, the main material development strategies are to strengthen the tooth structure and integrate antimicrobial activity. The clinical studies offered limited data, so the most appropriate material for surface root caries treatment is still inconclusive. However, atraumatic restorative treatment (ART) is an alternative treatment for patients with limiting conditions. Further clinical studies are required to confirm the efficacy of bioactive materials.

Influence of high-speed sintering protocols on translucency, mechanical properties, microstructure, crystallography, and low-temperature degradation of highly translucent zirconia.

OBJECTIVES: Impacts of high-speed sintering on the optical and mechanical properties, microstructure, crystallography, and low-temperature degradation of commercial yttria-partially stabilized zirconia (Y-PSZ) were investigated. METHODS: Five commercial Y-PSZ products (KATANA HT, KATANA STML, KATANA UTML, Zpex 4, and Zpex Smile) were investigated. Specimens were sintered following speed-sintering (~90 min) and conventional-sintering protocols (~7 h), and a group of KATANA STML was super-speed-sintered (18 min). Dimensions of the zirconia specimens after sintering were 14.5 mm (diameter) and 1.2 mm (thickness). Translucency was assessed using a colorimeter. Biaxial flexural strength was measured using a universal testing machine, followed by Weibull analysis. Scanning electron microscopy was used for microstructure assessments. X-ray diffraction was used to analyze the crystallography before and after hydrothermal aging. Low-temperature degradation (LTD) tests were performed at 134 °C under 2-3 bar water vapor in an autoclave. RESULTS: The translucency and flexural strength were not affected significantly by the sintering programs (p > 0.05). The conventionally sintered KATANA STML and speed-sintered Zpex 4 presented the highest and lowest Weibull modulus, respectively. The conventionally-sintered Y-PSZ had a larger average grain size and smaller fraction of fine grains than those of the speed-sintered specimens. The fractographic analysis of the speed- and conventionally sintered Y-PSZ yielded comparable results. The speed-sintered Y-PSZ exhibited a lower c-ZrO2 content than that of conventionally-sintered Y-PSZ, except for KATANA HT and KATANA STML. LTD tests indicated that some of the speed and conventionally-sintered Y-PSZ exhibited similar monoclinic volume fractions. SIGNIFICANCE: Speed-sintering programs are acceptable for Y-PSZ zirconia.

Effect of post-polymerization with autoclaving treatment on monomer elution and mechanical properties of 3D-printing acrylic resin for splint fabrication.

OBJECTIVES: To evaluate the effect of post-treatment autoclaving on monomer elution and mechanical properties of three-dimensionally (3D) printed resin for splint fabrication. METHODS: Photopolymer resin specimens (Dental LT Clear) were 3D-printed and processed according to the manufacturer's instructions. The specimens were randomly divided to different post-treatment protocols: water storage, autoclaving at different temperatures (121 °C or 132 °C), times (4 or 30 min) and no treatment as a control. The elution of UDMA, HEMA, and EGDMA monomers was determined using high-performance liquid chromatography (HPLC) by immersing the specimens in 75% ethanol for 72 h. The flexural modulus, surface microhardness and linear dimensional changes were measured. The monomer elution and flexural modulus were statistically analyzed using Welch's ANOVA followed by Dunnett's T3 tests, while the surface microhardness and dimensional changes were analyzed using one-way ANOVA followed by Bonferroni tests (α = 0.05). RESULTS: The overall monomer elution concentrations were significantly highest for the control group and lowest for specimens treated in an autoclave at 132 °C for 4 min. The flexural modulus was not significantly different between all groups. The surface microhardness was significantly higher for all autoclaved groups than the control and water storage groups. The linear expansion was significantly higher after post-treatment autoclaving in contrast to water storage. SIGNIFICANCE/CONCLUSIONS: Post-polymerization autoclave treatment of the 3D-printed resin reduced monomer elution and improved surface microhardness without deteriorating the flexural modulus. Post-treatment with an autoclave at 132 °C for 4 min can be recommended for 3D-printed resin for splint fabrication.

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.

Tissue Conditioner Incorporating a Nano-Sized Surface Pre-Reacted Glass-Ionomer (S-PRG) Filler.

We aimed to evaluate the properties of a novel tissue conditioner containing a surface pre-reacted glass-ionomer (S-PRG) nanofiller. Tissue conditioners containing 0 (control), 2.5, 5, 10, 20, or 30 wt% S-PRG nanofiller or 10 or 20 wt% S-PRG microfiller were prepared. The S-PRG nanofillers and microfillers were observed using scanning electron microscopy. The ion release, acid buffering capacity, detail reproduction, consistency, Shore A0 hardness, surface roughness, and Candida albicans adhesion of the tissue conditioners were examined. The results indicated that the nanofiller particles were smaller and more homogeneous in size than the microfiller particles. In addition, Al, B, F, and Sr ions eluted from S-PRG were generally found to decrease after 1 day. Acid neutralization was confirmed in a concentration-dependent manner. The mechanical properties of tissue conditioners containing S-PRG nanofiller were clinically acceptable according to ISO standard 10139-1:2018, although the surface roughness increased with increasing filler content. Conditioners with 5-30 wt% nanofiller had a sublethal effect on C. albicans and reduced fungal adhesion in vitro. In summary, tissue conditioner containing at least 5 wt% S-PRG nanofiller can reduce C. albicans adhesion and has potential as an alternative soft lining material.

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.

Novel antimicrobial denture adhesive containing S-PRG filler.

The antimicrobial effects of denture adhesives containing novel surface pre-reacted glass-ionomer (S-PRG) fillers were assessed. We prepared denture adhesives containing S-PRG (particle sizes: 1 and 3 µm; quantities: 5, 7.5, and 10 wt%). We evaluated acid buffering capacity, ion release, and antimicrobial effects of denture adhesives with and without S-PRG. Significantly higher pH changes were observed in 1 µm S-PRG adhesives than in 3 µm S-PRG adhesives. Adhesives containing 7.5 and 10 wt% S-PRG exhibited significantly higher ion release than adhesives with 5 wt% S-PRG. The 1µm-10wt% S-PRG denture adhesive exhibited significantly lower colony-forming units on the denture adhesive contact surface than in the control group; additionally, it exhibited excellent acid buffering capacity, ion release properties, and antimicrobial effect against C. albicans, C. glabrata, S. mutans, and A. naeslundii. Longer contact periods resulted in significantly lower adhesion of Candida albicans to the denture base resin treated with denture adhesive.