Shear bond strength of orthodontic brackets bonded with primer-incorporated orthodontic adhesives and unpolymerized 3-dimensional printing materials on 3-dimensional-printed crowns.

INTRODUCTION: The use of 3-dimensional (3D) printing techniques in fabricating crowns has increased the demand for bracket bonding onto these surfaces. The objective was to evaluate the shear bond strength (SBS) of orthodontic brackets bonded onto 3D-printed crowns using primer-incorporated orthodontic adhesives and 3D printing materials as orthodontic adhesives. METHODS: A total of 160 crowns were printed with 2 3D printing materials, DentaTOOTH (Asiga, Sydney, Australia) (group A) and NextDent C&B Micro Filled Hybrid (3D Systems, Soesterberg, Netherlands) (group N). Each group was randomly divided into 4 adhesive subgroups (n = 20): Transbond XT (for groups A [ATX] and N [NTX]; 3M Unitek, Monrovia, Calif), Ortho Connect (for groups A [AOC] and N [NOC]; GC Corporation., Tokyo, Japan), Orthomite LC (for groups A [AOM] and N [NOM]; Sun Medical, Co Ltd, Moriyama, Shiga, Japan), and unpolymerized liquid state of 3D printing resin (for groups A [AA] and N [NN]). SBS was measured with a universal testing machine at a crosshead speed of 0.5 mm/min. The adhesive remnant index and the mode of failure were analyzed under the microscope. Statistical analysis was performed at a significance level of α = 0.05. RESULTS: When used as adhesives (AA and NN), 3D printing materials showed no statistically significant difference in SBS compared with Transbond XT (ATX and NTX, respectively). In group N, NN showed a significantly higher SBS than primer-incorporated orthodontic adhesives (NOC and NOM; P <0.001). Adhesive failures were only observed in primer-incorporated orthodontic adhesives (AOC, NOC, AOM, and NOM). CONCLUSIONS: Primer-incorporated orthodontic adhesives, as well as unpolymerized 3D printing materials employed as orthodontic adhesives on 3D-printed crowns, exhibited comparable bonding strength to Transbond XT without surface modification. Despite variations in adhesive-related factors, all measurements stayed within clinically acceptable ranges, highlighting the potential of these materials for orthodontic bonding on 3D-printed crowns, simplifying clinical procedures without compromising bond strength.

Chlorhexidine-Containing Electrospun Polymeric Nanofibers for Dental Applications: An In Vitro Study.

Chlorhexidine is the most commonly used anti-infective drug in dentistry. To treat infected void areas, a drug-loaded material that swells to fill the void and releases the drug slowly is needed. This study investigated the encapsulation and release of chlorhexidine from cellulose acetate nanofibers for use as an antibacterial treatment for dental bacterial infections by oral bacteria Streptococcus mutans and Enterococcus faecalis. This study used a commercial electrospinning machine to finely control the manufacture of thin, flexible, chlorhexidine-loaded cellulose acetate nanofiber mats with very-small-diameter fibers (measured using SEM). Water absorption was measured gravimetrically, drug release was analyzed by absorbance at 254 nm, and antibiotic effects were measured by halo analysis in agar. Slow electrospinning at lower voltage (14 kV), short target distance (14 cm), slow traverse and rotation, and syringe injection speeds with controlled humidity and temperature allowed for the manufacture of strong, thin films with evenly cross-meshed, uniform low-diameter nanofibers (640 nm) that were flexible and absorbed over 600% in water. Chlorhexidine was encapsulated efficiently and released in a controlled manner. All formulations killed both bacteria and may be used to fill infected voids by swelling for intimate contact with surfaces and hold the drug in the swollen matrix for effective bacterial killing in dental settings.

Characterization of polymethylmethacrylate microspheres loaded with silver and doxycycline for dental materials applications.

OBJECTIVES: The manufacturing of polymethylmethacrylate(PMMA) microspheres loaded with doxycycline(DOX) and/or silver sulfate(Ag2SO4) to be incorporated into glass ionomer cement(GIC). METHODS: PMMA microspheres were manufactured with Ag2SO4(1-5%) and/or DOX(5-15%). Particle size, encapsulation efficiency and drug release were measured by light microscope, ICP, and HPLC. Microspheres were added to a dental GIC(20%w/w). Drug release and DTS were investigated. Minimum inhibitory concentration and antibacterial effects of PMMA microspheres into GIC materials were tested. RESULTS: The median diameter of 50 µm was obtained for microspheres. DOX was encapsulated at an efficiency of 8.3% using a theoretical loading of 15%DOX + 5%Ag2SO4. The Ag2SO4 encapsulation efficiency was 0.63% using a theoretical loading of 5%AgSO4. All groups showed burst release within the first day and continued released up to 15 days, with 60-83% of DOX and approximately 30% of silver. For GIC, approximately 15% of DOX and 0.18% of silver were released in a 7-day period. Microbiological results showed an antimicrobial effect against S. mutans when the lead formulation of microspheres was added. The DTS was reduced by the inclusion of microspheres. SIGNIFICANCE: PMMA microspheres containing DOX and Ag2SO4 offer a sustained antimicrobial activity for dental applications and promising potential for the biomedical field.

Effects of prolonged use of over-the-counter bleaching agents on enamel: An in vitro study.

This study evaluated the effects of four over-the-counter (OTC) bleaching products on the properties of enamel. Extracted human molars were randomly assigned into four groups (n = 5): PD: Poladay (SDI), WG: White Teeth Global (White Teeth Global), CW: Crest3DWhite (Procter & Gamble), and HS: HiSmile (HiSmile). The hydrogen peroxide (H2 O2 ) content in each product was analyzed via titration. Twenty teeth were sectioned into quarters, embedded in epoxy resin, and polished. Each quarter-tooth surface was treated with one of the four beaching times: T0: control/no-bleaching, T14: 14 days, T28: 28 days, and T56: 56 days. Materials were applied to enamel surfaces as recommended. Enamel surfaces were examined for ultramicrohardness (UMH), elastic modulus (EM), superficial roughness (Sa), and scanning electron microscopy (SEM). Ten additional teeth were used to evaluate color and degree of demineralization (DD) (n = 5). Data were statistically tested by two-way ANOVA and Tukey's tests (α = 5%). Enamel surfaces treated with PD and WG presented UMH values significantly lower than the controls (p < .05). Elastic modulus (E) was significantly reduced at T14 and T28 for PD, and at T14 for HS (p < .05). A significant increase in Sa was observed for CW at T14 (p < .05). Color changes were observed in the PD and WG groups. Additionally, DD analysis showed significant demineralization at T56 for CW. Overall, more evident morphological alterations were observed for bleaching products with higher concentrations of H2 O2 (p < .05), PD, and WG. Over-the-counter bleaching products containing H2 O2 can significantly alter enamel properties, especially when application time is extended.

Doxycycline release and antibacterial activity from PMMA/PEO electrospun fiber mats.

OBJECTIVE: To investigate the use of polymethyl methacrylate (PMMA) electrospun fiber mats containing different amounts of polyethylene oxide (PEO) as a doxycycline delivery system and to test antibacterial activity against an oral pathogen. METHODOLOGY: PMMA powders or PEO (mol wt 200 Kd) (10,20,30% w/w/) were dissolved in N, N-dimethylformamide (DMF) to obtain a final polymer concentration of 15% in DMF (w/v). 2% Doxycycline monohydrate was added to the solutions and submitted to vortex mixing. The solution was transferred to a plastic syringe and fit into a nanofiber electrospinning unit. The parameters applied were: voltage at 17.2 kV; distance of 20 cm between the needle tip and the collector plate; target speed at 2 m/min; and transverse speed at 1cm/min. Syringe pump speed was 0.15 mm/min. The drug release analysis was performed by removing aliquots of the drug-containing solution (in PBS) at specific periods. Doxycycline release was quantified using RP-HPLC. Fiber mats from all groups had their antibacterial action tested against S. mutans based on inhibition halos formed around the specimens. The experiments were performed in triplicate. Gravimetric analysis at specific periods was performed to determine any polymer loss. Morphological characterization of the electrospun fibers was completed under an optical microscope followed by SEM analysis. RESULTS: The addition of PEO to the PMMA fibers did not affect the appearance and diameter of fibers. However, increasing the %PEO caused higher doxycycline release in the first 24 h. Fibers containing 30% PEO showed statistically significant higher release when compared with the other groups. Doxycycline released from the fibers containing 20% or 30% of PEO showed effective against S. mutans. CONCLUSION: The incorporation of PEO at 20% and 30% into PMMA fiber mat resulted in effective drug release systems, with detected antibacterial activity against S. mutans.

Experimental composites of polyacrilonitrile-electrospun nanofibers containing nanocrystal cellulose.

OBJECTIVE: To test the effects of addition of polyacrilonitrile (PAN) nanofibers and nanocrystal cellulose (NCC)-containing PAN nanofibers on flexural properties of experimental dental composites. METHODS: 11wt% PAN in dimethylformamide (DMF) solution was electrospun at 17.2kVA and 20cm from the collector drum. NCC was added to the solution at 3wt%. Fiber mats were produced in triplicates and tested as-spun. Strips (5cm×0.5cm) were cut from the mat in an orientation parallel and perpendicular to the rotational direction of the collector drum. Tensile tests were performed and ultimate tensile strength (UTS), elastic modulus (E) and elongation at maximum stress (%) were calculated from stress/strain plots. Fiber mats were then infiltrated by resin monomers (50/50 BisGMA/TEGDMA wt%), stacked in a mold (2×15×25) and light-cured. Beams (2×2×25mm) were cut from the slabs and tested in a universal testing machine. Data were analyzed by multiple t-test and one-way ANOVA (α=0.05). RESULTS: Addition of 3% NCC resulted in higher tensile properties of the fibers. Fibers presented anisotropic behavior with higher UTS and E when tested in perpendicular orientation. The incorporation of 3% NCC-PAN nanofibers resulted in significant increase in work of fracture and flexural strength of experimental dental composite beams. SIGNIFICANCE: NCC was found to be a suitable nanoparticle to reinforce experimental dental composites by incorporation via nanofiber. This fundamental study warrants future investigation in the use of electrospun nanofibres as a way to reinforce dental composites.

Doxycycline release and antibacterial activity from PMMA/PEO electrospun fiber mats

Abstract Objective: To investigate the use of polymethyl methacrylate (PMMA) electrospun fiber mats containing different amounts of polyethylene oxide (PEO) as a doxycycline delivery system and to test antibacterial activity against an oral pathogen. Methodology: PMMA powders or PEO (mol wt 200 Kd) (10,20,30% w/w/) were dissolved in N, N-dimethylformamide (DMF) to obtain a final polymer concentration of 15% in DMF (w/v). 2% Doxycycline monohydrate was added to the solutions and submitted to vortex mixing. The solution was transferred to a plastic syringe and fit into a nanofiber electrospinning unit. The parameters applied were: voltage at 17.2 kV; distance of 20 cm between the needle tip and the collector plate; target speed at 2 m/min; and transverse speed at 1cm/min. Syringe pump speed was 0.15 mm/min. The drug release analysis was performed by removing aliquots of the drug-containing solution (in PBS) at specific periods. Doxycycline release was quantified using RP-HPLC. Fiber mats from all groups had their antibacterial action tested against S. mutans based on inhibition halos formed around the specimens. The experiments were performed in triplicate. Gravimetric analysis at specific periods was performed to determine any polymer loss. Morphological characterization of the electrospun fibers was completed under an optical microscope followed by SEM analysis. Results: The addition of PEO to the PMMA fibers did not affect the appearance and diameter of fibers. However, increasing the %PEO caused higher doxycycline release in the first 24 h. Fibers containing 30% PEO showed statistically significant higher release when compared with the other groups. Doxycycline released from the fibers containing 20% or 30% of PEO showed effective against S. mutans. Conclusion: The incorporation of PEO at 20% and 30% into PMMA fiber mat resulted in effective drug release systems, with detected antibacterial activity against S. mutans.

Dental Cements for Luting and Bonding Restorations: Self-Adhesive Resin Cements.

Self-adhesive resin cements combine easy application of conventional luting materials with improved mechanical properties and bonding capability of resin cements. The presence of functional acidic monomers, dual cure setting mechanism, and fillers capable of neutralizing the initial low pH of the cement are essential elements of the material and should be understood when selecting the ideal luting material for each clinical situation. This article addresses the most relevant aspects of self-adhesive resin cements and their potential impact on clinical performance. Although few clinical studies are available to establish solid clinical evidence, the information presented provides clinical guidance in the dynamic environment of material development.

Flexural properties of experimental nanofiber reinforced composite are affected by resin composition and nanofiber/resin ratio.

OBJECTIVES: To evaluate the influence of different resin blends concentrations and nanofibers mass ratio on flexural properties of experimental Poliacrylonitrile (PAN) nanofibers reinforced composites. MATERIALS AND METHODS: Poliacrylonitrile (PAN) nanofibers mats were produced by electrospinning and characterized by tensile testing and scanning electron microscopy (SEM). Experimental resin-fiber composite beams were manufactured by infiltrating PAN nanofiber mats with varied concentrations of BisGMA-TEGDMA resin blends (BisGMA/TEGDMA: 30/70, 50/50 and 70/30weight%). The mass ratio of fiber to resin varied from 0% to 8%. Beams were cured and stored in water at 37°C. Flexural strength (FS), flexural modulus (FM) and work of fracture (WF) were evaluated by three-point bending test after 24h storage. RESULTS: The tensile properties of the PAN nanofibers indicated an anisotropic behavior being always higher when tested in a direction perpendicular to the rotation of the collector drum. Except for WF, the other flexural properties (FS and FM) were always higher as the ratio of BisGMA to TEGDMA increased in the neat resin beams. The addition of different ratios of PAN fibers did not affect FS and FM of the composite beams as compared to neat resin beams (p>0.05). However, the addition of fibers significantly increased the WF of the composite beams, and this was more evident for the blends with higher TEGDMA ratios (p<0.05). SIGNIFICANCE: The inclusion of PAN nanofibers into resin blends did not negatively affect the properties of the composite and resulted in an increase in toughness that is a desirable property for a candidate material for prosthodontics application.

Durability of bonds and clinical success of adhesive restorations.

Resin-dentin bond strength durability testing has been extensively used to evaluate the effectiveness of adhesive systems and the applicability of new strategies to improve that property. Clinical effectiveness is determined by the survival rates of restorations placed in non-carious cervical lesions (NCCL). While there is evidence that the bond strength data generated in laboratory studies somehow correlates with the clinical outcome of NCCL restorations, it is questionable whether the knowledge of bonding mechanisms obtained from laboratory testing can be used to justify clinical performance of resin-dentin bonds. There are significant morphological and structural differences between the bonding substrate used in in vitro testing versus the substrate encountered in NCCL. These differences qualify NCCL as a hostile substrate for bonding, yielding bond strengths that are usually lower than those obtained in normal dentin. However, clinical survival time of NCCL restorations often surpass the durability of normal dentin tested in the laboratory. Likewise, clinical reports on the long-term survival rates of posterior composite restorations defy the relatively rapid rate of degradation of adhesive interfaces reported in laboratory studies. This article critically analyzes how the effectiveness of adhesive systems is currently measured, to identify gaps in knowledge where new research could be encouraged. The morphological and chemical analysis of bonded interfaces of resin composite restorations in teeth that had been in clinical service for many years, but were extracted for periodontal reasons, could be a useful tool to observe the ultrastructural characteristics of restorations that are regarded as clinically acceptable. This could help determine how much degradation is acceptable for clinical success.

Cements and adhesives for all-ceramic restorations.

Dental cements are designed to retain restorations, prefabricated or cast posts and cores, and appliances in a stable, and long-lasting position in the oral environment. Resin-based cements were developed to overcome drawbacks of nonresinous materials, including low strength, high solubility, and opacity. Successful cementation of esthetic restorations depends on appropriate treatment to the tooth substrate and intaglio surface of the restoration, which in turn, depends on the ceramic characteristics. A reliable resin cementation procedure can only be achieved if the operator is aware of the mechanisms involved to perform the cementation and material properties. This article addresses current knowledge of resin cementation concepts, exploring the bonding mechanisms that influence long-term clinical success of all-ceramic systems.

Mechanical stability of adhesives under water storage.

OBJECTIVES: To evaluate the effects of storage condition (wet or dry) and storage time (24h and 3 months) on the ultimate tensile strength (UTS) of Single Bond (SB), 3M-ESPE; Opti Bond Solo Plus (OB), Kerr; One Step (OS), Bisco, and Prime & Bond NT (PB), Dentsply adhesive resins. METHODS: Hourglass-shaped specimens were obtained from a metallic matrix. Each adhesive was dispensed to fill the molds completely and left undisturbed in a dark chamber for 4 min at 37 degrees C for solvent evaporation. They were individually light-cured for 80s at 500 mW/cm(2) and randomly divided into three groups: 24h of water storage; 3 months of water storage; 3 months of dry storage. The specimens were tested in tension at 0.5 mm/min using the microtensile method and data were analyzed by two-way ANOVA and SNK tests for each material. RESULTS: Water storage for 3 months did not cause significant changes in the UTS of any of the adhesives (p-value). Values for water storage ranged from 25.9 MPa for Single Bond at 24h to 32.7 MPa for Prime & Bond NT after 3 months. Dry storage for 3 months yielded significantly higher UTS for most adhesives, which ranged from approximately 20% for Opti Bond to 160% higher values for Single Bond compared to their 3 months wet storage values. CONCLUSION: The effects of storage condition and time on the UTS of adhesives were material-dependent.

Stability of wet versus dry bonding with different solvent-based adhesives.

OBJECTIVE: To evaluate the effects of surface moisture (wet or dry) and storage (24h or 3 months) on the microtensile bond strength (BS) of resin/dentin bonds mediated by two water/ethanol based adhesives Single Bond, 3M-ESPE, (SB) and Opti Bond Solo Plus, Kerr, (OB), and two acetone-based adhesives, One Step, Bisco, (OS) and Prime&Bond NT, Caulk/Dentsply, (PB). MATERIALS AND METHODS: Flat dentin surfaces were polished with 600-grit SiC paper, etched with 35% phosphoric acid for 15s and rinsed for 20s. Half the surface was maintained moist and the other half was air-dried for 30s. Each adhesive was applied simultaneously to both halves, left undisturbed for 30s and light-cured. Four-mm resin build-ups were constructed incrementally. After storage in water at 37 degrees C for 24h, slabs were produced by transversal sectioning and trimmed to an hourglass shape (0.8mm2). Half of the specimens were tested in tension at 0.6mm/min immediately after trimming and the other half after 3 months of water storage. Data were analyzed by two-way ANOVA and SNK for each material. RESULTS: Both moisture and storage affected BS to dentin, and was material-dependent. Dry bonding affected mostly the acetone-based adhesives. Larger reductions in bond strength were associated with dry bonding after 3 months of water storage. SIGNIFICANCE: Wet bonding resulted in more stable bonds over 3 months of water storage for most of the materials tested.