Effect of strontium fluoride on mechanical and remineralization properties of enamel: An in-vitro study on a modified orthodontic adhesive.

OBJECTIVES: Evaluate the ability of strontium fluoride on bond strength and enamel integrity after incorporation within orthodontic adhesive system as a delivery vehicle. METHODS: Experimental orthodontic adhesive system Transbond™ XT were modified with 1% Sr2+, 0.5% SrF2, 1% strontium, 0.5% Sr2+, 1% F-, 0.5% F-, and no additions were control. Mixing of formulation was monitored using Fourier transform infrared spectroscopy. Small-molecule drug-discovery suite was used to gain insights into Sr2+, F-, and SrF2 binding. Shear bond testing was performed after 6-months of ageing. Enamel blocks were cut, and STEM pictures were recorded. Specimens were indented to evaluate elastic modulus. Raman microscope was used to collect Raman spectra and inspected using a scanning electron microscope. Crystal structural analysis was performed using X-ray diffraction. Effect of material on cellular proliferation was determined. Confocal was performed to evaluate the effect of formulation on biofilms. RESULTS: FTIR of modified adhesives depicted peak changes within range due to various functional groups existing within samples. TEM represented structurally optimized hexagonal unit-cell of hydroxyapatite. Mean shear bond strength is recorded highest for Transbond XT with 1% SrF2. Dead bacterial percentage appeared higher in 0.5% SrF2 and 1% F- specimens. Crystal lengths showed an increase in 0.5% and 1% SrF2 specimens. Phase contrast within TEM images showed a union of 0.5% SrF2 crystal with enamel crystal with higher elastic modulus and highly mineralized crystalline hydroxyapatite. Intensity of ν1 PO43- and ν1 CO32- along with carbonate - / ν1PO43- ratio displayed good association with strontium fluoride. The formulation showed acceptable cell biocompatibility (p < 0.353). All specimens displayed characteristic diffraction maxima of different apatite angles within XRD. SIGNIFICANCE: Experimental results suggested good biocompatibility, adequate mechanical strength, and far-ranging crystallization ability. This would provide a new strategy to overcome the two major challenges of fixed orthodontics, biofilm growth, and demineralization of enamel.

Porphyromonas gingivalis can degrade dental zirconia.

OBJECTIVES: The aim of present study was to examine the effect of Porphyromonas gingivalis (P.g.) adhesion on dental zirconia by characterizing the physical and chemical properties. METHODS: Eighty polished-sintered zirconia discs were prepared and randomly distributed to 5 groups (n = 16): Zirconia cultured with - Group 1: broth containing P.g. for - 3 days; Group 2: 7 days; Group 3: broth (alone) for - 3 days; Group 4: 7 days; and Group 5: dry discs (negative control). After experimental period, broths were analyzed for pH and Zr release with inductively coupled plasma-optical emission spectroscopy (ICP-OES). The zirconia surface was evaluated by scanning electron microscope (SEM), atomic force microscopy (AFM), X-ray diffraction (XRD), water contact angle (WCA), and biaxial flexural strength (BFS). RESULTS: The mean pH with zirconia adhesion to P.g. group was significantly higher than the broth control (p < 0.05). As per ICP-OES, Zr ion/particulate release with P.g. adhesion to zirconia were significantly higher than the controls (p < 0.05). Post-experimental incubation, no defects were found on zirconia surfaces; tetragonal phase remained constant with no transformation to monoclinic phase but lower peak intensities were identified in experimental groups. WCA of zirconia surfaces with P.g. bacteria for 3 days (12.04° ± 2.05°) and 7 days (15.09° ± 2.95°) were significantly higher than zirconia surfaces immersed with broth (only) for 3 days (7.17° ± 1.09°) and 7 days (7.55° ± 0.65°), respectively (p < 0.05). BFS values of zirconia with P.g. for 3 days (632.57 ± 119.96 MPa) and 7 days (656.17 ± 100.29 MPa) were significantly lower than zirconia incubated in broth alone (765.01 ± 20.12 MPa) conditions (p < 0.05). SIGNIFICANCE: Under the conditions of present study, it can be concluded that P.g. adhesion on zirconia leads to structural alterations of dental zirconia further contributing to zirconia degradation.

Corrosion Resistance of Titanium Dental Implant Abutments: Comparative Analysis and Surface Characterization.

Metals subjected to the oral environment are prone to corrosion over time and this can be harmful. Metallic restoration components such as dental subgingival implant abutments are exposed to pH changes and different ions while in contact with saliva. The aim of the study was to evaluate the corrosion resistance of titanium dental implant abutments and to compare and contrast the surface characteristics of these alloys before and after corrosion. The corrosion examination (Ecorr, jcorr, OCP, polarization curve) of two implant abutments (TiDesign EV, Astra Tech, Dentsply, York, PA, USA; Individual Titanium Abutment, Apollo Implants Components, Pabianice, Poland) was performed in 0.9% NaCl and 5% HCl. Moreover, specimens were investigated using SEM-EDS before and after the corrosion test. The value of jcorr in NaCl was higher for Astra (34.2 × 10-8 ± 2.5 × 10-8 A/cm2) than for Apollo (8.8 × 10-8 ± 2.5 × 10-8 A/cm2). Whereas, in HCl, the opposite relationship was observed (Astra 2.9 × 10-4 ± 0.8 × 10-4 A/cm2 and Apollo 62.7 × 10-4 ± 9.3 × 10-4 A/cm2). An average reactive anodic current density in NaCl for Astra amounted up to ~0.2 × 10-5-1.5 × 10-5 A/cm2, while for Apollo-up to ~3.3-9.7 × 10-7 A/cm2. The composition of both alloys after corrosion in NaCl demonstrated some changes: a decrease in the Ti, and Al and an increase in oxygen content. Hence, both alloys after corrosion in HCl demonstrated some minor changes in the elemental composition. Based on the results it can be concluded that: 1. Astra and Apollo abutments revealed good corrosion resistance and a passivation layer on the surface. 2. Apollo abutments exhibited better corrosion resistance in a neutral environment, suggesting that Astra abutments were found to be more resistant to corrosion in an acidic medium.

The effect of in-office bleaching agents on the Vickers hardness and surface topography of polished and unpolished CAD/CAM composite materials.

In-office bleaching, using hydrogen peroxide, is effective to remove dental enamel stains. However, bleaching agents can deteriorate surface properties of CAD-CAM materials. This in vitro study aimed to investigate the effect of in-office bleaching agents on Vickers hardness and surface topography of polished and unpolished dental CAD-CAM composite materials (Grandio blocs, Lava Ultimate, BRILLIANT Crios, Cerasmart), and a polymer-infiltrated ceramic network block (Vita Enamic). The specimens were randomly divided into two groups: unpolished or polished. The micro-hardness and surface topography of each group were measured before bleaching, after a 60 min bleaching period, and 24-h and one-month post-bleaching. In-office bleaching significantly influenced the Vickers hardness of both the polished and unpolished CAD/CAM composite blocks, with Vita Enamic exhibiting the least hardness stability among all groups. Furthermore, in-office bleaching significantly influenced the surface roughness of unpolished CAD/CAM composite blocks. There was a significant difference in hardness reduction between the polished and unpolished specimens for most of the investigated materials at different time points. The bleaching did not influence the surface roughness of the investigated polished group, except for Vita Enamic and Lava Ultimate. However, it did influence the surface roughness of the investigated materials in the unpolished group.

Colour Parameters and Changes of Tea-Stained Resin Composite Exposed to Whitening Pen (In Vitro Study).

BACKGROUND: One of the crucial factors influencing the longevity of anterior aesthetic dental restorations is the colour stability of resin composites. Bleaching and whitening have become popular methods for enhancing dental aesthetics. Home whitening techniques, such as special pens, are widely available commercially. This in vitro study aimed to determine the efficiency of a whitening pen in removing tea stains from resin composite by measuring colour differences (ΔE00). Additionally, the study aimed to evaluate the variations in colour parameters measured by extra-oral and intra-oral spectrophotometers. METHODS: A total of 45 disc-shaped resin composite specimens were randomly divided into three groups; Group 1: stored in artificial saliva (control), Group 2: stored in artificial saliva followed by a whitening pen application, and Group 3: stored in tea followed by a whitening pen application. Colour measurements were taken three times for each specimen using two spectrophotometers (extra-oral and intra-oral devices); T1: before storage (baseline), T2: after storage in artificial saliva or tea for 6 days; and T3: after one week of whitening pen application in groups 2 and 3. The data were statistically analyzed using one-way ANOVA followed by the Tukey post hoc test (p ≤ 0.05). The independent sample t-test was also employed. The equation of CIEDE2000 (ΔE00) was used to calculate the colour difference between the dry, as-prepared specimens (baseline), and those after storage or bleaching. The colour changes exceeding the acceptability threshold (∆E00 = 1.8) were considered unacceptable. RESULTS: After whitening, the colour of the specimens stored in brewed tea (Group 3) remained unacceptable, as indicated by both the extra-oral and intra-oral spectrophotometers (ΔE00 = 4 and 2.9, respectively). Groups 1 and 2 exhibited lower ΔE00 values than Group 3 (p = 0.01 *). No significant difference was observed between Group 1 (stored in artificial saliva) and Group 2 (stored in artificial saliva and then bleached) (p = 0.3). Significant differences were consistently observed between the data obtained from the extra-oral spectrophotometer and the intra-oral one. CONCLUSIONS: The whitening pen proved ineffective in removing tea stains from resin composites. Although significant differences were found between the values obtained by the two spectrophotometers (extra-oral and intra-oral), both devices confirmed the unacceptable colour of the tea-stained resin composites after whitening.

Effect of Adding Silver-Doped Carbon Nanotube Fillers to Heat-Cured Acrylic Denture Base on Impact Strength, Microhardness, and Antimicrobial Activity: A Preliminary Study.

Poly (methyl methacrylate) (PMMA), is an acrylic polymer substance that is mostly used for denture base applications. The purpose of this laboratory study was to investigate the effect of adding 0.05 wt.% Ag-doped carbon nanotubes (CNT) to PMMA-based (PMMA and MMA) denture base material on the impact strength, microhardness, and antimicrobial activity. A total of 60 heat-cured acrylic resin specimens were prepared. The specimens were randomly divided into two main groups (n = 30/group), according to the powder used: (a) control group, using heat-cured PMMA; (b) treatment group, using a powder prepared by blending 0.05 wt.% silver-doped CNT nanoparticles with heat-cured PMMA. The impact strength, microhardness and anticandidal activity for each group were assessed via the Charpy, Vickers and agar diffusion tests, respectively (n = 10/test for each subgroup). Data were analyzed using independent-sample t-tests (p ≤ 0.05). The results of the impact strength test revealed that the treated heat-cured PMMA-MMA with Ag-doped CNT (2.2 kJ/mm2) was significantly higher than that of the control heat-cured PMMA (1.6 kJ/mm2). Similarly, the Vickers microhardness of the treatment group (52.7 VHN) was significantly higher than that of the control group (19.4 VHN). Regarding the agar diffusion test, after 24 h of incubation, the treated heat-cured PMMA with the Ag-doped CNT exhibited significantly higher anticandidal activity than that of the control group. Therefore, Ag-doped carbon nanotubes could be considered as promising fillers for the dental heat-cured acrylic resin to improve the resistance of the resultant denture against sudden fractures, scratching, and candida invasion.

Cathepsin-K inhibition enhances anti-cancerous activity within oral squamous cell carcinoma cells: Uncloaking the potency of new K21 formulation.

BACKGROUND: The ability of cancer cells to be invasive and metastasize depend on several factors, of which the action of protease activity takes center stage in disease progression. PURPOSE/OBJECTIVE: To analyze function of new K21 molecule in the invasive process of oral squamous cell carcinoma (OSCC) cell line. MATERIALS & METHODS: The Fusobacterium (ATCC 23726) streaks were made, and pellets were resuspended in Cal27 (ATCC CRL-2095) OSCC cell line spheroid cell microplate. Cells were seeded and Lysotracker staining performed for CathepsinK red channel. Cell and morphology were evaluated using Transmission Electron microscopy. Thiobarbituric acid assay was performed. OSCC was analyzed for Mic60. Raman spectra were collected from the cancer cell line. L929 dermal fibroblast cells were used for Scratch Assay. ELISA muti arrays were used for cytokines and matrix molecules. Internalization ability of fibroblast cells were also analyzed. Structure of K21 as a surfactant molecule with best docked poses were presented. RESULTS: Decrease in lysosomal staining was observed after 15 and 30 min of 0.1% treatment. Tumor clusters were associated with cell membrane destruction in K21 primed cells. There was functional silencing of Mic60 via K21, especially with 1% concentration with reduced cell migration and invasiveness. Raman intensity differences were seen at 700 cm-1, 1200 cm-1 and 1600 cm-1 regions. EVs were detected within presence of fibroblast cells amongst K21 groups. Wound area and wound closure showed the progress of wound healing. CONCLUSION: Over expression of CatK can be reduced by a newly developed targeted K21 based drug delivery system leading to reduced migration and adhesion of oral squamous cell carcinoma cells. The K21 drug formulation can have great potential for cancer therapies due to targeting and cytotoxicity effects.

Diagnostic Accuracy of CBCT for the Detection of Accessory Mental Foramina Using Different Devices and Imaging Modalities

This study investigated the diagnostic accuracy of CBCT for detection of accessory mental foramina (AMFs) in dry mandibles using two different devices and three different CBCT imaging modalities. A total of 40 dry mandibles (20 per group) were selected to generate corresponding CBCT images, each with three different CBCT imaging modalities (high, standard, and low doses), using ProMax 3D Mid (Planmeca) and Veraview X800 (J. Morita). The presence, count (n), location, and diameter of the AMFs were measured on both dry mandibles and CBCT scans. The Veraview X800 with different imaging modalities showed the highest accuracy (97.5%), while the ProMax 3D Mid in low-dose imaging modality exhibited the lowest accuracy (93.8%). The most common AMF sites on dry mandibles were anterior-cranial and posterior-cranial, while anterior-cranial was the most frequent on CBCT scans. As for AMF diameter, the mean mesiodistal and vertical diameters on dry mandibles were 1.89 mm and 1.47 mm, respectively, which were greater or equal to the values obtained from CBCT scans. The overall diagnostic accuracy for assessing AMFs exhibited good results, but some caution is warranted when using a low-dose imaging modality with a large voxel size (400 µm).

One-Pot Preparation of Cetylpyridinium Chloride-Containing Nanoparticles for Biofilm Eradication.

Quaternary ammonium compounds (QACs) have been widely used due to their excellent antimicrobial activity. However, using the technology where nanomaterials are employed as drug carriers to deliver QAC drugs has not been fully explored. In this study, mesoporous silica nanoparticles (MSNs) with short rod morphology were synthesized in a one-pot reaction using an antiseptic drug cetylpyridinium chloride (CPC). CPC-MSN were characterized via various methods and tested against three bacterial species (Streptococcus mutans, Actinomyces naeslundii, and Enterococcus faecalis), which are associated with oral infections, caries, and endodontic pathology. The nanoparticle delivery system used in this study prolonged the release of CPC. The manufactured CPC-MSN effectively killed the tested bacteria within the biofilm, and their size allowed them to penetrate into dentinal tubules. This CPC-MSN nanoparticle delivery system demonstrates potential for applications in dental materials.

Morphology and mechanical performance of dental crown designed by 3D-DCGAN.

OBJECTIVES: This study utilised an Artificial Intelligence (AI) method, namely 3D-Deep Convolutional Generative Adversarial Network (3D-DCGAN), which is one of the true 3D machine learning methods, as an automatic algorithm to design a dental crown. METHODS: Six hundred sets of digital casts containing mandibular second premolars and their adjacent and antagonist teeth obtained from healthy personnel were machine-learned using 3D-DCGAN. Additional 12 sets of data were used as the test dataset, whereas the natural second premolars in the test dataset were compared with the designs in (1) 3D-DCGAN, (2) CEREC Biogeneric, and (3) CAD for morphological parameters of 3D similarity, cusp angle, occlusal contact point number and area, and in silico fatigue simulations with finite element (FE) using lithium disilicate material. RESULTS: The 3D-DCGAN design and natural teeth had the lowest discrepancy in morphology compared with the other groups (root mean square value = 0.3611). The Biogeneric design showed a significantly (p < 0.05) higher cusp angle (67.11°) than that of the 3D-DCGAN design (49.43°) and natural tooth (54.05°). No significant difference was observed in the number and area of occlusal contact points among the four groups. FE analysis showed that the 3D-DCGAN design had the best match to the natural tooth regarding the stress distribution in the crown. The 3D-DCGAN design was subjected to 26.73 MPa and the natural tooth was subjected to 23.97 MPa stress at the central fossa area under physiological occlusal force (300 N); the two groups showed similar fatigue lifetimes (F-N curve) under simulated cyclic loading of 100-400 N. Designs with Biogeneric or technician would yield respectively higher or lower fatigue lifetime than natural teeth. SIGNIFICANCE: This study demonstrated that 3D-DCGAN could be utilised to design personalised dental crowns with high accuracy that can mimic both the morphology and biomechanics of natural teeth.

A Narrative Review of Bioactive Glass-Loaded Dental Resin Composites.

This review aims to provide a comprehensive analysis of the characterizations of bioactive glass (BAG)-loaded dental resin-based composite materials. Online databases (Web of Science, PubMed, and Science Direct) were used to collect data published from January 2011 to January 2022. Only BAG-containing resin adhesive and resin restorative composites are discussed in this narrative review. BAG-loaded resin composites exhibit excellent mineralization ability reflecting enhanced ion release, pH elevation, and apatite formation, especially regarding high BAG loading. This aids the anti-demineralization and remineralization of teeth. Furthermore, BAG-loaded resin composites demonstrated in vitro biocompatibility and antibacterial performance. It has been suggested that BAG fillers with small particle sizes and no more than 20 wt% in terms of loading amount should be used to guarantee the appropriate mechanical properties of resin composites. However, most of these studies focused on one or some aspects using different resin systems, BAG types, and BAG amounts. As such, this makes the comparison difficult, and it is essential to find an optimal balance between different properties. BAG-loaded resin composites can be regarded as bioactive materials, which present major benefits in dentistry, especially their capability in the bacterial inhibition, cell biocompatibility, anti-demineralization, and remineralization of teeth.

A simple AI-enabled method for quantifying bacterial adhesion on dental materials.

Purpose: Measurement of bacterial adhesion has been of great interest for different dental materials. Various methods have been used for bacterial counting; however, they are all indirect measurements with estimated results and therefore cannot truly reflect the adhesion status. This study provides a new direct measurement approach by using a simple artificial intelligence (AI) method to quantify the initial bacterial adhesion on different dental materials using Scanning Electron Microscope (SEM) images. Materials and Methods: Porphyromonas gingivalis (P.g.) and Fusobacterium nucleatum (F.n.) were used for bacterial adhesion on dental zirconia surfaces, and the adhesion was evaluated using SEM images at time points of one, seven, and 24 h(s). Image pre-processing and bacterial area measurement were performed using Fiji software with a machine learning plugin. The same AI method was also applied on SEM with Streptococcus mutans (S.m.) inoculated PMMA nano-structured surface at 1, 24, 72, and 168 h(s), and then further compared with the CLSM method. Results: For both P.g. and F.n. initiation adhesion on zirconia, a new linear correlation (r2 > 0.98) was found between bacteria adhered area and time, such that: b acteria   adhered   area   ( m m 2 ) ∝ log ⁡ ( time ) For S.m. on PMMA surface, live/dead staining CLSM method and the newly proposed AI method on SEM images were strongly and positively associated (Pearson's correlation coefficient r > 0.9), i.e. both methods are comparable. Conclusions: SEM images can be analyzed directly for both morphology and quantifying bacterial adhesion on different dental materials' surfaces by the simple AI-enabled method with reduced time, cost, and labours.

Biocompatibility and mechanical properties of an experimental E-glass fiber-reinforced composite for dentistry.

Objectives: To evaluate the biocompatibility and mechanical properties of experimental bis-phenol-A and bis-GMA free E-glass fiber-reinforced composites (FRCs) prepared with hexanediol dimethacrylate (HDDMA) based resin. Methods: Two ratios of HDDMA/TEGDMA resin were evaluated: exp-1 (70/30 wt.%) and exp-2 (50/50 wt.%) with two bis-GMA resin control groups (bis-GMA/MMA and bis-GMA/TEGDMA resins, both 70/30 wt.%). E-glass fibers were embedded into the resins to prepare FRCs specimens. Biocompatibility was assessed for cytoviability and biofilm formation with Streptococcus mutans, Streptococcus sanguinis, Enterococcus faecalis, and Candida albicans. Mechanical properties were evaluated for flexural strength and hardness (24 h, water storage 1 and 28 days), water sorption (1, 7, 14, and 28 days), contact angle, and surface roughness. The data were analyzed statistically by one-way and two-way ANOVA (p < 0.05). Results: Cytoviability of the experimental groups was significantly higher than the control groups (p < 0.05). The exp-1 cytoviability (98.2 ± 1.3%) met the ISO 10993-5 standard requirement for noncytotoxic materials. The adherence of bacteria to the experimental FRCs was visibly less than the controls, while Candida albicans adhered visibly more to the experimental groups than the controls (p < 0.05). Flexural strength showed slightly higher values for controls than for the experimental groups. The exp-1 hardness value was significantly higher in the control groups for all storage conditions (p < 0.05). The water sorption of the experimental groups was significantly higher than the controls. The surface roughness indicated no significant difference (p = 0.87). The exp-1 showed a higher contact angle with the control groups. Conclusion: The experimental HDDMA/TEGDMA-based FRCs might be potential alternatives for bis-GMA-based FRCs. Clinical significance: The HDDMA/TEGDMA E-glass FRCs might provide biocompatible restorations.

A biomimetic approach to evaluate mineralization of bioactive glass-loaded resin composites.

PURPOSE: This study explores novel solutions other than standard SBF for biomimetic evaluations of mineralization particularly for resin composites containing bioactive glass (BAG). METHODS: Experimental UDMA/TEGDMA resin composites with 0.0, 1.9, 3.8 or 7.7 vol% of 45S5 BAG fillers were prepared. Besides simulated body fluid (SBF) as control, the specimens were immersed in three other solutions either with bicarbonate which are Hank's balanced salt solution (HBSS) and cell culture medium (MEM), or without bicarbonate which is a novel Simple HEPES-containing Artificial Remineralization Promotion (SHARP) solution, for 3, 7 and 14 days. These solutions were then analyzed by ICP-OES and pH meter, and the surfaces of the BAG composites were analyzed by SEM, XRD and FTIR. RESULTS: ICP-OES revealed Ca and P concentration continuously decrease, while Si concentration increases with time in the solutions other than SBF, which showed almost unchanged elemental concentration. Only SHARP solution is able to maintain a constant pH over the immersion time. SEM, together with XRD and FTIR, showed nano-sized octacalcium phosphate (OCP) nanospheres formation on 3.8 and 7.7 vol% BAG composites after 14 days immersion in HBSS (500-600 nm) and MEM (300-400 nm). SHARP solution enabled OCP formation after 3 days and then self-assembled into urchin-like carbonated hydroxyapatite (CHA) microspheres encompassed with nanorods of 100 nm width and 8 µm length after 14 days of immersion for 7.7 vol% BAG composites. CONCLUSION: This study suggests SHARP solution can evaluate mineralization biomimetically whereas CHA microspheres can be formed on BAG-containing resin composites.

Accuracy of CBCT in the Identification of Mental, Lingual, and Retromolar Foramina: A Comparison with Visual Inspection of Human Dry Mandibles.

The present dry-mandible study evaluated the presence of the mental (MF), lingual (LF), and retromolar (RMF) foramina to assess the accuracy of CBCT in detecting these anatomical structures. In total, 38 human dry mandibles were analyzed (30 men, 8 women; mean age: 61.9 ± 13.7 years). CBCT scans were taken using low-dose parameters, and LF, MF, and RMF were assessed visually and radiographically. Both the presence (yes/no) and the count (n) of each foramen were compared between CBCTs and visual assessment. For the presence assessment, only RMF exhibited a significant difference between CBCT and visual inspection (P = .035). For count, the RMF (P = .049) and paramedian LF (P = .003) exhibited differences between the two methods. The agreement between CBCT and visual inspection was excellent for the MF, moderate-excellent for the LF, and low-moderate for the RMF. Intra- and interassessor agreement varied from excellent (MF), to moderate-excellent (LF), and low-moderate (RMF). The LF and RMF represent challenging structures to identify on CBCT images due to their limited dimension. False negative findings in CBCTs in the assessment of foramina, especially LF, might lead to surgical complications during implant surgery.

Highly Segregated Biocomposite Membrane as a Functionally Graded Template for Periodontal Tissue Regeneration.

Guided tissue regeneration (GTR) membranes are used for treating chronic periodontal lesions with the aim of regenerating lost periodontal attachment. Spatially designed functionally graded bioactive membranes with surface core layers have been proposed as the next generation of GTR membranes. Composite formulations of biopolymer and bioceramic have the potential to meet these criteria. Chitosan has emerged as a well-known biopolymer for use in tissue engineering applications due to its properties of degradation, cytotoxicity and antimicrobial nature. Hydroxyapatite is an essential component of the mineral phase of bone. This study developed a GTR membrane with an ideal chitosan to hydroxyapatite ratio with adequate molecular weight. Membranes were fabricated using solvent casting with low and medium molecular weights of chitosan. They were rigorously characterised with scanning electron microscopy, Fourier transform infrared spectroscopy in conjunction with photoacoustic sampling accessory (FTIR-PAS), swelling ratio, degradation profile, mechanical tensile testing and cytotoxicity using human osteosarcoma and mesenchymal progenitor cells. Scanning electron microscopy showed two different features with 70% HA at the bottom surface packed tightly together, with high distinction of CH from HA. FTIR showed distinct chitosan dominance on top and hydroxyapatite on the bottom surface. Membranes with medium molecular weight showed higher swelling and longer degradation profile as compared to low molecular weight. Cytotoxicity results indicated that the low molecular weight membrane with 30% chitosan and 70% hydroxyapatite showed higher viability with time. Results suggest that this highly segregated bilayer membrane shows promising potential to be adapted as a surface layer whilst constructing a functionally graded GTR membrane on its own and for other biomedical applications.

The biocompatibility of glass-fibre reinforced composites (GFRCs) - a systematic review.

PURPOSE: Fiber-reinforced composites (FRCs) have received considerable attention, owing to their potential use in dental prostheses or bone fracture fixation applications. The aim of this systematic review was to analyze and report the biological properties of FRCs reported in the existing literature. STUDY SELECTIONS: A systematic search of four databases (PubMed/MEDLINE, Scopus, Web of Science, and Cochrane library) was performed to identify all relevant studies published between 1962 and 2019. The search was limited to laboratory-based studies published in English. Citation mining was also performed through cross-referencing of included studies and hand searching of relevant journals. RESULTS: A total of 1283 potentially relevant articles were initially identified, and thirty-three articles were full-text screened. In the final ten studies included for review, four investigated bacterial adhesion and growth abilities on FRCs, four investigated the fibroblastic cytotoxicity of different surface-treated FRCs, and two investigated the osseointegration between bone and FRCs. Owing to the heterogeneity of fiber types, FRC-coating, and lack of standardized testing protocols, a meta-analysis was not feasible. The included studies indicated that glass fibers, and in particular E-glass fibers, are superior to ceramics and other FRCs in terms of bacterial adherence, fibroblast cytotoxicity, and cell viability. CONCLUSIONS: Glass-fiber-reinforced composites are cytocompatible materials that possess satisfactory biological properties and can be used in dental prosthesis and craniofacial implants. Further research is necessary to regulate the matrix ion release/degradation of FRCs to prolong the initially demonstrated properties.

The trends of dental biomaterials research and future directions: A mapping review.

OBJECTIVE: This literature research aimed to compare, contrast and quantify the innovations in the most commonly used dental biomaterials. METHODOLOGY: Original research articles based on experimental dental biomaterials published between 2007 and 2019 were retrieved and reviewed. A search of electronic databases, PubMed, Scopus, and Web of Science indexed dental/biomaterials journals, has been conducted. The inclusion criteria in this research were: synthesis of experimental dental materials, whereas commercial dental materials, review articles, and clinical trials (case reports) were excluded. RESULTS: It was found that the amount of publications related to dental subgingival implants, computer-aided modeling ceramics, aesthetic restorative materials, adhesives cements, ceramics, bioceramics, endodontic materials, bioactive scaffolds, stem cells, and guided-tissue membranes had increased significantly from 2007. At the same time, the number of publications related to dental cements, silver amalgam, and dental alloys has decreased. For characterization of dental materials it was noted that mechanical properties were tested mostly for restorative materials. On the other hand, biological properties were most assessed for dental subgingival implants and endodontic materials, however, physical properties predominantly for bioceramics. CONCLUSION: It is concluded that to meet clinical demands there was more focus on restorative materials that provided better aesthetics, including resin composites, adhesive resin composites (luting cements), zirconia, and other ceramics. The boost in laboratory and animal research related to bioceramics was attributed to their regenerative potential. This current literature study will help growing researchers to consider and judge the direction to which research might be guided in order to plan prospective research projects.

Trans-Cinnamaldehyde Attenuates Enterococcus faecalis Virulence and Inhibits Biofilm Formation.

Enterococcus faecalis as an important nosocomial pathogen is critically implicated in the pathogenesis of endocarditis, urinary tract, and persistent root canal infections. Its major virulence attributes (biofilm formation, production of proteases, and hemolytic toxins) enable it to cause extensive host tissue damage. With the alarming increase in enterococcal resistance to antibiotics, novel therapeutics are required to inhibit E. faecalis biofilm formation and virulence. Trans-cinnamaldehyde (TC), the main phytochemical in cinnamon essential oils, has demonstrated promising activity against a wide range of pathogens. Here, we comprehensively investigated the effect of TC on planktonic growth, biofilm formation, proteolytic and hemolytic activities, as well as gene regulation in E. faecalis. Our findings revealed that sub-inhibitory concentrations of TC reduced biofilm formation, biofilm exopolysaccharides, as well as its proteolytic and hemolytic activities. Mechanistic studies revealed significant downregulation of the quorum sensing fsr locus and downstream gelE, which are major virulence regulators in E. faecalis. Taken together, our study highlights the potential of TC to inhibit E. faecalis biofilm formation and its virulence.

The influence of the resin-based cement layer on ceramic-dentin bond strength.

The purpose of the study was to measure the cement thickness obtained when ceramic rods were luted to dentin and to analyze the relation between cement thickness and the previously published tensile bond strength of similar test specimens. In addition, the ISO standard 4049:2019 method was used to determine the film thickness of the used cements. Zirconia (n = 100) and lithium disilicate (n = 50) rods were cemented to bovine dentin using one of five different resin-based cements. The ceramic-dentin test specimens were cut into two slices and the cement thickness was measured using a scanning electron microscope and compared to the bond strength values of similar specimens already published. The mean cement thickness recorded for ceramic rods cemented to dentin was in the range 20-40 µm, which was larger than the cement film thickness found by the ISO method. The cement film thickness determined according to ISO standard methods did not concur with the results obtained when cementing ceramic rods to dentin. For cementing ceramic restorations, a cement thickness in the range 25-35 µm seems to be favorable for the bond strength.