Synthesis of Submicrometric Chitosan Particles Loaded with Calcium Phosphate for Biomedical Applications.

Chitosan particles loaded with dibasic calcium phosphate anhydrous (DCPA) is a promising strategy for combining antimicrobial and osteoconduction properties in regenerative medicine. However, mostly micrometer-sized particles have been reported in the literature, limiting their use and reducing their effect in the biomedical field. We have recently overcome this limitation by developing submicrometer-sized particles with electrospray technique. The objective of this study was to understand how the process parameters control the size and properties of submicrometer chitosan particles loaded with DCPA. Solutions of 10 mg/mL chitosan and 2.5 mg/mL DCPA in a 90% acetic acid were electrosprayed under three distinct flow rate conditions: 0.2, 0.5, and 1.0 mL/h. The particles were crosslinked in a glutaraldehyde atmosphere and characterized in terms of their morphology, inorganic content, zeta potential, and minimum inhibitory concentration (MIC) against S. mutans. All conditions showed particles with two similar morphologies: one small-sized with a spherical shape and another larger-sized with a bi-concave shape. All generated a broad particle size distribution, with a similar mean size of ~ 235 nm. The addition of DCPA decreased the zeta potential for all the samples, but it was above 30 mV, indicating a low aggregation potential. The lower flow rate showed the worst efficacy for DCPA incorporation. Antimicrobial activity was greater in chitosan/DCPA particles with flow rate of 0.5 mL/h. It can be concluded that the flow rate of 0.5 mL/h presents the best compromise solution in terms of morphology, zeta potential, MIC, and inorganic content.

Relationship between toothpastes properties and patient-reported discomfort: crossover study.

OBJECTIVES: This study aims to correlate patient-reported reactions with in vitro analyses of the pH, abrasive quality, and cytotoxicity of four toothpastes. MATERIALS AND METHODS: One hundred twenty-one patients received non-identified samples of toothpaste to be used for 6 days and answered a questionnaire about their sensations. In vitro analysis: the pH of toothpastes was measured with a pH meter. The abrasivity of toothpastes was evaluated against composite resin specimens (n = 10). A toothbrushing machine was used to simulate wear, which was indirectly measured by mass loss using a scale. Cell culture media conditioned with toothpaste were used to assess the cytotoxicity. Confluent cells were kept in contact with the conditioned media or control for 24 h. The cell viability was measured using the 3-(bromide, 4,5-dimethylthiazol-2yl)-2,5-diphenyltetrazolium (MTT)-reduction assay. The obtained data on the pH, weight loss, and cell viability were compared by ANOVA/Tukey's tests (p < 0.05). RESULTS: With the exception of the bleaching effect paste, the Oral B® paste produced the highest frequencies of irritation reports, tooth sensitivity, taste discomfort, and texture discomfort in the clinical study; patients also reported rougher teeth, soft tissue peeling, dry mouth, thrush, tingling, and taste changes in response to this paste. The in vitro analysis demonstrated that Oral B® had the lowest pH, the highest abrasivity, and produced the lowest cell viability (p < 0.01). CONCLUSION: Results suggest that low pH toothpastes that are highly abrasive and cytotoxic may cause undesirable reactions in patients. CLINICAL RELEVANCE: Toothpaste's properties should be well known for indication to patient therefore minimizing discomfort reports.

The impact of chitosan in experimental resin with different photoinitiator systems.

OBJECTIVE: to investigate the effect of different concentrations of chitosan added to experimental resins containing either BAPO or camphorquinone (CQ) as photoinitiators, regarding degree of conversion (DC), flexural strength (FS), flexural elastic modulus (E), Knoop microhardness (KHN), cytotoxicity, genotoxicity and antimicrobial activity. METHODS: Experimental resins with polymeric matrix of BisGMA and TEGDMA was added either 0.5 wt% BAPO or 0.5 wt% camphorquinone/0.2% amine along with and chitosan concentrations of 0.5%; 1.0% or 2.0%. Degree of conversion was measured using Fourier transformed infrared spectroscopy. Flexural strength and elastic modulus were obtained through three-point bending test and Knoop microhardness was measured in a microidenter. Direct cytotoxicity was performed in human keratinocytes and genotoxicity test was done in murine macrophages cells. Antimicrobial activity was acessed against Staphylococcus aureus and Streptococcus mutans through the inhibition halo. Data were analyzed using two-way ANOVA and Tukey teste (α = 0.05). RESULTS: The materials containing photoinitiator BAPO showed higher values of DC, FS, E, and KHN compared to resins with CQ. The addition of chitosan did not affect the properties of these materials. However, in resins containing CQ, the addition of chitosan improve these properties compared to control group. For the groups containing BAPO the chitosan reduced cytotoxicity and genotoxicity compared to materials with camphorquinone. The materials with 1.0% and 2.0% chitosan showed increased antibacterial activity in the materials containing BAPO as photoinitiator for both bacteria. SIGNIFICANCE: The alternative photoinitiator BAPO and chitosan can improve physical and biological properties of photoactivated resins when compared with the materials with photoinitiator camphorquinone.

Photobiomodulation Therapy as an Adjuvant Treatment of Cervicofacial Liposuction Complications.

Introduction: Cervical suction lipectomy (CSL) procedures result in practically inevitable complications after the operation, such as facial edema and bruise. Photobiomodulation therapy (PBMT) can be used for analgesia, modulation of inflammatory processes, and improved tissue healing. Case Report: We have reported two cases of patients in which this therapy was used to manage complications-related CSL. As they had already been medicated and still had these side effects, the PBMT was proposed for local analgesia, nerve repair, and modulation of the inflammatory process. Within 72 hours after a single PBMT session, there was an important reduction in the severity of all situations. Conclusion: PBMT seems safe and effective in managing pain and edema-related CSL.

Development, characterization and antimicrobial activity of multilayer silica nanoparticles with chlorhexidine incorporated into dental composites.

OBJECTIVE: In this study a dentistry nanocomposite with prolonged antibacterial activity using silica nanoparticles (SNPs) loaded with chlorhexidine (CHX) was developed. METHODS: SNPs were coated with the Layer-by-Layer technique. Dental composites were prepared with organic matrix of BisGMA/TEGDMA and SNPs with or without CHX (0, 10, 20 or 30% w/w). The physicochemical properties of the developed material were evaluated and agar diffusion method was used to test the antibacterial. In addition, the biofilm inhibitory activity of the composites was evaluated against S. mutans. RESULTS: SNPs were rounded with diameters about 50 nm, the organic load increased with increasing deposited layers. Material samples with SNPs loaded with CHX (CHX-SNPs) showed the highest values of post-gel volumetric shrinkage, that ranged from 0.3% to 0.81%. Samples containing CHX-SNPs 30% w/w showed the highest values of flexural strength and modulus of elasticity. Only samples containing SNPs-CHX showed growth inhibition against S. mutans, S. mitis and S. gordonii in a concentration-dependent manner. The composites with CHX-SNPs reduced the biofilm formation of S. mutans biofilm at 24 h and 72 h. SIGNIFICANCE: The nanoparticle studied acted as fillers and did not interfere with the evaluated physicochemical properties while providing antimicrobial activity against streptococci. Therefore, this initial study is a step forward to the synthesis of experimental composites with improved performance using CHX-SNPs.

Fiber post cementation strategies: effect of mechanical cycling on push-out bond strength and cement polymerization stress.

PURPOSE: To evaluate the effect of mechanical cycling and cementation strategies on the push-out bond strength between fiber posts and root dentin and the polymerization stresses produced using three resin cements. MATERIALS AND METHODS: Eighty bovine mandibular teeth were sectioned to a length of 16 mm, prepared to 12 mm, and embedded in self-curing acrylic resin. The specimens were then distributed into 8 groups (n = 10): Gr1 - Scotchbond Multi Purpose + RelyX ARC; Gr2 - Scotchbond Multi Purpose + RelyX ARC + mechanical cycling; Gr3 - AdheSE + Multilink Automix; Gr4 - AdheSE + Multilink Automix + mechanical cycling; Gr5 - phosphoric acid + RelyX U100 (self-adhesive cement); Gr6 - phosphoric acid+ RelyX U100 + mechanical cycling; Gr7 - RelyX U100; Gr8 - RelyX U100 + mechanical cycling. The values obtained from the push-out bond strength test were submitted to two-way ANOVA and Tukey's test (p = 0.05), while the values obtained from the polymerization stress test were subjected to one-way ANOVA and Tukey's test (α = 0.05). RESULTS: Mechanical cycling did not affect the bond strength values (p = 0.236), while cementation strategies affected the push-out bond strength (p < 0.001). Luting with RelyX U100 and Scotch Bond Multi Purpose + RelyX ARC yielded higher push-out bond strength values. The polymerization stress results were affected by the factor "cement" (p = 0.0104): the self-adhesive cement RelyX U100 exhibited the lowest values, RelyX ARC resulted in the highest values, while Multilink Automix presented values statistically similar to the other two cements. CONCLUSION: The self-adhesive cement appears to be a good alternative for luting fiber posts due to the high push-out bond strengths and lower polymerization stress values.

Effects of the crosslinking of chitosan/DCPA particles in the antimicrobial and mechanical properties of dental restorative composites.

The development of restorative materials containing antibacterial agents is an alternative to reduce the progression of caries lesions. OBJECTIVE: to compare the influence of the degree of crosslinking of chitosan particles loaded with dibasic calcium phosphate (DCPA) on the mechanical properties, degree of conversion (DC), and antimicrobial properties of experimental composites. METHODS: Chitosan/DCPA particles were synthesized by the electrospraying, crosslinked by 0, 8, or 16 h in glutaraldehyde, and characterized by zeta potential and minimum inhibitory concentration (MIC) against S. mutans. Experimental resin composites of Bis-GMA and TEGDMA and 59.5% of barium glass were synthesized, chitosan/DCPA particles were added at 0 or 0.5 wt% with the different crosslinking time. The materials were subject to DC analysis, three-point bending test at 24 h and 7 days, and antimicrobial assays. Data were submitted to one-way ANOVA and Tukey test (α = 0.05). RESULTS: The particles with longer crosslinking time presented higher zeta potential and MIC, and the composite containing these particles showed significantly higher biofilm inhibition than the control group. The other two groups were similar to each other and the control. The composite containing particles with 88 h crosslinking time showed the lowest flexural strength at 7 days in water, and materials with non-crosslinked particles and longer crosslinking time presented flexural strength similar to control. The flexural modulus and DC showed no statistical difference among groups. SIGNIFICANCE: composite resin containing 0.5% chitosan/DCPA particles crosslinked by 16 h showed a reduction of biofilm formation without affecting the mechanical properties in relation to the control.

Effect of immediate or delayed light activation on curing kinetics and shrinkage stress of dual-cure resin cements.

OBJECTIVES: This study evaluated the effect of light activation (absence, immediate, or delayed) on conversion kinetics and polymerization stress of three commercial dual-cured resin cements (Enforce, RelyX ARC, and Panavia F). METHODS: Degree of conversion (DC) was monitored for 30 minutes using real-time near­Fourier transform infrared spectroscopy. The cement was mixed, placed on the spectrometer sample holder, and light activated either immediately or after five minutes (delayed light activation). When no light activation was performed, the materials were protected from light exposure (control). DC was evaluated at five and 30 minutes postmixture. Maximum rates of polymerization (Rp(max)) were obtained from the first derivative of the DC vs time curve. Polymerization stress was monitored for 30 minutes in 1-mm-thick specimens inserted between two cylinders attached to a universal testing machine. Data were submitted to analysis of variance/Tukey tests (α=0.05). RESULTS: Immediate light activation promoted the highest DC at five minutes. At 30 minutes, only RelyX ARC did not present a significant difference in DC between activation modes. Enforce and Panavia F presented higher Rp(max) for immediate and delayed light-activation, respectively. RelyX ARC showed similar Rp(max) for all activation modes. The absence of light activation resulted in the lowest stress followed by delayed light activation, while immediate light activation led to the highest values. RelyX ARC showed higher stress than Enforce, while the stress of Panavia F was similar to that of the others. CONCLUSION: Delayed light activation reduced the polymerization stress of the resin cements tested without jeopardizing DC.

Clinical performance and chemical-physical properties of bulk fill composites resin -a systematic review and meta-analysis.

OBJECTIVES: The objective of this study was to perform a meta-analysis of clinical and laboratory studies to compare the performance of bulk-fill and conventional composite resins in terms of polymerization shrinkage, polymerization stress, cusp deflection, marginal quality, degree of conversion, microhardness, flexural strength, fracture strength and clinical performance. DATA: One hundred three articles were included in this study, and the Peto method was used to compare the bulk-fill and conventional composites using the RevMan software. SOURCES: Searches were performed in the PubMed and Scopus databases. STUDY SELECTION: Laboratory studies and randomized clinical trials comparing one of the previous detailed outcomes between bulk-fill and control composites were included. CONCLUSIONS: The bulk-fill composite resins showed less shrinkage, polymerization stress, cusp deflection and microhardness than conventional composites, while both materials presented a similar marginal quality, flexural strength and fracture strength. Also, bulk-fill materials with regular viscosity showed similar shrinkage. The conversion of bulk-fill materials with flowable consistency were similar to conventional composite resins with a thickness of up to 2mm and greater than conventional composites with a thickness greater than 2mm. Despite these in vitro differences, the clinical performance of bulk-fill and conventional composite resins was similar in randomized clinical trials, with one to ten years of follow up. In conclusion, the bulk-fill materials show better or similar performance to the conventional materials in clinical trials and laboratory studies in terms of volumetric shrinkage, polymerization stress, cusps deflection and marginal quality, with the only exception being the lower level of microhardness observed for bulk-fill composites with thickness up to 2mm.

Antibacterial resin-based composite containing chlorhexidine for dental applications.

OBJETICVE: The aim of this study was to develop a composite material with antibacterial activity using MMT loaded with clorhexidine (CHX). For that it was used a BisGMA/TEGDMA matrix and added low concentration of MMT/CHX. The aim was to evaluate the drug release capacity of MMT, and not to provide reinforcement. METHODS: Six experimental composites were made with organic matrix of BisGMA/TEGDMA in equal proportions by weight. The composites received organophlizated montmorillonite with or without CHX. The concentrations were 2,5; 5 or 10% by weight. Degree of conversion (DC) was evaluated using FTIR (peak 6165 cm-1; n=5). Specimens for flexural properties (10×2×1mm) were immediate tested (24h). Elastic modulus(E) and flexural strength (FS) was measured using the three point bending test (n=10). Inibition halo was used to test the antibacterial activity against Staphylococcus aureus, Streptococcus mutans, and Porphyromonas gingivalis (n=5 for each bacteria). The inhibition of biofilm formation (BF) was evaluated by inserting polymerized disc of composite in to a culture media colonized with Streptococcus mutans (n=10). The release of CHX was measured using ultraviolet (255nm) for 10 days (n=5). The data of degree of conversion was analysed using Kruskal-Wallis/ Mann-Whitney, and the other variables using two-way ANOVA/Tukey, always considering a global level of significance of 5%. RESULTS: DC ranged from 71% to 74%. E ranged from 5.7 to 8.1GPa. FS ranged from 61.4 to 74.7MPa. There were no statistical differences among the groups for all the variables. For the three bacteria tested the composites with CHX loaded presented inhibition of growth for all concentration, except for 2,5% that did not inihibited the growth of P. gingivalis. BF was lower for the groups with 10% MMT/CHX, all groups presented BF, even those without CHX loaded. All concentrations presented release off CHX during all the 28 days analyzed. CONCLUSIONS: Within the limitation of this study it can be concluded that: all concentrations tested presented release of CHX and reduced BF. All concentration presented antibacterial activity for the three bacteria tested, except for 2,5% that did not inhibit the growth of P. gingivalis. The presence of MMT with CHX loaded did not interfere in the properties evaluated.

Periodontal clinical evaluation before and after surgically assisted rapid maxillary expansion.

INTRODUCTION: The surgically assisted rapid maxillary expansion is a procedure that reduces the resistance of the sutures correcting the posterior crossbite in adults. OBJECTIVE: The aim of this study was to evaluate the periodontal status of 17 adults submitted to this procedure. METHODS: The clinical attachment level (CAL), gingival recession, attached gingiva and bleeding were evaluated in maxillary first premolars and molars, central and lateral incisors of right and left sides before surgery, 5 days and 6 months after. Means, standard deviation, medians, minimum and maximum values were compared among the evaluations using the Friedman and McNemar tests. RESULTS: There was a statistically significant increase in CAL in the right central incisor, right and left premolars and right and left molars. There was a statistically significant increase in gingival recession in the right and left premolars and molars. The amount of attached gingiva significantly decreased in right premolars and right and left molars. There was increase in bleeding in most of the teeth. CONCLUSION: Results indicated that the surgically assisted rapid maxillary expansion might cause alterations in periodontal tissue.

A comparative study of bulk-fill composites: degree of conversion, post-gel shrinkage and cytotoxicity.

Bulk-fill composites are claimed to be restorative materials used in deep preparations and effectively photoactivated in layers up to 4 mm. The aim of the present study was to evaluate the degree of conversion, post-gel volumetric shrinkage, and cytotoxicity of six bulk-fill and two conventional composites. Degree of conversion was determined by FTIR spectroscopy; post-gel volumetric shrinkage was determined using the strain gauge method; and cytotoxicity in human fibroblasts was evaluated indirectly by the MTT assay. Data were subjected to one-way ANOVA/Tukey's test (α = 0.05). All materials, including bulk-fill and conventional composites, were classified as non-toxic, with cell viability higher than 70%. Bulk-fill composites exhibited volumetric shrinkage similar to or lower (1.4 to 0.4%) than that of conventional composites (1.7-2.1%). However, only four of the bulk-fill composites were able to sustain a homogeneous conversion at the 4-mm depth. Despite their non-toxicity and shrinkage similar to that of conventional materials, not all commercial bulk-fill materials were able to maintain a conversion as high as 80% of the superficial layer, at the 4-mm depth, indicating some failure in the bulk-fill design of some commercial brands. Therefore, the use of bulk-fill materials in dental practice is advantageous, but special attention should be given to the selection and correct use of the materials.

Mechanical characterization and ion release of bioactive dental composites containing calcium phosphate particles.

OBJECTIVE: to verify the effect of the addition of dicalcium phosphate dihydrate (DCPD) particles functionalized with di- or triethylene glycol dimethacrylate (DEGDMA or TEGDMA) on the degree of conversion (DC), post-gel shrinkage (PS), mechanical properties, and ion release of experimental composites. METHODS: Four composites were prepared containing a BisGMA/TEGDMA matrix and 60 vol% of fillers. The positive control contained only barium glass fillers, while in the other composites 15 vol% of the barium was replaced by DCPD. Besides the functionalized particles, non-functionalized DCPD was also tested. DC after 24 h (n = 3) was determined by FTIR spectroscopy. The strain gage method was used to obtain PS 5 min after photoactivation (n = 5). Flexural strength and modulus (n = 10) were calculated based on the biaxial flexural test results, after specimen storage for 24 h or 60 days in water. The same storage times were used for fracture toughness testing (FT, n = 10). Calcium and phosphate release up to 60 days was quantified by ICP-OES (n = 3). Data were analyzed by ANOVA/Tukey test (alpha: 5%). RESULTS: Composites containing functionalized DCPD presented higher DC than the control (p < 0.001). The material containing DEGDMA-functionalized particles showed higher PS than the other composites (p < 0.001). After 60 days, only the composite with DEGDMA-functionalized DCPD presented fracture strength similar to the control, while for flexural modulus only the composite with TEGDMA-functionalized particles was lower than the control (p < 0.001). FT of all composites containing DCPD was higher than the control after 60 days (p < 0.005). Calcium release was higher for the composite with non-functionalized DCPD at 15 days and no significant reductions were observed for composites with functionalized DCPD during the observation period (p < 0.001). For all the tested composites, phosphate release was higher at 15 days than in the subsequent periods, and no difference among them was recorded at 45 and 60 days (p < 0.001). CONCLUSIONS: DCPD functionalization affected all the studied variables. The composite with DEGDMA-functionalized particles was the only material with strength similar to the control after 60 days in water; however, it also presented the highest shrinkage. The presence of DCPD improved FT, regardless of functionalization. DCPD functionalization reduced ion release only during the first 15 days.

Chemical and Mechanical Properties of Experimental Dental Composites as a Function of Formulation and Postcuring Thermal Treatment.

This study evaluated the influence of formulation and thermal treatment on the degree of conversion, fracture toughness, flexural strength, and elastic modulus of experimental composites. Six composites were analyzed at BisGMA : TEGDMA molar ratios of 1 : 1 and 7 : 3 with filler at 30, 50, and 70 wt%. The degree of conversion was analyzed by Fourier transform infrared spectroscopy, fracture toughness was measured using the single-edge notched beam, and flexural strength and elastic modulus were measured with the 3-point bend test. For all tests, one-half of the specimens received thermal treatment at 170°C for 10 min. Data were analyzed by the Kruskal-Wallis or ANOVA/Tukey's test (α = 5%). The 1 : 1 BisGMA : TEGDMA ratio showed higher properties than the 7 : 3 ratio. Although the material with 70% filler had a conversion lower than the one with 50%, it showed higher mechanical properties. The thermal treatment improved all properties in all materials. Therefore, the use of an equimolar ratio of BisGMA : TEGDMA can be paired with 70 wt% filler to design dental composites that possess increased advantageous physical and chemical properties. Furthermore, the simple and low-cost method of thermal treatment proposed for use in clinical dentistry has been shown to effectively improve the properties of all evaluated materials.

Polymerization stress related to radiant exposure and its effect on microleakage of composite restorations.

OBJECTIVES: Verify the influence of radiant exposure (dose) on polymerization stress and microleakage of composite restorations using two adhesive systems. METHODS: An experimental composite (1BisGMA:1TEGDMA, 75wt.% filler) was subjected to 3, 6, 12 or 24J/cm(2) under 500mW/cm(2). Stress was measured in 1-mm height specimens placed between two glass rods (Ø=5mm) attached to a testing machine. Microleakage was assessed in cylindrical restorations (Ø=5mm, h=2mm) with enamel margins, using Adper Single Bond 2 (SB) or Adper Prompt (PR). After storage, specimens were subjected to dye penetration (50% AgNO(3)) and sectioned twice, perpendicularly. Microleakage of the 8tooth/composite interfaces was recorded in millimeters. KHN was measured at both surfaces of cylindrical specimens (Ø=5mm, 1 or 2mm height). ANOVA/Tukey test were used (alpha=0.05). KHN top and bottom were compared using paired t-tests. RESULTS: Stress increased significantly with dose (3J/cm(2): 1.4+/-0.3(c); 6J/cm(2): 4.3+/-0.5(b); 12J/cm(2): 9.3+/-0.6(a); 24J/cm(2): 9.9+/-0.7(a), in MPa). For both average and maximum microleakage, interactions were not statistically significant (p>0.05). Tooth average microleakage was influenced by the adhesive system (SB

Influence of cavity dimensions and their derivatives (volume and 'C' factor) on shrinkage stress development and microleakage of composite restorations.

OBJECTIVES: To determine, in vitro, the influence of cavity dimensions on shrinkage stress development and microleakage of composite restorations. METHODS: Cylindrical cavities with 2, 3, 4 or 6 mm diameter and 1 or 2 mm depth were prepared in bovine incisors (with enamel margins) and reproduced in photoelastic resin. Cavities were restored in bulk (Single Bond+Filtek Z250). Stress fringes were analyzed 10 min after photoactivation. Restored teeth were stored for 24 h, coated with nail polish and immersed in 50% AgNO3 for 2 h, followed by 6 h in developing solution. Specimens were sectioned twice and microleakage was measured under 20x magnification. Photoelastic data were analyzed descriptively only, due to lack of variability in some groups. Microleakage was analyzed through (generalized linear) regression models. Pearson correlation coefficients were computed to evaluate the relationship between microleakage and 'C' factor or volume. RESULTS: Fringe order was higher at the internal angles than at the margins of the restorations. There was a trend for higher fringe orders with increasing diameter and depths. Regression analysis revealed a significant influence of restoration depth for diameters above 2mm. The effect of diameter on microleakage is significantly higher (p < 0.0001) for 2-mm deep restorations, compared to those 1-mm deep. Pearson correlation coefficients suggest some relationship between microleakage and volume (r = 0.724, p < 0.0001), but not between microleakage and 'C' factor (r = 0.048, p = 0.6120). CONCLUSIONS: Shrinkage stress and microleakage were higher in restorations with larger diameters and depths. Microleakage seemed to be related to a restoration's volume, but not to its 'C' factor.

Combination of Bioactive Polymeric Membranes and Stem Cells for Periodontal Regeneration: In Vitro and In Vivo Analyses.

Regeneration of periodontal tissues requires a concerted effort to obtain consistent and predictable results in vivo. The aim of the present study was to test a new family of bioactive polymeric membranes in combination with stem cell therapy for periodontal regeneration. In particular, the novel polyester poly(isosorbide succinate-co-L-lactide) (PisPLLA) was compared with poly(L-lactide) (PLLA). Both polymers were combined with collagen (COL), hydroxyapatite (HA) and the growth factor bone morphogenetic protein-7 (BMP7), and their osteoinductive capacity was evaluated via in vitro and in vivo experiments. Membranes composed of PLLA/COL/HA or PisPLLA/COL/HA were able to promote periodontal regeneration and new bone formation in fenestration defects in rat jaws. According to quantitative real-time polymerase chain reaction (qRT-PCR) and Alizarin Red assays, better osteoconductive capacity and increased extracellular mineralization were observed for PLLA/COL/HA, whereas better osteoinductive properties were associated with PisPLLA/COL/HA. We concluded that membranes composed of either PisPLLA/COL/HA or PLLA/COL/HA present promising results in vitro as well as in vivo and that these materials could be potentially applied in periodontal regeneration.

Influence of polymeric matrix on the physical and chemical properties of experimental composites.

Nowadays, the main reasons for replacement of resin-based composite restorations are fracture or problems with the integrity of their interface, such as marginal staining, microleakage, or secondary caries. The aim of the present study was to evaluate the influence of the organic matrix on polymerization stress (PS), degree of conversion (DC), elastic modulus (E), flexural strength (FS), Knoop hardness (KHN), sorption (SP), and solubility (SL). In order to obtain a material which combines better mechanical properties with lower PS, seven experimental composites were prepared using BisGMA to TEGDMA molar ratios of 2:8, 3:7, 4:6, 5:5, 6:4, 7:3 and 8:2 and 40% of silica. PS was obtained in a universal testing machine, using acrylic as bonding substrate. DC was determined using Fourier Transform Raman spectroscopy. E and FS were obtained by the three-point bending test. KHN was measured by a microindentation test using a load of 25 g for 30 s. SP and SL were assessed according to ISO 4049. The data were submitted to one-way ANOVA. The increase in BisGMA concentration resulted in the decrease of PS, DC, E, FS and KHN. However, it did not change the SP and SL values. FS, E and KHN showed a strong and direct relationship with the DC of the materials. The composite material with a BisGMA to TEGDMA molar ratio of 1:1 was the one with better mechanical properties and lower PS.

Experimental and FE displacement and polymerization stress of bonded restorations as a function of the C-Factor, volume and substrate stiffness.

OBJECTIVES: To determine the free surface displacement of resin-composite restorations as a function of the C-Factor, volume and substrate stiffness, and to compare the results with interfacial stress values evaluated by finite element analysis (FEA). METHODS: Surface displacement was determined by an extensometer using restorations with 4 or 6mm diameter and 1 or 2mm depth, prepared in either bovine teeth or glass. The maximum displacement of the free surface was monitored for 5 min from the start of photoactivation, at an acquisition rate of 1s(-1). Axisymmetric cavity models were performed by FEA. Structural stiffness and maximum stresses were investigated. RESULTS: For glass, displacement showed a stronger correlation with volume (r=0.771) than with C-Factor (r=0.395, p<0.001 for both). For teeth, a stronger correlation was found with C-Factor (r=0.709; p<0.001) than with volume (r=0.546, p<0.001). For similar dimensions, stress and displacement were defined by stiffness. Simultaneous increases in volume and C-Factor led to increases in stress and surface displacement. Maximum stresses were located at the cavosurface angle, internal angle (glass) and at the dentine-enamel junction (teeth). The displacement of the restoration's free surface was related to interfacial stress development. CONCLUSIONS: Structural stiffness seems to affect the shrinkage stress at the tooth/resin-composite interface in bonded restorations. Deep restorations are always problematic because they showed high shear stress, regardless of their width. FEA is the only tool capable of detecting shear stress due to polymerization as there is still no reliable experimental alternative.

Correlation between polymerization stress and interfacial integrity of composites restorations assessed by different in vitro tests.

OBJECTIVE: to correlate polymerization stress data obtained under two compliance conditions with those from different interfacial quality tests. METHODS: Six commercial composites were tested (Filtek Z250/3M ESPE, Heliomolar/Ivoclar Vivadent, Aelite LS Posterior/Bisco, Filtek Supreme/3M ESPE, ELS/Saremco and Venus Diamond/Heraeus Kulzer). Bond strength (BS) was evaluated by push-out test on slices of bovine dentin (2-mm thick) with tapered cavities. For microleakage (ML) and gap analysis, cylindrical cavities in bovine incisors (4-mm diameter and 1.5-mm height) were restored and epoxy replicas of the cavo-surface margins were prepared for analysis under scanning electron microscopy (200×). The same specimens were submitted to a microleakage protocol using AgNO3 as tracer. After sectioned twice perpendicularly, ML was determined under a stereomicroscope (60×). Polymerization stress (PS, n=5) was determined by the insertion of the composite (h=1.5mm) between poly(methyl methacrylate), PMMA, or glass rods (Ø=4 mm) attached to a universal testing machine. Data were analyzed using Kruskal-Wallis (ML and gaps), and ANOVA/Tukey (BS and PS, α=5%). Pearson's correlation test was used to verify correlations between stress and interfacial quality. RESULTS: BS varied from 4.7 to 7.9 MPa. Average ML data ranged from 0.34 to 0.89 mm. Maximum ML varied from 0.61 to 1.34 mm. Gap incidence varied from 13 to 47%. PS ranged from 2.5 to 4.4 MPa in PMMA, and between 2.1 and 8.2 in glass. Statistically significant correlations were observed between stress and interfacial quality, except between BS and PS in glass. These correlations were stronger when PMMA was used as bonding substrate. CONCLUSIONS: PS data obtained using a high compliance testing system showed a stronger correlation with "in vitro" interfacial integrity results, compared to data from a low compliance system.