Long-term evaluation of early-enamel lesions treated with novel experimental tricalcium silicate paste: A 2-year randomized clinical trial.

OBJECTIVE: The aim of the current study is to evaluate the remineralization potential of experimental tricalcium silicate (TCS) paste in comparison with more popular remineralizing agents like silver diamine fluoride potassium iodide (SDF-KI) and casein phosphopeptide amorphous calcium phosphate (CPP-ACP) on early enamel lesions. MATERIALS AND METHODS: Forty-five patients in the age range of 15-50 years had early enamel lesions on the buccal surface of molar teeth. The patients were randomly divided into three treatment groups (SDF-KI, CPP-ACP, and TCS group) with 15 patients per group. Lesions were evaluated clinically by DIAGNOdent pen immediately and after 3,6,12, and 24 months of treatment. RESULTS: The study was completed with 45 patients and 92 teeth. Twice-daily application of CPP-ACP and TCS paste showed a significant remineralization effect on early enamel lesions after 24 months (p < 0.001). Also, annual application of SDF-KI showed a significant remineralization effect after 24 months (p < 0.001). There was a significant difference between (SDF-KI and CPP-ACP) and (SDF-KI and TCS) at the different follow-up periods 3,6,12, and 24 months (p < 0.001). Meanwhile, there was no significant difference between CPP-ACP and TCS at the mentioned follow-up periods (p > 0.05). CONCLUSION: TCS showed potential remineralization for early enamel lesions. CLINICAL RELEVANCE: Experimental TCS is a promising remineralizing agent for management of early enamel lesions.

pH-dependent delivery of chlorhexidine from PGA grafted mesoporous silica nanoparticles at resin-dentin interface.

BACKGROUND: A low pH environment is created due to the production of acids by oral biofilms that further leads to the dissolution of hydroxyapatite crystal in the tooth structure significantly altering the equilibrium. Although the overall bacterial counts may not be eradicated from the oral cavity, however, synthesis of engineered anti-bacterial materials are warranted to reduce the pathogenic impact of the oral biofilms. The purpose of this study was to synthesize and characterize chlorhexidine (CHX)-loaded mesoporous silica nanoparticles (MSN) grafted with poly-L-glycolic acid (PGA) and to test the in vitro drug release in various pH environments, cytotoxicity, and antimicrobial capacity. In addition, this study aimed to investigate the delivery of CHX-loaded/MSN-PGA nanoparticles through demineralized dentin tubules and how these nanoparticles interact with tooth dentin after mixing with commercial dentin adhesive for potential clinical application. RESULTS: Characterization using SEM/TEM and EDX confirmed the synthesis of CHX-loaded/MSN-PGA. An increase in the percentage of drug encapsulation efficiency from 81 to 85% in CHX loaded/MSN and 92-95% in CHX loaded/MSN-PGA proportionately increased with increasing the amount of CHX during the fabrication of nanoparticles. For both time-periods (24 h or 30 days), the relative microbial viability significantly decreased by increasing the CHX content (P < 0.001). Generally, the cell viability percentage of DPSCs exposed to MSN-PGA/Blank, CHX-loaded/MSN, and CHX-loaded/MSN-PGA, respectively was > 80% indicating low cytotoxicity profiles of experimental nanoparticles. After 9 months in artificial saliva (pH 7.4), the significantly highest micro-tensile bond strength value was recorded for 25:50 CHX/MSN and 25:50:50 CHX/MSN-PGA. A homogenous and widely distributed 50:50:50 CHX-loaded/MSN-PGA nanoparticles exhibited excellent bonding with the application of commercially available dentin adhesive. CONCLUSIONS: A pH-sensitive CHX release response was noted when loaded in MSN grafted PGA nanoparticles. The formulated drug-loaded nanocarrier demonstrated excellent physicochemical, spectral, and biological characteristics. Showing considerable capacity to penetrate effectively inside dentinal tubules and having high antibacterial efficacy, this system could be potentially used in adhesive and restorative dentistry.

Effect of Propolis Nanoparticles against Enterococcus faecalis Biofilm in the Root Canal.

To determine the antibacterial effect of propolis nanoparticles (PNs) as an endodontic irrigant against Enterococcus faecalis biofilm inside the endodontic root canal system. Two-hundred-ten extracted human teeth were sectioned to obtain 6 mm of the middle third of the root. The root canal was enlarged to an internal diameter of 0.9 mm. The specimens were inoculated with E. faecalis for 21 days. Following this, specimens were randomly divided into seven groups, with 30 dentinal blocks in each group including: group I-saline; group II-propolis 100 µg/mL; group III-propolis 300 µg/mL; group IV-propolis nanoparticle 100 µg/mL; group V-propolis nanoparticle 300µg/mL; group VI-6% sodium hypochlorite; group VII-2% chlorhexidine. Dentin shavings were collected at 200 and 400 µm depths, and total numbers of CFUs were determined at the end of one, five, and ten minutes. The non-parametric Kruskal-Wallis and Mann-Whitney tests were used to compare the differences in reduction in CFUs between all groups, and probability values of p < 0.05 were set as the reference for statistically significant results. The antibacterial effect of PNs as an endodontic irrigant was also assessed against E. faecalis isolates from patients with failed root canal treatment. Scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM) were also performed after exposure to PNs. A Raman spectroscope, equipped with a Leica microscope and lenses with curve-fitting Raman software, was used for analysis. The molecular interactions between bioactive compounds of propolis (Pinocembrin, Kaempferol, and Quercetin) and the proteins Sortase A and ß-galactosidase were also understood by computational molecular docking studies. PN300 was significantly more effective in reducing CFUs compared to all other groups (p < 0.05) except 6% NaOCl and 2% CHX (p > 0.05) at all time intervals and both depths. At five minutes, 6% NaOCl and 2% CHX were the most effective in reducing CFUs (p < 0.05). However, no significant difference was found between PN300, 6% NaOCl, and 2% CHX at 10 min (p > 0.05). SEM images also showed the maximum reduction in E. faecalis with PN300, 6% NaOCl, and 2% CHX at five and ten minutes. CLSM images showed the number of dead cells in dentin were highest with PN300 compared to PN100 and saline. There was a reduction in the 484 cm-1 band and an increase in the 870 cm-1 band in the PN300 group. The detailed observations of the docking poses of bioactive compounds and their interactions with key residues of the binding site in all the three docking protocols revealed that the interactions were consistent with reasonable docking and IFD docking scores. PN300 was equally as effective as 6% NaOCl and 2% CHX in reducing the E. faecalis biofilms.

Quaternary ammonium silane (k21) based intracanal medicament triggers biofilm destruction.

BACKGROUND: Compare antimicrobial efficacy of a quarternary ammonium silane (QAS)/k21 as an intracanal medicament against E. faecalis and C. albicans biofilms formed on root dentin. METHODOLOGY: Dentin blocks were sterilized and E. faecalis and C. albicans microbial colonies were counted for colony-forming-units against 2%k21, 2%CHX and Ca(OH)2 medicaments. Biofilm colonies after 7 days on dentin were analysed using confocal laser scanning microscopy with live/dead bacterial viability staining. TEM was done to study dentin collagen matrix. Dentin discs from 3rd day and 7th day well plate was used for Raman spectra and observed under fluorescent-microscope. Docking studies were carried out on MMP-2 S1 binding-domain with k21. RESULTS: There was reduction of E. faecalis/C. albicans when k21, chlorhexidine and calcium hydroxide were used with highest percentage in 2%k21 treated specimens. 2%k21 showed dense and regular collagen network with intact cross-banding and decreased Raman intensity for 2%k21 on 3rd day. NaOCl + k21 showed least adherence, whereas saline groups showed highest adherence of E. faecalis and C. albicans to root-canal dentin. Alizarin red staining of hDPSCs revealed calcium deposition in all groups with significant difference seen amongst 2%k21 groups. MMP-2 ligand binding was seen accurately indicating possible target sites for k21 intervention. CONCLUSION: 2%k21 can be considered as alternative intracanal medicament.

Correction to: the Effect of Cross-Linking Efficiency of Drug-Loaded Novel Freeze Gelated Chitosan Templates for Periodontal Tissue Regeneration.

The correct spelling of the second author's name is Liebert Parreiras Nogueira.

The Effect of Cross-linking Efficiency of Drug-Loaded Novel Freeze Gelated Chitosan Templates for Periodontal Tissue Regeneration.

Innovative strategies for periodontal regeneration have been the focus of research clusters across the globe for decades. In order to overcome the drawbacks of currently available options, investigators have suggested a novel concept of functionally graded membrane (FGM) templates with different structural and morphological gradients. Chitosan (CH) has been used in the past for similar purpose. However, the composite formulation of composite and tetracycline when cross-linked with glutaraldehyde have received little attention. Therefore, the purpose of the study was to investigate the drug loading and release characteristics of novel freeze gelated chitosan templates at different percentages of glutaraldehyde. These were cross-linked with 0.1 and 1% glutaraldehyde and loaded with doxycycline hyclate. The electron micrographs depicted porous morphology of neat templates. After cross-linking, these templates showed compressed ultrastructures. Computerized tomography analysis showed that the templates had 88 to 92% porosity with average pore diameter decreased from 78 to 44.9 µm with increasing concentration. Fourier transform infrared spectroscopy showed alterations in the glycosidic segment of chitosan fingerprint region which after drug loading showed a dominant doxycycline spectral composite profile. Interestingly, swelling profile was not affected by cross-linking either at 0.1 and 1% glutaraldehyde and template showed a swelling ratio of 80%, which gained equilibrium after 15 min. The drug release pattern also showed a 40 µg/mL of release after 24 h. These doxycycline-loaded templates show their tendency to be used in a functionally graded membrane facing the defect site.

Characterization of Chitosan/TiO2 Nano-Powder Modified Glass-Ionomer Cement for Restorative Dental Applications.

OBJECTIVES: We are introducing novel glass-ionomer cement (GIC) dually-modified with chitosan (CH) in the liquid phase and titanium-dioxide nano-powder (TiO2 /NP) in the powder phase. The aim was to investigate the effect of this dual-modification on the antibacterial properties against S. mutans biofilms and on the bulk and surface mechanical properties. METHODS: Commercially available powder/liquid restorative GIC was used in this study. The GIC specimens were modified with 3% (w/w) TiO2 /NP, 10% (v/v) CH solution, or dually-modified with TiO2 /CH. The non-modified GIC was used as a control. The biofilms formations were characterized by SEM, live/dead assay using confocal-microscopy, colony-forming unit counts, and MTS assay. The bulk and surface mechanical properties were characterized in terms of flexural and compressive strengths and surface hardness, respectively. RESULTS: With the dual-modification, a significant improvement in the antibacterial properties was found both qualitatively and quantitatively. The synergetic effect of the dual-modification was also reflected on the enhancement of the flexural and compressive strengths. However, no difference was found in surface hardness. CONCLUSIONS: The modification of GIC powder with TiO2 /NP showed to be more effective in enhancing the mechanical properties. However, the enhancement in the antibacterial properties was more evident with CH incorporation in GIC liquid. CLINICAL SIGNIFICANCE: This study introduced novel glass ionomer cement dually-modified with TiO2 NP and chitosan with superior mechanical and antibacterial properties for potential applications in restorative and preventive dentistry. The modification of GIC powder with TiO2 NP showed to be more effective in enhancing the mechanical properties. However, the enhancement in the antibacterial properties was more evident with CH incorporation in GIC liquid. Although of the promising synergetic effect of the dual-modification of GIC with TiO2 NP/CH, further clinically-related studies are recommended. (J Esthet Restor Dent 29:146-156, 2017).

High-Intensity Focused Ultrasound in Dentistry: A Literature Review.

Although high-intensity focused ultrasound (HIFU) has been applied widely in medicine, utilising its non-invasive dual ablation and thermal coagulation properties, its application in dentistry has primarily remained in the research phase, predominantly in in vitro studies. Nonetheless, there has been a consistent increase in the number of publications on this subject in recent decades, focusing on areas such as remineralisation of dentine surfaces, removal of smear layers, drug delivery, and microbial elimination. The number of advantages HIFU can offer, such as its non-surgical nature, absence of ionising radiation, lack of residue, and absence of aerosols, is driving this upward trend, indicating the potential for HIFU in clinical dentistry and ongoing efforts towards developing HIFU-based devices for routine dental use. This succinct review aims to outline the historical context, operational mechanisms of HIFU, summarise recent dental research, and provide a forward-looking perspective on the role of HIFU in modern clinical dentistry.

The Synergistic Effect of High Intensity Focused Ultrasound on In-vitro Remineralization of Tooth Enamel by Calcium Phosphate Ion Clusters.

Background: Remineralization of dental enamel is an important intervention strategy for the treatment of demineralized lesions. Existing approaches have limitations such as failure to adequately reproduce both the ideal structural and mechanical properties of the native tooth. The ability of ultrasound to control and accelerate the crystallization processes has been widely reported. Therefore, a new approach was explored for in-vitro enamel remineralization involving the synergistic effect of high-intensity focused ultrasound (HIFU) coupled with calcium phosphate ion clusters (CPICs). Methods: The demineralized enamel was treated with CPICs, with or without subsequent HIFU exposure for different periods (2.5, 5, and 10 min). The specimens were characterized by scanning electron microscopy (SEM), atomic force microscopy (AFM), and Raman spectroscopy. The surface hardness and crystallographic properties of the treated specimens were evaluated using Vickers microhardness testing and X-ray diffraction (XRD), respectively. Results: SEM revealed distinct, organized, and well-defined prismatic structures, showing clear evidence of remineralization in the combined CPIC/HIFU treatment groups. AFM further revealed a decrease in the surface roughness values with increasing HIFU exposure time up to 5 min, reflecting the obliteration of interprismatic spaces created during demineralization. The characteristic Raman band at 960 cm-1 associated with the inorganic phase of enamel dominated well in the HIFU-treated specimens. Importantly, microhardness testing further demonstrated that new mineral growth also recovered the mechanical properties of the enamel in the HIFU-exposed groups. Critical to our aspirations for developing this into a clinical process, these results were achieved in only 5 min. Conclusion: HIFU exposure can synergise and significantly accelerate in-vitro enamel remineralization process via calcium phosphate ion clusters. Therefore, this synergistic approach has the potential for use in future clinical interventions.

Development of a bioactive dentin adhesive resin modified with magnesium-doped synthetic hydroxyapatite crystals.

The aim is to evaluate the development of an experimental multi-mode/Universal resin-based dentin adhesive modified with synthetic Mg2+ doped hydroxyapatite crystals (HAp) having self-remineralization and antibiofilm properties. HAp doped with Mg2+ was prepared by the precipitation method. Experimental adhesives were subjected to degree of conversion and X-ray diffraction test for size and crystal structure. Bond strength was tested, and electron microscopy (SEM/TEM) imaging of resin-dentin interface was done along with nanoleakage, nanoindentation, confocal and Raman analyses. S. mutans was analysed using CLSM images against modified adhesive specimens. Nucleating abilities within the resin-dentin specimens are determined by measuring Ca2+. Alkaline phosphatase, Runx2, and Ocn transcripts are amplified using quantitative polymerase chain reaction (q-PCR). A calcium assay is performed to quantify level of mineralisation. When compared to control adhesives, the 0.5% Hap/Mg2+ containing experimental dentin adhesive demonstrated improved interaction with dentin. The preservation of uniform intact hybrid layer with the absence of nanoleakage indicated dentin bond integrity with 0.5% HAP/Mg2+ modified adhesive. Self-remineralization and antibiofilm potentials are supported.

Evaluation of Antibacterial Efficacy of High-Intensity Focused Ultrasound Versus Photodynamic Therapy Against Enterococcus faecalis-Infected Root Canals.

OBJECTIVE: The high incidence of endodontic failure is associated with the remnants of Enterococcus faecalis present within the intricate anatomies of the root canal system (RCS), often inaccessible by the current endodontic practices. This study was aimed at evaluating the effect of high-intensity focused ultrasound (HIFU) and photodynamic therapy (PDT) on E. faecalis biofilms in artificially infected root canals for the potential application in current endodontic practices. METHODS: Forty-five single-rooted extracted teeth were instrumented using hand files, sterilized in an autoclave, infected with E. faecalis and incubated for 4 wk. The specimens were treated and identified as follows: Control, 4% sodium hypochlorite (NaOCl); riboflavin (1 mg/mL); light only; HIFU (250 kHz, 20 W, 60s); PDT; riboflavin/HIFU; light/HIFU; and riboflavin/HIFU/light. Bactericidal efficacy was determined by colony-forming units (CFU), (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) (MTT) assay, scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM). RESULTS: Enterococcus faecalis biofilm exhibited significantly lower metabolic activity when treated with HIFU (250 kHz, 20 W, 60 s) compared with the control (4% NaOCl) and PDT groups. A similar phenomenon was observed with the CFU assay. HIFU remained the most effective treatment modality, with consistent results in CLSM and SEM. CONCLUSION: This study highlighted the potential application of HIFU as an adjunct drug-free, non-destructive root canal disinfection method for endodontic treatment, suggesting an alternative to the current gold standard of 4% NaOCl and PDT.

"No-Primer" Resin Cementation of Lithium Disilicate Ceramic: A Microtensile Bond Strength Evaluation.

OBJECTIVE: The objective of this study was to evaluate the resin-ceramic adhesion of a long-carbon-chain silane (LCSI)-containing resin cement. METHODS: Polished lithium disilicate ceramic discs were etched with hydrofluoric acid and randomly assigned into four groups; (PSAP), cemented using a silane-free resin cement with no prior priming; (PSAP-S), primed using a silane-containing primer before cementation using a silane-free resin cement; (PSAU), cemented using a LCSI-containing resin cement with no prior priming; (PSAU-S), primed as for the group (PSAP-S) and cemented using a LCSI-containing resin cement. The cemented blocks were sectioned into microbeams. The resin-ceramic microtensile bond strength (µTBS) was measured at 1 week and after thermocycling. The failure modes of the tested microbeams were evaluated. RESULTS: The µTBS of the LCSI-containing and silane-free resin cements, either with or without a prior priming step, did not significantly differ. The adhesion of the LCSI-containing resin cement to lithium disilicate ceramic, either with or without a prior priming step, did not significantly deteriorate after artificial aging. CONCLUSIONS: The long-carbon-chain silane (LCSI) monomer incorporated in the resin cement eliminated the need for a silane priming step of a hydrofluoric acid-etched lithium disilicate ceramic.

Cytotoxicity and antimicrobial efficiency of ZrO2 nanoparticles reinforced 3D printed resins.

OBJECTIVE: The aim of this study was to investigate the potential antimicrobial and cytotoxic effect of modified 3D printed resin with ZrO2 nanoparticles, as long-term provisional restoration. In addition, the study involved artificial aging process for three months to observe stability of 3D printed resin. METHODS: Functionalized ZrO2 nanoparticles with γ-MPS were characterized using transmission electron microscopy, scanning electron microscope and Fourier-transform infrared spectroscopy. Dental resin was incrementally impregnated with γ-MPS modified nanoparticles at different concentrations (0, 1, 3, and 5 wt%). Specimens were printed, post-cured and placed in artificial saliva at 37 oC for 48 h or aged for 3 months. Discrepancy in composition and roughness were monitored using FTIR and AFM, respectively. Biocompatibility was evaluated using human oral fibroblasts. Antimicrobials capacity and biofilm adhesion were measured with Streptococcus mutans and Candida albicans. RESULTS: The microscopic and spectroscopic analyses confirmed γ-MPS coating around ZrO2 nanoparticles. The addition of nanoparticles (>1 wt%) significantly increased the surface roughness. Cytotoxicity results were in agreement with the recommended range of oral biomaterials standard. Moreover, the antimicrobial activity significantly improved with increasing the filler concentration. Despite the decrease in antimicrobial efficacy after 3 months of aging, modified resin revealed a critical ability to dominate biofilm formation. SIGNIFICANCE: The addition of ZrO2 nanoparticles showed significant antimicrobial capability of a 3D printed resin without inducing any cellular side effects. Thus, the modification of a 3D printed resin with ZrO2 nanoparticles has a promising future in the dental field for fabricating long-term provisional restorations.

Remineralization of early enamel lesions with a novel prepared tricalcium silicate paste.

To evaluate the remineralization potential of prepared tricalcium silicate (TCS) paste compared to silver diamine fluoride-potassium iodide (SDF-KI) and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on artificial enamel lesions. Thirty permanent sound molars were collected for the study. After cleaning, root cutting, and applying acid-resistant nail varnish, leaving a 4 × 4 mm buccal window, the teeth were subjected to demineralization process. The teeth were divided into three treatment groups (n = 10). In each group, the teeth were sectioned buccolingually to obtain two halves (30 self-control and 30 experimental halves). The self-control halves were subjected to cross-sectional microhardness (CSMH), energy-dispersive X-ray spectroscopy at 50, 100, and 150 µm from the external enamel surface, and micromorphological analysis at the superficial enamel surface. The experimental halves were subjected to the same tests after 30 days of remineralization. Three-way analysis of variance (ANOVA) outcomes showed no significant difference in CSMH after treatment among the three different groups at the different levels (p > 0.05). Meanwhile, three-way ANOVA outcomes showed a significant difference in calcium/ phosphate ratio after treatment among the three different groups at the different levels. (p < 0.05). The tricalcium silicate paste used in this study showed potential remineralization in subsurface enamel lesions.

Efficacy of Mouth Rinses and Nasal Spray in the Inactivation of SARS-CoV-2: A Systematic Review and Meta-Analysis of In Vitro and In Vivo Studies.

Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is a global and evolving pandemic associated with heavy health and financial burdens. Considering the oral cavity as the major reservoir for SARS-CoV-2, a systematic review and meta-analysis were conducted to assess the efficacy of mouth rinses and nasal sprays in reducing the salivary viral load of SARS-CoV-2. All in vivo and in vitro studies that assessed the virucidal efficacy of mouth rinses and nasal sprays against SARS-CoV-2 and were published in the English language from December 2019 to April 2022 were considered for analyses. Special Medical Subject Headings terms were used to search Pubmed, Scopus, Embase Ovid, and Web of Science databases. The toxicological data reliability assessment tool (ToxRToool) was used to assess the quality of the included studies. Thirty-three studies (11 in vivo and 22 in vitro) were deemed eligible for inclusion in this analysis. Results of the pooled data showed that povidone-iodine is the most efficacious intervention in vivo in terms of reducing the SARS-CoV-2 salivary viral load, followed by chlorhexidine. The mean difference in the viral load was 86% and 72%, respectively. Similarly, povidone-iodine was associated with the highest log10 reduction value (LRV) in vitro, followed by cetylpyridinium chloride, (LRV = 2.938 (p < 0.0005) and LRV = 2.907 (p = 0.009), respectively). Povidone-iodine-based oral and nasal preparations showed favourable results in terms of reducing SARS-CoV-2 viral loads both in vivo and in vitro. Considering the limited number of patients in vivo, further studies among larger cohorts are recommended.

Effect of post-curing light exposure time on the physico-mechanical properties and cytotoxicity of 3D-printed denture base material.

OBJECTIVE: This study investigated the effect of post curing light exposure time on the physico-mechanical properties and cytotoxicity of a 3D-printed PMMA-based denture material in comparison to a conventional heat-cured alternative as a control. METHODS: 3D-printed specimens were fabricated followed by post-curing for 0, 5, 10 or 20 min at 200 W and light wavelength range of 390-540 nm. Heat-cured specimens were fabricated using a standard protocol. Specimens were placed in artificial saliva at 37 â„ƒ for 48 h (immediate groups) and 6 months (aged group), then evaluated flexural strength/modulus, fracture toughness, microhardness, and degree of conversion. Water sorption and solubility was assessed after 28 days. Flexural strength, flexural modulus, and fracture toughness were tested through three-point bending tests, while the surface hardness was tested using Vickers's test. Fractured specimens were viewed by scanning electron microscope (SEM). Cytotoxicity in term of cell viability was evaluated using human oral fibroblasts. RESULTS: Flexural strength/modulus, fracture toughness and surface hardness significantly improved with the increase in light curing time up to 20 min. The same pattern of improvement was found with degree of conversion, water sorption, solubility, and cell viability. There was no significant difference (p < 0.01) between heat-cured material and 3D specimens post-cured for 20 min in term of flexural strength/modulus, surface hardness, and degree of conversion at the two-storage time points. SIGNIFICANCE: Generally, the physico-mechanical properties of the 3D-printed denture base material improve as post curing time increases up to 20 min which exhibited comparable performance as the conventional heat-cured control.

Formulation of nano-graphene doped with nano silver modified dentin bonding agents with enhanced interfacial stability and antibiofilm properties.

OBJECTIVE: The aim of this study was to synthesize and characterize reduced nano graphene oxide (RGO) and graphene nanoplatelets (GNPs) doped with silver nanoparticles (nAg) and to prepare an experimental dentin adhesive modified with RGO/nAg and GNP/nAg nanofillers for studying various biological and mechanical properties after bonding to tooth dentin. METHODS: Nanoparticles were characterized for their morphology and chemical structure using electron microscopy and infrared spectroscopy. Experimental dentin adhesive was modified using two weight percentage (0.25% and 0.5%) of RGO/nAg and GNP/nAg to study its degree of conversion (DC), antimicrobial potential, and cytotoxicity. The effect and significance of these modified bonding agents on resin-dentin bonded interface were investigated by evaluating interfacial nanoleakage, micropermeability, nanodynamic mechanical analysis, micro-tensile bond strength (µTBS), and four-point bending strength (BS), RESULTS: Both 0.25% and 0.5% GNP/nAg graphene-modified adhesives showed comparable DC values to the commercial and experimental adhesive (range: 42-46%). The bacterial viability of the groups 0.25% and 0.5% GNP-Ag remained very low under 25% compared to RGO/nAg groups with low cytotoxicity profiles (cell viability>85%). Resin-bonded dentin interface created with GNP/nAg showed homogenous, well-defined hybrid layer and regularly formed long resin tags devoid of any microporosity as evidenced by SEM and confocal microscopy. The lowest nanoleakage and highest bending strength and µTBS was recorded for 0.25% GNP/nAg after 12 months of ageing. A significantly increased nanoelasticity was seen for all experimental groups except for control groups. SIGNIFICANCE: The addition of 0.25% GNP/nAg showed optimized anti-biofilm properties without affecting the standard adhesion characteristics.

Silver-loaded mesoporous silica nanoparticles enhanced the mechanical and antimicrobial properties of 3D printed denture base resin.

The aim of this study is to develop a novel 3D printed denture base resin material modified with mesoporous silica nanocarrier loaded with silver (Ag/MSN) to enhance mechanical and antimicrobial properties. Acrylate resin-based was incorporated with various proportion of Ag/MSN (0.0-2.0 wt%). Specimens with different geometry were printed and characterized accordingly for the effect of modification on properties such as: mechanical and physical properties, chemical composition and degree of conversion, as well as biological response in term of biocompatibility and antimicrobial against oral fibroblast and candida biofilm (C. albicans), respectively. The consecutive addition of Ag/MSN improved significantly surface hardness and crack propagation resistance, while flexural strength remained similar to control; however, a negligible decrease was observed with higher concentrations ≥1 wt%. No significant difference was noticed with water sorption, while water solubility had a remarkable trend of reduction associated with filler content. The surface roughness significantly increased when concentration of Ag/MSN was ≥1.0 wt%. A significant reduction in C. albicans biofilm mass, as the inhibition proficiency was correlated with the proportion of the filler. With respect to the amount of Ag/MSN, the modification was compatible toward fibroblast cells. The sequential addition of Ag/MSN enhanced significantly the mechanical and antimicrobial properties of the 3D printed resin-based material without affecting adversely compatibility. The acrylic resin denture base material has susceptibility of microbial adhesion which limits its application. Silver loaded MSN showed a significant performance to enhance antimicrobial activity against C. albicans which is the main cause of denture stomatitis. The proposed invention is a promise technique for clinical application to provide an advanced prosthesis fabrication and serve as long-term drug delivery.

Development of 3D printed dental resin nanocomposite with graphene nanoplatelets enhanced mechanical properties and induced drug-free antimicrobial activity.

OBJECTIVES: Oral prosthetic rehabilitation has been used for a long time to restore function and natural appearance; however, it is still one of the most challenging areas in dentistry due to its technical fabrication process and biological behavior. Considering the advantages of additive manufacturing technology, this study introduced the feasibility of developing a 3D printed resin-based composition modified with graphene nanoplatelets (GNPs) to improve properties. METHODS: Acrylate-based resin was impregnated with different concentrations of GNPs (0.0-0.25 wt%), and then different aspects such as mechanical, physical, biological and antimicrobial were analyzed to evaluate the effectiveness. TEM and SEM were used to characterize GNPs and their existence within the resin. Surface topography and roughness were evaluated using AFM. The degree of conversion and composition were confirmed by FTIR. Mechanical properties were detected using bending strength, microhardness and nanoindentation. Biocompatibility and antimicrobial activities were assessed with oral fibroblast and Candida albicans (C. albicans), respectively. In addition, most of the measurements were performed repeatedly after 3 months of storage in artificial saliva to evaluate performance. RESULTS: GNPs improved strength significantly at low concentrations ≤ 0.05 wt%, while the addition up to 0.25 wt% enhanced printed nanocomposite hardness and elasticity. The modification did not induce a toxic response, as its biocompatibility was within the recommended range of biomedical devices. Antimicrobial activity was of prominence, as GNPs showed an outstanding route of reducing C. albicans activity associated with filler proportion. SIGNIFICANCE: The embedment of GNPs in 3D printed resin can become a key material for customized applications that require high antimicrobial, stiffness and strength properties.

Evaluation of usage-induced degradation of different endodontic file systems.

To evaluate structural profiles and mechanical behaviour of WaveOne Gold (WOG), Twisted File Adaptive (TFA) and XP-endo shaper (XPS) instruments after root canal preparation. Standardized in vitro shaping was performed in presence of 5.25% sodium hypochlorite. File morphology was analyzed using scanning electron microscopy; X-ray diffraction analysis was performed before and after use along with Raman spectroscopy. Nanoindentation was carried out to characterize surface topography. Ni2+ release was measured at 1, 3, 5 and 7 days. X-ray photoelectron spectroscopy (XPS) analysis was done before and after use. After allocating scan line shifts like in WOG, mechanical deformation was shown using first order polynomials. XPS file system showed minimal grooves on surface. SEM of WOG instrument showed scraping surface defects. Hardness varied from 8.11 ± 0.99 GPa in TFA system to 6.7 ± 1.27 GPa and 4.06 ± 4.1 GPa in XPS and WOG. Ni2+ concentration from WOG was 171.2 µg/L. Raman peak at 540-545 cm-1 is attributed to Cr2O3. High resolution of Ti 2p spectrum show distinctive peaks with binding energies dominating in WOG, XPS and TFA file system. XRD exhibited NiTi phases with diffraction peaks. WOG files showed more surface deterioration and less passive layer formation as compared to TFA and XPS systems.