Physical, Mechanical, and Anti-Biofilm Formation Properties of CAD-CAM Milled or 3D Printed Denture Base Resins: In Vitro Analysis.

PURPOSE: To investigate surface characteristics (roughness and contact angle), anti-biofilm formation, and mechanical properties (mini-flexural strength) of computer-aided design and computer-aided manufacturing (CAD-CAM) polymethylmethacrylate (PMMA) polymer, and three-dimensional (3D) printed resin for denture base fabrication compared with conventional heat polymerized denture base resins. MATERIALS AND METHODS: A total of 60 discs and 40 rectangular specimens were fabricated from one CAD-CAM (AvaDent), one 3D printed (Cosmos Denture), and two conventional heat polymerized (Lucitone 199 and VipiWave) materials for denture base fabrication. Roughness was determined by Ra value; the contact angle was measured by the sessile drop method. The biofilm formation inhibition behavior was analyzed through Candida albicans adhesion, while mini-flexural strength test was done using a three-point bending test. The data were analyzed using descriptive and analytical statistics (α = 0.05). RESULTS: The CAD-CAM PMMA group showed the lowest C. albicans adhesion (log CFU/mL: 3.74 ± 0.57) and highest mini-flexural strength mean (114.96 ± 16.23 MPa). 3D printed specimens presented the highest surface roughness (Ra: 0.317 ± 0.151 µm) and lowest mini-flexural strength values (57.23 ± 9.07 MPa). However, there was no statistical difference between CAD-CAM PMMA and conventional groups for roughness, contact angle, and mini-flexural strength. CONCLUSIONS: CAD-CAM milled materials present surface and mechanical properties similar to conventional resins and show improved behavior in preventing C. albicans adhesion. Nevertheless, 3D printed resins present decreased mini-flexural strength.

Stepwise stress testing of different CAD-CAM lithium disilicate veneer application methods applied to lithium disilicate substructures.

STATEMENT OF PROBLEM: Whether a computer-aided design and computer-aided manufacture (CAD-CAM) fabricated high-translucency lithium disilicate veneer on a lithium disilicate substructure would increase the strength of the restoration compared with a traditional feldspathic porcelain veneer is unclear. PURPOSE: The purpose of this in vitro study was to evaluate the effect of different lithium disilicate veneer application methods on a lithium disilicate substructure on their biaxial flexural stress (BFS). MATERIAL AND METHODS: Lithium disilicate disks were fabricated so that when combined with the veneering disks, they had a dimension of 12×1.2 mm. Experimental groups were as follows (n=15): resin-bonded lithium disilicate veneer, lithium disilicate veneer adhesively cemented to lithium disilicate; sintered lithium disilicate veneer, lithium disilicate veneer sintered to lithium disilicate; sintered feldspathic veneer, feldspathic porcelain applied to lithium disilicate; and monolithic lithium disilicate, the control group. Weibull distribution survival analysis was used to compare the differences in the resistance to fracture after fatigue. The total number of cycles was analyzed by using 1-way ANOVA (α=.05). A finite element analysis (FEA) was also performed. The maximum principal stress (MPS) was used as the failure criterion. RESULTS: The sintered feldspathic veneer group had significantly lower fatigue resistance than sintered lithium disilicate veneer or resin-bonded lithium disilicate veneer (P<.05). The resin-bonded lithium disilicate veneer group showed significantly more fractured fragments than the other groups. No statistical difference was observed in the number of cycles. The lithium disilicate veneered groups presented similar resistance to fatigue as the monolithic specimens of the same overall dimensions. Higher peaks of MPS were observed for groups monolithic lithium disilicate, sintered lithium disilicate veneer, and sintered feldspathic veneer than for resin-bonded lithium disilicate veneer. CONCLUSIONS: Veneering a lithium disilicate substructure with a lithium disilicate veneer, bonded or sintered, increased resistance to fatigue compared with a feldspathic porcelain veneer. The lithium disilicate veneer groups had similar fatigue resistance to that of the monolithic group.

Fracture Resistance Behaviors of Titanium-Zirconium and Zirconia Implants.

PURPOSE: To evaluate the fracture resistance behaviors of titanium-zirconium, one-piece zirconia, and two-piece zirconia implants restored by zirconia crowns and different combinations of abutment materials (zirconia and titanium) and retention modes (cement-retained and screw-retained zirconia crowns). MATERIAL AND METHODS: Three research groups (n=12) were evaluated according to combinations of abutment material, retention mode, and implant type. In the control group (TTC), titanium-zirconium implants (∅ 4.1 mm RN, 12 mm, Roxolid; Straumann USA, Andover, MA) and prefabricated titanium abutments (RN synOcta Cementable Abutment, H 5.5 mm; Straumann USA) were used to support cement-retained zirconia crowns. In the second group (ZZC), one-piece zirconia implants (PURE Ceramic Implant Monotype, ∅ 4.1 mm RD, 12 mm, AH 5.5 mm; Straumann USA) were used to support cement-retained zirconia crowns. In the third group (ZTS), two-piece zirconia implants (PURE Ceramic Implant, ∅ 4.1 mm RD, 12 mm) and prefabricated titanium abutments (CI RD PUREbase Abutment, H 5.5 mm) were used to support screw-retained zirconia crowns. All zirconia crowns were manufactured in the same anatomic contour with a 5-axis dental mill and blended 3 and 5 mol% yttria-stabilized zirconia (LayZir A2). Implants were inserted into specimen holders made of epoxy resin-glass fiber composite. All specimens were then subject to artificial aging in an incubator at 37°C for 90 days. Fracture resistance of specimen assemblies was tested under static compression load using the universal testing machine based on ISO14801 specification. The peak fracture loads were recorded. All specimens were examined at the end of the test microscopically at 5× and 10× magnification to detect any catastrophic failures. Comparisons between groups for differences in peak fracture load were made using Wilcoxon Rank Sum tests and Weibull and Kaplan-Meier survival analyses (α = 0.05). RESULTS: The TTC group (942 ± 241 N) showed significantly higher peak fracture loads than the ZZC (645 ± 165 N) and ZTS (650 ± 124 N) groups (p < 0.001), while there was no significant difference between ZZC and ZTS groups (p = 0.940). The survival probability based on the Weibull and Kaplan-Meier models demonstrated different failure molds between titanium-zirconium and zirconia implants, in which the TTC group remained in the plastic strain zone for a longer period before fracture when compared to ZZC and ZTS groups. Catastrophic failures, with implant fractures at the embedding level or slightly below, were only observed in the ZZC and ZTS groups. CONCLUSIONS: Cement-retained zirconia crowns supported by titanium-zirconium implants and prefabricated titanium abutments showed superior peak fracture loads and better survival probability behavior. One-piece zirconia implants with cement-retained zirconia crowns and two-piece zirconia implants with screw-retained zirconia crowns on prefabricated titanium abutment showed similar peak fracture loads and survival probability behavior. Titanium-zirconium and zirconia implants could withstand average intraoral mastication loads in the incisor region. This study was conducted under static load, room temperature (21.7°C), and dry condition, and full impacts of intraoral hydrothermal aging and dynamic loading conditions on the zirconia implants should be considered and studied further.

Fatigue Failure Load of Lithium Disilicate Restorations Cemented on a Chairside Titanium-Base.

PURPOSE: To evaluate the fatigue failure load of distinct lithium disilicate restoration designs cemented on a chairside titanium base for maxillary anterior implant-supported restorations. MATERIALS AND METHODS: A left-maxillary incisor restoration was virtually designed and sorted into 3 groups: (n = 10/group; CTD: lithium disilicate crowns cemented on custom-milled titanium abutments; VMLD: monolithic full-contour lithium disilicate crowns cemented on a chairside titanium-base; VCLD: lithium disilicate crowns bonded to lithium disilicate customized anatomic structures and then cemented onto a chairside titanium base). The chairside titanium base was air-abraded with aluminum oxide particles. Subsequently, the titanium base was steam-cleaned and air-dried. Then a thin coat of a silane agent was applied. The intaglio surface of the ceramic components was treated with 5% hydrofluoric acid (HF) etching gel, followed by silanization, and bonded with a resin cement. The specimens were fatigued at 20 Hz, starting with a 100 N load (5000× load pulses), followed by stepwise loading from 400 N up to 1400 N (200 N increments) at a maximum of 30,000 cycles each. The failure loads, number of cycles, and fracture analysis were recorded. The data were statistically analyzed using one-way ANOVA, followed by pairwise comparisons (p < 0.05). Kaplan-Meier survival plots and Weibull survival analyses were reported. RESULTS: For catastrophic fatigue failure load and the total number of cycles for failure, VMLD (1260 N, 175,231 cycles) was significantly higher than VCLD (1080 N, 139,965 cycles) and CDT (1000 N, 133,185 cycles). VMLD had a higher Weibull modulus demonstrating greater structural reliability. CONCLUSION: VMLD had the best fatigue failure resistance when compared with the other two groups.

Influence of CAD-CAM diamond bur deterioration on surface roughness and maximum failure load of Y-TZP-based restorations.

PURPOSE: To investigate the influence of CAD-CAM diamond bur deterioration on surface roughness (Ra) and maximum failure load (Lf) of Y-TZP-based ceramic (YZ) substructures (SB) veneered with a feldspathic porcelain. METHODS: Two sets of burs (B1 and B2) were used to fabricate 30 YZ SB each in a CAD/CAM system (Cerec InLab). The SB were identified (1-30) according to the milling sequence (MS). SEM images of the burs were recorded before milling, and after milling 15 and 30 SB. The SB Ra was measured. All SB were veneered, cemented onto a fiber reinforced epoxy resin die, and loaded to failure. Specimens from B1 group were cyclic fatigued (106 cycles) before loading to failure. Fractographic analysis was performed. Data were statistically analyzed using Student's t-test, Weibull analysis, Pearson's correlation and ANOVA (α= 0.05). RESULTS: The mean Ra value of B1 specimens was statistically greater than B2. Weibull modulus of B1 and B2 were statistically similar. The correlation between MS and Lf was not statistically significant for the groups. MS and Ra had significant correlation for both groups (B1: r= -0.514, P= 0.015; B2: r= -0.462, P= 0.03). Although the visual aspect (SEM) of the burs was similar after 30 millings, the mean Ra values were significantly different after 27 millings for B1 and 24 millings for B2.

Pressable feldspathic inlays in premolars: effect of cementation strategy and mechanical cycling on the adhesive bond between dentin and restoration.

PURPOSE: To evaluate the effect of the cementation strategy and mechanical cycling (MC) on the microtensile bond strength (MTBS) of feldspathic inlays cemented to premolars. MATERIALS AND METHODS: Forty-eight human premolars were prepared and porcelain inlays were produced. Specimens were allocated into 3 groups, based on the cementation strategy: 1) conventional adhesive cementation (RelyX ARC, 3M ESPE): application of etch-and-rinse single bottle adhesive to dentin / ceramic surface treated with hydrofluoric acid (HF) and silane (S) / cementation with resin cement; 2) simplified cementation using a self-adhesive resin cement (RelyX U100, 3M ESPE); 3) modified simplified cementation using a self-adhesive resin cement (RelyX U100, 3M ESPE) with HF+S treatment. Half of the specimens from each group were submitted to MC (2x106 pulses, frequency = 4 Hz, load = 100 N). Each specimen was serially sliced for MTBS and the failures were classified. The stress distribution analysis using FEA was verified. RESULTS: All of the bar-samples from G2 were lost during cutting of the specimens. Mechanical-cycling had no significant effect on bond strength, whereas cementation strategy significant affected MTBS results. The most common type of failure was cohesive of cement. FEA showed that stresses were concentrated mainly at the loading region going up to the root fixation. CONCLUSION: Porcelain inlays cemented with conventional resin cement or self-adhesive resin cement should be associated with ceramic surface treatment. FEA showed the most critical zone for failure is located in the cement region close to the marginal crest.

Effect of the addition of silanated silica on the mechanical properties of microwave heat-cured acrylic resin.

OBJECTIVES: The purpose of this study was to evaluate the flexural strength and Vickers hardness of a microwave energy heat-cured acrylic resin by adding different concentrations of silane surface-treated nanoparticle silica. METHODS: Acrylic resin specimens with dimensions of 65 × 10 × 2.5 mm were formed and divided into five experimental groups (n = 10) according to the silica concentration added to the acrylic resin mass (weight %) prior to polymerisation : G1, without silica; G2, 0.1% silica; G3, 0.5% silica; G4, 1.0% silica; and G5, 5.0% silica. The specimens were submitted to a three-point flexural strength test and to the Vickers hardness test (HVN). The data obtained were statistically analysed by anova and the Tukey test (α = 0.05). RESULTS: Regarding flexural strength, G5 differed from the other experimental groups (G1, G2, G3 and G4) presenting the lowest mean, while G4 presented a significantly higher mean, with the exception of group G3. Regarding Vickers hardness, a decrease in values was observed, in which G1 presented the highest hardness compared with the other experimental groups. CONCLUSION: Incorporating surface-treated silica resulted in direct benefits in the flexural strength of the acrylic resin activated by microwave energy; however, similar results were not achieved for hardness.

A 58S bioactive glass for dentin hypersensitivity and erosive tooth wear: An in vitro study.

OBJECTIVES: To assess the effect of an experimental 58S bioactive glass on dentin permeability (dP) and erosive tooth wear (dentin surface loss - dSL). METHODS: 58S bioactive glass was synthetized using a sol-gel methodology, following by lyophilization and calcination, then mixed with phosphoric acid to obtain a paste (BGP). Forty-eight dentin disks (1 mm-thick) were used for dP, and 48 dentin slabs (3 mm × 3 mm) for dSL, which were assessed at three time intervals: post-EDTA (5 min in 17% EDTA solution); post-treatment (C: distilled water; BGP: experimental bioactive glass paste; NP: Nupro prophylaxis paste; CXT: Clinpro XT varnish); and post-erosive/abrasive cycling. Data were statistically analyzed (α=0.05). RESULTS: For dP and dSL, Groups did not differ significantly post-EDTA (p>0.05). Post-treatment, all groups showed lower dP than C (p<0.05), without differing significantly among them. For the dSL analysis, Groups C, BGP and NP did not differ significantly, showing lower values than CXT (p<0.05). Post-cycling, C continued to show the highest dP (p<0.05). Specimens from Group CXT had the lowest dP and did not differ from NP (p=0.86) which did not differ from BGP (p=0.193). For C and BGP, dP value was higher post-cycling than post-treatment (p<0.05). For NP and CXT, these experimental times did not differ (p>0.05). Post-cycling, dSL for C, BGP and NP did not differ significantly; values were higher than those for CXT (p<0.05). CONCLUSIONS: BGP reduced dP after application, with a reduced effect after cycling. Nonetheless, it was not able to protect dentin against erosive tooth wear. CLINICAL SIGNIFICANCE: Minimizing dentin hypersensitivity is a challenge in the field of dentistry. The development of alternative products with potential to obliterate dentinal tubules and provide resistance to chemical/mechanical stimuli is, thus, highly desirable. We have proposed a material able to reduce dentin permeability, which has emerged as a promising alternative for this purpose.

Influence of toothbrush abrasion and surface treatments on the color and translucency of resin infiltrated hybrid ceramics.

PURPOSE: The study compared the color change, lightness, and translucency of hybrid resin ceramics exposed to toothbrush abrasion and surface treatment. MATERIALS AND METHODS: Four hybrid ceramics [Lava Ultimate (LU), Vita Enamic (EN), Shofu HC (SH), and Crystal Ultra (CU)] were compared with a glass-ceramic (Vita Mark II) control. One hundred and twenty specimen blocks were prepared using a precision saw machine. Specimens in each material were divided into four subgroups based on the surface treatment (polishing or staining) and a storage medium (water or citric acid). Simulated tooth brushing with a mixture of 100 RDA (radioactive abrasives) with 0.3 ml distilled water was used for 3650 cycles (7300 strokes) for each specimen. Measurements for the color change, lightness, and translucency were measured after toothbrushing using a spectrophotometer. Statistical analysis compared outcomes using paired t-test, ANOVA, and Tukey post hoc test. RESULTS: The maximum color change was identified in SH (stained acid) [1.44 (0.40)], whereas the lowest was identified in EN (polished water) [0.66 (0.16)] material. The maximum and minimum loss of surface translucency was observed in SH (polished water) [12.3 (0.52)] and EN (stained acid) [6.5 (0.55)] specimens, respectively. Lastly, loss of lightness was the highest in VM (polished acid) [69 (0.95)], whereas the lowest was observed in CU (stained water) [56.7 (0.86)]. CONCLUSION: The comparison presented a significant effect of toothbrush abrasion on translucency and lightness of the hybrid resin ceramics. Color change was not significantly influenced irrespective of the storage medium employed. Surface staining demonstrated the preservation and stability of color and optical properties under the influence of toothbrush abrasion and chemical trauma.

Effect of a chlorhexidine-encapsulated nanotube modified pit-and-fissure sealant on oral biofilm.

The purpose of this study was to characterize a chlorhexidine-encapsulated nanotube modified pit-and-fissure sealant for biofilm development prevention. HS (commercial control); HNT (HS+15wt%Halloysite®-clay-nanotube); CHX10% (HS+15wt% HNT-encapsulated with chlorhexidine 10%); and CHX20% (HS+15wt% HNT-encapsulated with CHX20%) were tested. Degree-of-conversion (DC%), Knoop hardness (KHN), and viscosity were analyzed. The ability of the sealant to wet the fissures was evaluated. Specimens were tested for zones of inhibition of microbial growth. S. mutans biofilm was tested by measuring recovered viability. Data were statistically analyzed (p<0.05). DC% was significantly higher for the HNT-CHX groups. For KHN, CHX10% presented a lower mean value than the other groups. Adding HNT resulted in higher viscosity values. The biofilm on CHX10% and CHX20% sealants presented remarkable CFU/mL reduction in comparison to the HS. The experimental material was able to reduce the biofilm development in S. mutans biofilm without compromising the sealant properties.

Influence of Toothbrush Abrasion and Surface Treatments on Roughness and Gloss of Polymer-Infiltrated Ceramics.

The aim of this study was to compare the surface roughness and gloss of polymer-infiltrated ceramics after simulated in vitro toothbrushing in different storage mediums. Four polymer- infiltrated ceramics were evaluated, Lava ultimate (LU), Vita enamic (EN), Shofu (SH), and Crystal ultra (CU). The control group was a feldspathic ceramic, Vita Mark II (VM). One hundred and twenty specimens (12 × 14 × 2.5 mm) were prepared using a precision saw. For each material (n = 24), the specimens were allocated into two groups, polished and stained. The specimens of each group were stored (for 7 days) in either citric acid (0.2N) or distilled water. Data for surface gloss (ΔE*SCE-SCI) and roughness (Ra) were evaluated before (baseline) and after simulated toothbrushing. For toothbrushing simulation, a toothpaste slurry containing a toothpaste of 100 relative dentin abrasion (RDA) and 0.3 ml distilled water was used for 3650 cycles (7300 strokes) for each specimen. Data were analyzed using t-test and ANOVA. A p-value of ≤ to 0.05 was considered significant. The highest mean value of surface gloss was identified in CU (stained-water) (4.3 (0.47)) (ΔE*) and EN (stained-acid) (4.3 (1.00)) (ΔE*) specimens, whereas the lowest mean value was shown by SH (stained-acid) (2.04 (0.42)) (ΔE*) samples. The highest mean value of surface roughness was observed in SH (0.40 (0.99)) Ra (stained-acid) whereas the lowest in VM (0.13 (0.039)) Ra (polished- water). A significant difference (p < 0.05) was observed in surface roughness and gloss between the materials with simulated toothbrushing, except in VM and LU, respectively. Therefore, it can be concluded that simulated toothbrushing impacts on surface roughness and gloss, irrespective of the storage medium.

Resin-based dental materials containing 3-aminopropyltriethoxysilane modified halloysite-clay nanotubes for extended drug delivery.

OBJECTIVE: To synthesize and characterize a novel resin-based dental material containing 3-aminopropyltriethoxysilane (APTES) surface-modified halloysite-clay nanotubes (HNTs) for long-term delivery of guest molecules. METHODS: The optimal concentrations of HNT (10, 15, 20 wt.%) and silane (0, 2, 4 vol.%sil) to be incorporated into the resin-based materials were determined (15 wt.%HNT, 4 vol.%sil) after assessment of the mechanical properties (DC%, degree of conversion; FS, flexural strength; FM, flexural modulus; and UTS, ultimate tensile strength). The HNTsil-powder was loaded with chlorhexidine (CHX) to evaluate the effect of the silanization on drug release. Resin-discs were prepared for the following groups: RES (resin), HNT (resin+15 wt.%HNT), HNTsil (resin+15 wt.%HNT silanized), HNT-CHX (resin+15 wt.%HNT loaded with chlorhexidine), HNTsil-CHX (resin+15 wt.%HNTsil-CHX), and 0.2 vol.%CHX (resin+0.2 vol.%CHX solution). Specimens were stored in water for 1, 3, 5, 10, and 15 days at 37 °C. Aliquots from each time point and the final 15-day specimens were evaluated for the zone of inhibition (ZOI) against Streptococcus mutans. CHX release was analyzed using spectrophotometry at absorbance of 300 nm. Data were statistically analyzed (α = 0.05). RESULTS: All materials presented similar DC%. Reduced FS but increased FM was detected for 20 wt.%HNT-4%APTES. Groups with 15 wt.% and 20 wt.%HNT with/without APTES presented higher values of UTS. Agar diffusion data indicates that the HNTsil-CHX had a greater ZOI than all other groups over 15 days. HNTsil-CHX had the highest absorbance for day 1 but presented similar values to other groups every time point after. SIGNIFICANCE: Silanization of nanotubes followed by encapsulation of chlorhexidine is a promising technique for long-term delivery of guest molecules.

Chlorhexidine-modified nanotubes and their effects on the polymerization and bonding performance of a dental adhesive.

OBJECTIVES: The purpose of this study was to synthesize chlorhexidine (CHX)-encapsulated aluminosilicate clay nanotubes (Halloysite®, HNTs) and to incorporate them into the primer/adhesive components of an etch-and-rinse adhesive system (SBMP; Scotchbond Multipurpose, 3M ESPE) and to test their effects on degree of conversion, viscosity, immediate and long-term bonding to dentin. METHODS: CHX-modified HNTs were synthesized using 10% or 20% CHX solutions. The primer and the adhesive components of SBMP were incorporated with 15wt.% of the CHX-encapsulated HNTs. Degree of conversion (DC) and viscosity analyses were performed to characterize the modified primers/adhesives. For bond strength testing, acid-etched dentin was treated with one of the following: SBMP (control); 0.2%CHX solution before SBMP; CHX-modified primers+SBMP adhesive; SBMP primer+CHX-modified adhesives; and SBMP primer+CHX-free HNT-modified adhesive. The microtensile bond strength test was performed after immediate (24h) and long-term (6 months) of water storage. Data were analyzed using ANOVA and Tukey (α=5%) and the Weibull analysis. RESULTS: DC was greater for the CHX-free HNT-modified adhesive, whereas the other experimental adhesives showed similar DC as compared with the control. Primers were less viscous than the adhesives, without significant differences within the respective materials. At 24h, all groups showed similar bonding performance and structural reliability; whereas at the 6-month period, groups treated with the 0.2%CHX solution prior bonding or with the CHX-modified primers resulted in greater bond strength than the control and superior reliability. SIGNIFICANCE: The modification of a primer or adhesive with CHX-encapsulated HNTs was an advantageous approach that did not impair the polymerization, viscosity and bonding performance of the materials, showing a promising long-term effect on resin-dentin bonds.

Novel fluoride and stannous -functionalized ß-tricalcium phosphate nanoparticles for the management of dental erosion.

OBJECTIVE: To evaluate the anti-erosive effect of solutions containing ß-tricalcium phosphate (ß-TCP) nanoparticles functionalized with fluoride or with fluoride plus stannous on enamel and dentin. METHODS: ß-TCP nanoparticles were synthesized and characterized by X-ray diffraction (XRD) and transmission electron microscopy (TEM). Sixty enamel and dentin specimens were randomly allocated into the groups (n = 10): Control (water); F (NaF, 225 ppm F-); F + Sn (NaF + SnCl2, 800 ppm Sn2+); F+ß-TCP (F+40 ppm ß-TCP); F + Sn+ß-TCP (F + Sn+40 ppm ß-TCP); F + Sn+100ß-TCP (F + Sn+100 ppm ß-TCP). Specimens underwent erosion-remineralization cycling (5 min immersion into 1 % citric acid solution and 60 min exposure to artificial saliva, 4×/day, 5 days). Immersion in the test solutions was performed for 2 min, 2×/day. Surface loss (SL, in µm) was determined by optical profilometry at the end of cycling. Data were analyzed using one way-ANOVA and Tukey's tests (α = 0.05). RESULTS: XRD confirmed the ß-TCP phase. TEM micrographs showed differences between the bare nanoparticle and the ß-TCP functionalized with F and Sn. All enamel groups presented lower SL than the control, with F + Sn, F + Sn+ß-TCP, and F + Sn+100ß-TCP showing the lowest values. For dentin, all the groups had lower SL than the control. F+ß-TCP presented the lowest SL, significantly differing from all the other groups. CONCLUSION: ß-TCP nanoparticles functionalized with fluoride showed improved anti-erosive effect compared to the fluoride solution on dentin. There was no significant effect of the ß-TCP nanoparticles functionalized with fluoride plus stannous in both substrates. CLINICAL RELEVANCE: ß-TCP nanoparticles are a promising agent to be added to oral health products to improve the protective effect of fluoride against dentin erosion.

Physicochemical and biological properties of novel chlorhexidine-loaded nanotube-modified dentin adhesive.

A commercially available three-step (etch-and-rinse) adhesive was modified by adding chlorhexidine (CHX)-loaded nanotubes (Halloysite®, HNT) at two concentrations (CHX10% and CHX20%). The experimental groups were: SBMP (unmodified adhesive, control), HNT (SBMP modified with HNT), CHX10 (SBMP modified with HNT loaded with CHX10%), and CHX20 (SBMP modified with HNT loaded with CHX20%). Changes in the degree of conversion (DC%), Knoop hardness (KHN), water sorption (WS), solubility (SL), antimicrobial activity, cytotoxicity, and anti-matrix metalloproteinase [MMP-1] activity (collagenase-I) were evaluated. In regards to DC%, two-way ANOVA followed by Tukey's post-hoc test revealed that only the factor "adhesive" was statistically significant (p < 0.05). No significant differences were detected in DC% when 20 s light-curing was used (p > 0.05). For Knoop microhardness, one-way ANOVA followed by the Tukey's test showed statistically significant differences when comparing HNT (20.82 ± 1.65) and CHX20% (21.71 ± 2.83) with the SBMP and CHX10% groups. All adhesives presented similar WS and cytocompatibility. The CHX-loaded nanotube-modified adhesive released enough CHX to inhibit the growth of S. mutans and L. casei. Adhesive eluates were not able to effectively inhibit MMP-1 activity. The evaluation of higher CHX concentrations might be necessary to provide an effective and predictable MMP inhibition. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res B Part B, 2018. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 868-875, 2019.

Effect of Traditional Household Processes on Iron, Zinc and Copper Bioaccessibility in Black Bean (Phaseolus vulgaris L.).

Micronutrient deficiencies are a major public health problem. Beans are an important plant-based source of iron, zinc and copper, but their absorption is reduced in the presence of anti-nutrients such as phytates, polyphenols and tannins. Soaking and discarding the soaking water before cooking is unanimously recommended, but this can result in mineral loss. Data on the consequences for mineral bioaccessibility is still limited. This study aimed to evaluate iron, zinc and copper bioaccessibility in black beans cooked (regular pan, pressure cooker) with and without the soaking water. For that, three batches of black beans were investigated in triplicate, each split in nine parts (raw grains and four different household processes in duplicate) and analyzed by applying the quarter technique, resulting in a grand total of 164 samples. Minerals were quantified by ICP-MS (inductively coupled plasma mass spectrometry), myo-inositol phosphates (InsP5, InsP6) by HPLC (high-performance liquid chromatography) ion-pair chromatography, total polyphenols using Folin-Denis reagent and condensed tannins using Vanillin assay. Mineral bioaccessibility was determined by in vitro digestion and dialysis. All treatments resulted in a statistically significant reduction of total polyphenols (30%) and condensed tannins (20%). Only when discarding the soaking water a loss of iron (6%) and copper (30%) was observed, and InsP6 was slightly decreased (7%) in one treatment. The bioaccessibility of iron and zinc were low (about 0.2% iron and 35% zinc), but copper presented high bioaccessibility (about 70%). Cooking beans under pressure without discarding the soaking water resulted in the highest bioaccessibility levels among all household procedures. Discarding the soaking water before cooking did not improve the nutritional quality of the beans.

Clindamycin-modified Triple Antibiotic Nanofibers: A Stain-free Antimicrobial Intracanal Drug Delivery System.

INTRODUCTION: A biocompatible strategy to promote bacterial eradication within the root canal system after pulpal necrosis of immature permanent teeth is critical to the success of regenerative endodontic procedures. This study sought to synthesize clindamycin-modified triple antibiotic (metronidazole, ciprofloxacin, and clindamycin [CLIN]) polymer (polydioxanone [PDS]) nanofibers and determine in vitro their antimicrobial properties, cell compatibility, and dentin discoloration. METHODS: CLIN-only and triple antibiotic CLIN-modified (CLIN-m, minocycline-free) nanofibers were processed via electrospinning. Scanning electron microscopy, Fourier-transform infrared spectroscopy (FTIR), and tensile testing were performed to investigate fiber morphology, antibiotic incorporation, and mechanical strength, respectively. Antimicrobial properties of CLIN-only and CLIN-m nanofibers were assessed against several bacterial species by direct nanofiber/bacteria contact and over time based on aliquot collection up to 21 days. Cytocompatibility was measured against human dental pulp stem cells. Dentin discoloration upon nanofiber exposure was qualitatively recorded over time. The data were statistically analyzed (P < .05). RESULTS: The mean fiber diameter of CLIN-containing nanofibers ranged between 352 ± 128 nm and 349 ± 128 nm and was significantly smaller than PDS fibers. FTIR analysis confirmed the presence of antibiotics in the nanofibers. Hydrated CLIN-m nanofibers showed similar tensile strength to antibiotic-free (PDS) nanofibers. All CLIN-containing nanofibers and aliquots demonstrated pronounced antimicrobial activity against all bacteria. Antibiotic-containing aliquots led to a slight reduction in dental pulp stem cell viability but were not considered toxic. No visible dentin discoloration upon CLIN-containing nanofiber exposure was observed. CONCLUSIONS: Collectively, based on the remarkable antimicrobial effects, cell-friendly, and stain-free properties, our data suggest that CLIN-m triple antibiotic nanofibers might be a viable alternative to minocycline-based antibiotic pastes.

Synthesis and characterization of novel halloysite-incorporated adhesive resins.

OBJECTIVE: To investigate the effects of Halloysite® aluminosilicate clay nanotubes (HNTs) addition on selected physical, mechanical, and biological properties of experimental adhesive resins. METHODS: Experimental dentin adhesive resins were prepared by mixing Bis-GMA, TEGDMA, HEMA (50/25/25wt.%), and photo-initiators. As-received HNTs were then incorporated into the resin mixture at distinct concentrations: 0 (HNT-free, control), 1, 2.5, 5, 7.5, 10, and 20wt.%. The degree of conversion (DC), radiopacity (RP), Knoop hardness (KHN), flexural strength (FS), and cytotoxicity analyses were carried out for each adhesive formulation. The adhesive resin of Adper Scotchbond Multi-Purpose (SBMP) was used as the commercially available reference for both the RP and cytotoxicity tests. Data were statistically analyzed using One-Way ANOVA and Tukey's test (p≤0.05). RESULTS: All adhesives exhibited similar DC (p=0.1931). The RP of adhesives was improved with the addition of up to 5wt.% of HNTs (p<0.001). Adhesives containing 5-10wt.% of HNTs led to greater KHN when compared to the control (p<0.001). The FS was reduced only when 20wt.% of HNTs was added (p≤0.001). None of the prepared adhesives was cytotoxic. CONCLUSION: The incorporation of up to 10wt.% of HNTs into the adhesive resins did not jeopardize the tested physical and biological properties. CLINICAL SIGNIFICANCE: When using HNTs as carriers of drugs/bioactive compounds, the amount of the former added into adhesive resin materials should not exceed 10wt.%; otherwise, a significant reduction in physicomechanical properties may be expected.

Influence of convergence angle of tooth preparation on the fracture resistance of Y-TZP-based all-ceramic restorations.

OBJECTIVE: To investigate the influence of the convergence angle of tooth preparation on the fracture load of Y-TZP-based ceramic (YZ - Vita YZ) substructure (SB) veneered with a feldspathic porcelain (VM9 - Vita VM9). METHODS: Finite element stress analysis (FEA) was performed to examine the stress distribution of the system. Eighty YZ SB were fabricated using a CAD-CAM system and divided into four groups (n=20), according to the total occlusal convergence (TOC) angle: G6 - 6° TOC; G12 - 12° TOC; G20 - 20° TOC; and G20MOD - 20° TOC with modified SB. All SB were veneered with VM9, cemented in a fiber reinforced epoxy resin die, and loaded to failure. Half of the specimens from each group (n=10) were cyclic fatigued (10(6) cycles) before testing. Failure analysis was performed to determine the fracture origin. Data were statistically analyzed using Anova and Tukey's tests (α=0.05). RESULTS: The greatest mean load to fracture value was found for the G20MOD, which was predicted by the FEA. Cyclic fatigue did not significantly affect the load of fracture. Catastrophic failure originating from the internal occlusal surface of the SB was the predominant failure mode, except for G20MOD. SIGNIFICANCE: The YZ-VM9 restorations resisted greater compression load than the usual physiological occlusal load, regardless of the TOC angle of preparations. Yet, the G20MOD design produced the best performance among the experimental conditions evaluated.

Influência da Concentração e do Tempo de Condicionamento com Ácido Hidrofluorídrico na Rugosidade e Morfologia Superficial de uma Zircônia Glazeada / Influence of Hydrofluoric Acid Concentration and Etching Time on the Surface Roughness and Morphology of a Glazed Zirconia

Objetivo: Avaliar o efeito da concentração e do tempo de condicionamento com ácido fluorídrico na rugosidade e morfologia superficial de uma zircônia glazeada. Materiais e Métodos: Blocos de cerâmica à base de zircônia (5×5×3 mm) (Vita YZ-2000-Cubes, Vita- Zahnfabrik, Alemanha) foram confeccionados e divididos em 6 grupos, de acordo com os fatores "concentração do ácido fluorídrico (HF)" (5% e 10%) e "tempo de condicionamento" (20 s, 60 s e 90 s) (n=2): HF10/20 = HF 10% + 20 s; HF10/60 = HF 10% + 60 s; HF10/90 = HF 10% + 90 s; HF5/20 = HF 5% + 20 s; HF5/60 = HF 5% + 60 s; HF5/ 90 = HF 5% + 90 s. O glaze (Vita Akzent, Vita-Zahnfabrik, Alemanha) foi aplicado com o auxílio de um pincel e sinterizado de acordo com as recomendações do fabricante. Após os diferentes protocolos de condicionamento, foram aferidas cinco medições de rugosidade (Ra) para cada espécime em Perfilômetro Digital (Wyko®, Modelo NT- 1100, Veeco, EUA). Os dados (µm) obtidos foram analisados estatisticamente com análise de variância (ANOVA 2-fatores) e Teste de Tukey (95%). Resultados: O fator "concentração do ácido fluorídrico" (p=0,149) não foi significante estatísticamente. No entanto, o fator "tempo de condicionamento" (p=0,009) foi significante. A interação entre os fatores também apresentou significância estatística (p=0,00). As médias de rugosidade (±desvio-padrão) obtidas foram (µm): GHF10/20=1,94(±0,72)A, GHF5/90=1,92(±0,19)A, GHF5/ 20=1,38(±0.48)AB, GHF5/60=1,18(±0,63)B, GHF10/60=1,17(±0,30)B, GHF10/90=0,82(±0,27)B (Tukey). Conclusão: Conclui-se que o ácido fluorídrico (10%) em maior concentração, associado a um menor tempo de condicionamento (20 s), promoveu maior rugosidade superficial da zircônia glazeada. (AU)

Objective: The aim of this study was to evaluate the effect of different etching protocols on the surface roughness of a glazed zirconia. Material and Methods: Zirconia ceramic-blocks (5 × 5 × 3 mm) (Vita YZ-2000-Cubes, Vita-Zahnfabrik, Germany) were prepared and divided into 6 groups according to the variables "concentration of hydrofluoric acid (HF)" (5 % and 10 %) and " etching time " (20 s, 60 s and 90 s) (n = 2), as follows: HF10/20 = HF 10% + 20 s; HF10/60 = HF 10% + 60 s; HF10/90 = HF 10% + 90 s; HF5/20 = HF 5% + 20 s; HF5/60 = HF 5% + 60 s; HF5/90 = HF 5% + 90 s. The glaze (Vita Akzent, Vita- Zahnfabrik, Germany) was applied with a brush and sintered according to the manufacturer's recommendations. After different etching protocols, five roughness (Ra) measurements were taken for each specimen in a digital profilometer (Wyko ®, Model NT-1100, Veeco, USA). The data were statistically analyzed using analysis of variance (ANOVA 2­way) and Tukey's test (95%). Results: The variable "concentration of hydrofluoric acid" (p=0.149) was not statistically significant, while the variable "etching time" (p=0.009) was significant. The interaction between variables was statistically significant (p = 0.00). The roughness averages (± standard deviation) obtained were (µm): GHF10/20=1.94(±0.72)A, GHF5/90=1.92(±0.19)A, GHF5/ 20=1.38(±0.48)AB, GHF5/60=1.18(±0.63)B, GHF10/60=1.17(±0.30)B, GHF10/90=0.82(±0.27)B (Tukey). Conclusion: It can be concluded that hydrofluoric acid (10%) at a higher concentration associated with a lower etching time (20 s) promoted higher superficial roughness on glazed zirconia. (AU)