Remineralization of demineralized dentin using a dual analog system.

OBJECTIVE: Improved methods are needed to remineralize dentin caries in order to promote conservation of dentin tissue and minimize the surgical interventions that are currently required for clinical treatment. Here, we test the hypothesis that bulk substrates can be effectively mineralized via a dual analog system proposed by others, using a tripolyphosphate (TPP) "templating analog" and a poly(acrylic acid) (PAA) or poly(aspartic acid) (pAsp) "sequestration analog," the latter of which generates the polymer-induced liquid-precursor (PILP) mineralization process studied in our laboratory. MATERIAL & METHODS: Demineralized human dentin slices were remineralized with and without pre-treatment with TPP, using either PAA or pAsp as the PILP process-directing agent. A control experiment with no polymer present was used for comparison. RESULTS: No mineralization was observed in any of the PAA groups. In both the pAsp and no polymer groups, TPP inhibited mineralization on the surfaces of the specimens but promoted mineralization within the interiors. Pre-treatment with TPP enhanced overall mineralization of the pAsp group. However, when analysed via TEM, regions with little mineral were still present. CONCLUSION: Poly(acrylic acid) was unable to remineralize demineralized dentin slices under the conditions employed, even when pre-treated with TPP. However, pre-treatment with TPP enhanced overall mineralization of specimens that were PILP-remineralized using pAsp.

Analysis of interfacial structure and bond strength of self-etch adhesives.

PURPOSE: To determine the bond strength, nanoleakage and interfacial morphology of four self-etch adhesives bonded to superficial dentin. METHODS: Microtensile (MT) (n= 15) and single plane shear (SP) (n= 8) bond tests were performed using human dentin polished through 320-grit SiC paper. Clearfil Protect Bond (PB), Clearfil S3 Bond (S3), Prompt L-Pop (PLP) and G-Bond (GB) were used according to their manufacturers' instructions. Composite was applied as cylinders with a thickness of 4 mm with a 1 mm diameter and stored in water at 370C for 24 hours. Specimens were debonded with a testing machine at a cross-head speed of 1 mm/minute. Means and standard deviations of bond strength were calculated. Data were analyzed using ANOVA. Fisher's PLSD intervals were calculated at the 0.05 level of significance. Failure modes were determined at x100. The hybrid layer was revealed by treatment with 5N HC1/5% NaOCl or fractured perpendicular to the interface and sputter coated with gold. Specimens were viewed at x1,000, x2,500, and x5,000 in a field emission SEM at 15 kV. Teeth (n=2) sectioned into 0.9 mm-thick slabs were immersed in ammoniacal silver nitrate solution for 24 hours, rinsed and immersed in photo-developing solution for 8 hours. Specimens were sectioned (90 nm-thick) and observed under TEM. RESULTS: Means ranged from 25.0 to 73.1 MPa for MT and from 15.5 to 56.4 MPa for SP. MT values were greater than SP, but were highly correlated (R2 = 0.99, P= 0.003) and provided the same order for the systems studied. Fisher's PLSD intervals (P< 0.05) for bond strength techniques and adhesives results were 1.7 and 2.3 MPa, respectively. Failures sites were mixed. TEM showed that hybrid layers were -0.5 pm for PB, GB and S3 and approximately 5 microm for PLP. SEM showed morphologic differences among adhesives. Silver nitrate deposits were observed within the interfaces for all adhesive systems.

Tissue-specific calibration of extracellular matrix material properties by transforming growth factor-ß and Runx2 in bone is required for hearing.

Physical cues, such as extracellular matrix stiffness, direct cell differentiation and support tissue-specific function. Perturbation of these cues underlies diverse pathologies, including osteoarthritis, cardiovascular disease and cancer. However, the molecular mechanisms that establish tissue-specific material properties and link them to healthy tissue function are unknown. We show that Runx2, a key lineage-specific transcription factor, regulates the material properties of bone matrix through the same transforming growth factor-ß (TGFß)-responsive pathway that controls osteoblast differentiation. Deregulated TGFß or Runx2 function compromises the distinctly hard cochlear bone matrix and causes hearing loss, as seen in human cleidocranial dysplasia. In Runx2+/⁻ mice, inhibition of TGFß signalling rescues both the material properties of the defective matrix, and hearing. This study elucidates the unknown cause of hearing loss in cleidocranial dysplasia, and demonstrates that a molecular pathway controlling cell differentiation also defines material properties of extracellular matrix. Furthermore, our results suggest that the careful regulation of these properties is essential for healthy tissue function.

Si and Ca individually and combinatorially target enhanced MC3T3-E1 subclone 4 early osteogenic marker expression.

This study tests the hypothesis that silicon and calcium ions combinatorially target gene expression during osteoblast differentiation. MC3T3-E1 subclone 4 osteoblast progenitors (transformed mouse calvarial osteoblasts) were exposed to Si(4+) (from Na(2)SiO(3)) and Ca(2+) (from CaCl(2):H(2)O) ion treatments both individually (0.4 mM each + control treatment) and combinatorially (0.4 mM Si(4+) + 0.4 mM Ca(2+) + control treatment) and compared to control treated (α-minimum essential medium, 10% fetal bovine serum, and 1% penicillin-streptomycin) cells. Cell proliferation studies showed no significant increase in cell density between treatments over 5 days of culture. Cellular differentiation studies involved addition of ascorbic acid (50 mg/L) for all treatments. Relative gene expression was determined for collagen type 1 (Col(I)α1/Col(I)α2), core-binding factor a (cbfa1/Runx2), and osteocalcin (OCN), which indicated osteoblast progenitor differentiation into a mineralizing phenotype. Increased Si(4+) or Ca(2+) ion treatments enhanced Col(I)α1, Col(I)α2, Runx2, and OCN expression, while increased Si(4+) + Ca(2+) ion treatments enhanced OCN expression. Moreover, it was found that a Si(4+)/Ca(2+) ratio of unity was optimal for maximal expression of OCN. Collagen fiber bundles were dense, elongated, and thick within extracellular matrices (ECM) exposed to Si(4+) and Si(4+) + Ca(2+) treatments, while collagen fiber bundles were sparse, short, and thin within Ca(2+) and control treated ECM. These results indicated that individual ions enhance multiple osteogenic gene expression, while combined ion treatments enhance individual gene expression. In addition, these results indicated that Si(4+) enhanced osteoblast gene expression and ECM formation at higher levels than Ca(2+). These results support the larger concept that ions (possibly released from bioactive glasses) could control bone formation by targeting osteoblast marker expression.

The Role of Process-Directing Agents on Enamel Lesion Remineralization: Fluoride Boosters.

The aim of this study was to investigate the effects of two process-directing agents (polyaspartic acid and osteopontin) used in a polymer-induced liquid-precursor (PILP) process on the remineralization of bacteria-induced enamel demineralization. Enamel demineralization lesions (depths of about 180-200 µm) were created and exposed to Streptococcus mutans, cultured with a 10% sucrose solution for 21 days, and remineralized using a PILP process (pH = 7.4, 14 days) with a calcium phosphate solution containing either polyaspartic acid or osteopontin in the presence or absence of fluoride (0.5 ppm). The specimens were examined under scanning electron microscopy. The fluoride was successfully incorporated into the PILP remineralization process for both polyaspartic acid and osteopontin. When the fluoride was added to the PILP remineralization solution, there was more uniform remineralization throughout the lesion than with either polyaspartic acid or osteopontin alone. However, in the absence of these process-directing agents, fluoride alone showed less remineralization with the formation of a predominantly surface-only layer. The PILP remineralization process relies on the ability of process-directing agents to stabilize calcium phosphate ions and holds promise for enamel lesion remineralization, and these agents, in the presence of fluoride, seem to play an important role as a booster or supplement in the continuation of remineralization by reducing the mineral gains at the surface layer.

Effect of mucoprotein on the bond strength of resin composite to human dentin.

The purpose of this study was to test the bond strength and analyze the morphology of the dentin-adhesive interface of two etch and rinse and two self-etch adhesive systems with two kinds of artificial saliva (with and without 450 mg/L mucin) contamination under different conditions of decontaminating the interface. Bonded specimens were sectioned perpendicularly to the bonded surface in 1-mm thick slabs. These 1-mm thick slabs were remounted in acrylic blocks and sectioned in sticks perpendicular to the bonding interfaces with a 1-mm(2) area. Nine specimens from each condition were tested after 24 h on a testing machine (Instron) at a speed of 0.5 mm/min for a total of 360 specimens. Mean and standard deviations of bond strength (MPa) were calculated. ANOVA showed significant differences as well as Fisher's PLSD intervals (p < 0.05). The following values are the results for different groups: Control group 34-60 MPa, saliva without mucin 0-52 MPa, and saliva with mucin 0-57 MPa. Failure sites were mixed and adhesive failure was common for the low bond strength results. P&BNT with ideal conditions and following the manufacturer's instructions (control) had the highest bond strengths and the dentin-adhesive interface exhibited an ideal morphology of etch-and-rinse system. SEM gave complementary visual evidence of the effect in the dentin/adhesive interface structure with some contaminated conditions compared with their respective control groups. This in vitro artificial saliva model with and without mucin showed that an organic component of saliva could increase or decrease the bond strength depending on the specific bonding agent and decontamination procedure.

The effect of E-glass fibers and acrylic resin thickness on fracture load in a simulated implant-supported overdenture prosthesis.

STATEMENT OF PROBLEM: Implant overdenture prostheses are prone to acrylic resin fracture because of space limitations around the implant overdenture components. PURPOSE: The purpose of this study was to evaluate the influence of E-glass fibers and acrylic resin thickness in resisting acrylic resin fracture around a simulated overdenture abutment. MATERIAL AND METHODS: A model was developed to simulate the clinical situation of an implant overdenture abutment with varying acrylic resin thickness (1.5 or 3.0 mm) with or without E-glass fiber reinforcement. Forty-eight specimens with an underlying simulated abutment were divided into 4 groups (n=12): 1.5 mm acrylic resin without E-glass fibers identified as thin with no E-glass fiber mesh (TN-N); 1.5 mm acrylic resin with E-glass fibers identified as thin with E-glass fiber mesh (TN-F); 3.0 mm acrylic resin without E-glass fibers identified as thick without E-glass fiber mesh (TK-N); and 3.0 mm acrylic resin with E-glass fibers identified as thick with E-glass fiber mesh (TK-F). All specimens were submitted to a 3-point bending test and fracture loads (N) were analyzed with a 2-way ANOVA and Tukey's post hoc test (α=.05). RESULTS: The results revealed significant differences in fracture load among the 4 groups, with significant effects from both thickness (P<.001) and inclusion of the mesh (P<.001). Results demonstrated no interaction between mesh and thickness (P=.690). The TN-N: 39 ±5 N; TN-F: 50 ±6.9 N; TK-N: 162 ±13 N; and TK-F: 193 ±21 N groups were all statistically different (P<.001). CONCLUSIONS: The fracture load of a processed, acrylic resin implant-supported overdenture can be significantly increased by the addition of E-glass fibers even when using thin acrylic resin sections. On a relative basis, the increase in fracture load was similar when adding E-glass fibers or increasing acrylic resin thickness.

Polymer-Induced Liquid Precursor (PILP) remineralization of artificial and natural dentin carious lesions evaluated by nanoindentation and microcomputed tomography.

OBJECTIVES: The study evaluates the efficacy to remineralize artificial and natural dentin lesions through restorative dental procedures that include the Polymer-Induced Liquid Precursor (PILP) method comprising polyaspartic acid (pAsp). METHODS: Novel ionomeric cement compositions based on bioglass 45S5 and pAsp mixtures, as well as conditioning solutions (conditioner) containing 5 mg/mL pAsp, were developed and tested on demineralized dentin blocks (3-4 mm thick) on shallow and deep lesions with the thickness of 140 µm ± 50 and 700 µm ± 50, respectively. In the first treatment group, 20 µL of conditioner was applied to demineralized shallow (n = 3) and deep (n = 3) lesion specimens for 20 s before restoration with glass ionomer cement (RMGIC). For the PILP cement treatment group, cement was applied onto the wet surface of the demineralized specimen for both shallow (n = 3) and deep (n = 3) artificial lesions after the application of the conditioner and before the final restoration. Sample groups were compared to RMGIC restoration, for both shallow and deep lesions (n = 3 each) and treatments in PILP-solution (n = 3 for deep lesions) without restoration for 4 weeks. All of the restored specimens were immersed in simulated body fluid (SBF) solution for 2 weeks and 4 weeks for shallow and deep lesions respectively to allow for remineralization. The artificial lesion specimens were evaluated for changes in the nanomechanical profile (E-modulus and hardness) using nanoindentation. Shallow lesions were analyzed by SEM under vacuum for changes in morphology caused by PILP treatments. Also, a pilot study on human third molars with moderate lesions in dentin (n = 3) was initiated to test the efficacy of treatments in natural lesions based on mineral densities using microcomputed tomography (µCT) at 0, 1, and 3 months. RESULTS: This study showed that functional remineralization of artificial lesions using PILP-releasing restoratives occurred, indicated by an increase of the elastic modulus in shallow lesions and in the middle zone of deep artificial lesions. The mechanical improvement was significant when compared to RMGIC restoration without pAsp (P < 0.05). Nonetheless, recovery across artificial lesions was most significant when specimens were immersed into PILP-solution with restorative (P < 0.01). Furthermore, natural lesions increased in mineral volume content to a higher degree when the restorative treatment included the PILP-method (P < 0.05). However, none of the natural lesions recovered to full mineral degree regardless of the treatments. CLINICAL SIGNIFICANCE/CONCLUSION: These findings indicate the benefit of PILP applications in the functional repair of dentin caries and illustrate the challenge to integrate the PILP-method into a restorative approach in minimally invasive dental procedures.

Bond strength of adhesives to dentin contaminated with smoker's saliva.

The purpose of this study was to determine the effects of contamination with smoker's and non-smoker's saliva on the bond strength of resin composite to superficial dentin using different adhesive systems. The interfacial structure between the resin and dentin was evaluated for each treatment using environmental scanning electron microscopy (ESEM). Freshly extracted human molars were ground with 600-grit SiC paper to expose the superficial dentin. Adhesives [One-Up-Bond-F-Plus (OUFP) and Adper-Prompt-L-Pop (APLP)] and resin composite (TPHSpectrum) were bonded to the dentin (n = 8/group, 180 total specimens) under five surface conditions: control (adhesive applied following manufacturers' instructions); saliva, then 5-s air dry, then adhesive; adhesive, saliva, 5-s air dry; adhesive, saliva, 5-s water rinse, 5-s air dry (ASW group); and adhesive, saliva, 5-s water rinse, 5-s air dry, reapply adhesive (ASWA group). After storage in water at 37 degrees C for 24 h, the specimens were debonded under tension at a speed of 0.5 mm/min. ESEM photomicrographs of the dentin/adhesive interfaces were taken. Mean bond strength ranged from 8.1 to 24.1 MPa. Fisher's protected least significant difference (P = 0.05) intervals for critical adhesive, saliva, and surface condition differences were 1.3, 1.3, and 2.1 MPa, respectively. There were no significant differences in bond strength to dentin between contamination by smoker's and nonsmoker's saliva, but bond strengths were significantly different between adhesive systems, with OUFP twice as strong as APLP under almost all conditions. After adhesive application and contamination with either smoker's or nonsmoker's saliva followed by washing and reapplication of the adhesive (ASWA group), the bond strength of both adhesive systems was the same as that of the control group.

Enhanced silver diamine fluoride therapy using the PILP method -A nanoindentation study.

The aim of this study was to evaluate the feasibility of applying the polymer-induced liquid-precursor (PILP) method to enhance silver diamine fluoride (SDF) therapy. One hundred forty micrometer deep artificial caries lesions were treated with (A) 38% SDF solution and (B) 38% SDF containing poly-L-aspartic acid (pASP). Changes in the nanomechanical profile across the lesion were evaluated. Hydrated artificial lesions had a low reduced elastic modulus (0.3 GPa) and nanohardness (0.02 GPa) region extending about 100 µm into the lesion, with a gradual linear increase to about 168 µm where the values plateaued to around 18 GPa/1.0 GPa. Topical application of SDF resulted in significantly recovered properties (p<0.001). SDF containing pASP resulted in greater nanomechanical properties compared to SDF alone, showing similar sloped regions up to 96 µm, then SDF alone dropped while SDF containing pASP continued at a modest slope until reaching normal at 144 µm. This nanoindentation study shows enhanced SDF therapy using the PILP method.

The Academy of Dental Materials: Providing roots and wings.

OBJECTIVES: The long history of the Academy of Dental Materials (ADM) is documented with its strategies (a) to rapidly communicate science among its members, (b) to establish special awards to stimulate new science, and (c) to develop new dental materials scientists. METHODS: We searched the history of the last 35 years of the ADM newsletters, transactions, journals, and officer notes. We document the (a) presidents, (b) meeting history, (c) membership growth, and (d) development of special awards through 2019 with the recent creation of the ADM Marshall Post-Doctoral Award. RESULTS: There are 36 years of recent ADM history, 42 international meetings, membership growth to 400 individuals from 15 countries, service of 19 presidents, Paffenbarger annual Awardees since 1989, induction of >200 fellows, and recognition of the first winner of Marshall Post-Doctoral Award in 2018. New directions for recruiting members are suggested. Three potential new thrusts for the organization are presented: artificial intelligence, genetic engineering, and intensive member mentoring. SIGNIFICANCE: These suggestions for the ADM provide a path for the ADM to continue to adapt to the ever changing scientific landscape.

Integrating the PILP-mineralization process into a restorative dental treatment.

The addition of charged polymers, like poly-aspartic acid (pAsp), to mineralizing solutions allows for transport of calcium and phosphate ions into the lumen of collagen fibrils and subsequent crystallization of oriented apatite crystals by the so-called Polymer-Induced Liquid Precursor (PILP) mineralization process, leading to the functional recovery of artificial dentin lesions by intrafibrillar mineralization of collagen. OBJECTIVE: To evaluate the feasibility of applying the PILP method as part of a restorative treatment and test for effectiveness to functionally remineralize artificial lesions in dentin. MATERIALS AND METHODS: Two methods of providing pAsp to standardized artificial lesions during a restorative procedure were applied: (A) pAsp was mixed into commercial RMGI (resin modified glass ionomer) cement formulations and (B) pAsp was added at high concentration (25mg/ml) in solution to rehydrate lesions before restoring with a RMGI cement. All specimens were immersed in simulated body fluid for two weeks to allow for remineralization and then analyzed for dehydration shrinkage, integrity of cement-dentin interface, degree of mineralization, and changes in the nanomechanical profile (E-modulus) across the lesion. RESULTS: After the remineralization treatment, lesion shrinkage was significantly reduced for all treatment groups compared to demineralized samples. Pores developed in RMGI when pAsp was added. A thin layer at the dentin-cement interface, rich in polymer formed possibly from a reaction between pAsp and the RMGI. When analyzed by SEM under vacuum, most lesions delaminated from the cement interface. EDS-analysis showed some but not full recovery of calcium and phosphorous levels for treatment groups that involved pAsp. Nanoindentations placed across the interface indicated improvement for RMGI containing 40% pAsp, and were significantly elevated when lesions were rehydrated with pAsp before being restored with RMGI. In particular the most demineralized outer zone recovered substantially in the elastic modulus, suggesting that functional remineralization has been initiated by pAsp delivery upon rehydration of air-dried demineralized dentin. In contrast, the effectiveness of the RMGI on functional remineralization of dentin was minimal when pAsp was absent. SIGNIFICANCE: Incorporation of pAsp into restorative treatments using RMGIs promises to be a feasible way to induce the PILP-mineralization process in a clinical setting and to repair the structure and properties of dentin damaged by the caries process.

Fatigue of dentin-composite interfaces with four-point bend.

OBJECTIVES: The objective was to determine the fracture and cyclic fatigue properties of composite-dentin beams bonded with a self-etching adhesive in four-point bend. METHODS: Beams of rectangular cross-section were shaped to a size of approximately 0.87mmx0.87mmx10mm and placed in a four-point bending apparatus, with the loading points 1.8 and 7.2mm apart, with the interface centered between the inner rollers. Cyclical loading was performed in Hanks' Balanced Salt Solution at 25 degrees C, with forces between 54% and 99% of the bending strength of the bonded beams. RESULTS: Solid dentin and solid composite beams [n=6] had bending strengths of 164.4 and 164.6MPa, respectively, under monotonically increasing loads. Bonded beams [n=6] had strengths of 90.6MPa. No significant difference was found between solid composite and solid dentin beams, the bonded beams were different (ANOVA, p<0.0001) With long-term cycling, stresses below 49MPa were tolerated for 10(6) cycles, but with increasing stress up to 90MPa, beams failed earlier, demonstrating that subcritical fatigue cycling will eventually cause failure. SIGNIFICANCE: Fatigue may be a significant mechanism of dentin-composite bond degradation.

SEM evaluation of resin-carious dentin interfaces formed by two dentin adhesive systems.

OBJECTIVES: We investigated the influence of dentin tubule direction and identifiable zone of carious dentin on the microstructure and the thickness of the hybrid-like layer (HL) formed by self-etch and etch-rinse adhesive systems. METHODS: An etch-rinse and a self-etching adhesive were bonded to dentin carious zones divided into groups with parallel or perpendicular orientation relative to the dentin tubules at the resin-carious dentin interface (N=5/variable). Bonds were prepared to each of the four zones of carious dentin apparent after staining with Caries Detector: pink, light pink, transparent and apparently normal; six non-carious third molars were controls. The microstructure and thickness of the HL were determined by SEM and compared using three-way ANOVA and Tukey's multiple comparisons (p<0.05). RESULTS: Etch-rinse controls gave thicker HLs than self-etching systems; orientation did not affect thickness for the self-etch system. Perpendicular orientations gave thicker HLs than parallel for the pink zone bonded with the etch-rinse system. For both adhesives, HL thickness in the pink zone was significantly greater than in light pink for the perpendicular group, but no significant differences were found among other variables. HL microstructure was more granular and rougher for the etch-rinse than for the self-etching system. Pores and cracks were obvious in the more demineralized zones. Resin tags were shorter and irregular in the transparent zone and often were completely absent in the outer demineralized zones (pink, light pink). SIGNIFICANCE: Microstructure of bonded interfaces varies markedly depending on adhesive system, tubule orientation and carious zone.

Effect of sterilization by gamma radiation on nano-mechanical properties of teeth.

OBJECTIVES: Extracted teeth used in dental research need to be considered infective and hence be sterilized without the materials' properties being altered. This study examined the effect of gamma radiation on the nano-mechanical properties of dentin and enamel of extracted human third molars. METHODS: Whole teeth were sterilized using gamma radiation doses of 7 kGy and 35 kGy, respectively; teeth of the control group were not treated with gamma radiation. Crowns were sectioned occlusally and polished. Elastic modulus and hardness were tested using atomic force microscopy with nano-indentations under wet conditions. RESULTS: The authors found no significant dose-response relationship in elastic modulus or hardness in either dentin or enamel. SIGNIFICANCE: Nano-indentation is a common technique for the determination of local mechanical properties in biological hard tissues. Gamma radiation is an efficient way to sterilize extracted teeth while alteration of dentin and enamel mechanical properties are minimized.

Effect of pre- and postpolymerization on flexural strength and elastic modulus of impregnated, fiber-reinforced denture base acrylic resins.

STATEMENT OF PROBLEM: Impregnated fibers require light polymerization; however, little information exists about how different protocols might affect the mechanical properties of reinforced denture base materials. PURPOSE: The purpose of this study was to compare the effects of pre- or postpolymerization of preimpregnated fibers on the flexural strength and elastic modulus of a reinforced autopolymerized and a heat-polymerized acrylic resin. MATERIAL AND METHODS: Seventy-two specimens were divided into 12 treatment groups (n=6), according to type of acrylic resin (autopolymerized or heat polymerized), type of reinforcement, and its pre- or postpolymerization. Impregnated glass fibers (Fibrex-Lab), unimpregnated glass fibers (Fibrante), and ribs made from a restorative composite resin (Z250) were used as reinforcements. The reinforcements were light polymerized either before or after incorporation and processing of the acrylic resins. Specimens were tested in 3-point load and the data were analyzed using 2-way ANOVA and Tukey post hoc test (alpha=.05). Specimens were further examined using light microscopy, atomic force microscopy, and scanning electron microscopy. RESULTS: Elastic modulus was significantly higher for heat-polymerized acrylic resins than for autopolymerized acrylic resins (P<.001). Prepolymerized fibers increased both flexural strength and elastic modulus of autopolymerized acrylic resins significantly more than postpolymerized fibers (P<.001); however, postpolymerized fibers yielded a higher elastic modulus than prepolymerized fibers for the heat-polymerized material (P<.001). CONCLUSIONS: Prepolymerized fibers improved the overall mechanical properties of reinforced autopolymerized acrylic resins more than postpolymerized fibers. However, postpolymerization of fibers yielded higher elastic modulus for reinforced heat-polymerized acrylics.

Four-point bending evaluation of dentin-composite interfaces with various stresses.

UNLABELLED: Fracture properties of composite-dentin beams bonded with a self-etching adhesive were tested following short term pretreatments to simulate potential degradation mechanisms (thermal cycling, immersion in 5% NaOCl, or fatigue cycling). Beams of rectangular cross-section were shaped to a size of approximately 0.87 x 0.87 x 10 mm and placed in a four-point bending apparatus, with the loading points 1.8 and 7.2 mm apart, with the interface centered between the inner rollers. Testing was performed in Hanks' Balanced Salt Solution at 25 degrees C. Solid dentin and solid composite beams [n = 6] had bending strengths of 164.4 and 164.6 MPa, respectively, under monotonically increasing loads. Bonded beams [n = 6] had strengths of 56.3 MPa. Thermo-cycling (5 degrees to 55 degrees C), NaOCl solution immersion, or 105 of pre-fatigue cycles did not decrease the strength. CONCLUSION: Thermal stress, exposure to NaOCL, or 105 cycles of mechanical stress does not decrease bond strength of composite bonded to dentin as tested in four-point bending.

Influence of fluoride on the mineralization of collagen via the polymer-induced liquid-precursor (PILP) process.

OBJECTIVE: The polymer-induced liquid-precursor (PILP) mineralization process has been shown to remineralize artificial dentin lesions to levels consistent with those of native dentin. However, nanoindentation revealed that the moduli of those remineralized lesions were only ∼50% that of native dentin. We hypothesize that this may be due to the PILP process having been previously optimized to obtain high amounts (∼70wt%) of intrafibrillar crystals, but without sufficient interfibrillar mineral, another significant component of dentin. METHODS: Fluoride was added to the PILP-mineralization of collagen from rat tail tendon at varying concentrations to determine if a better balance of intra- versus inter-fibrillar mineralization could be obtained, as determined by electron microscopy. Nanoindentation was used to determine if fluoridated apatite could improve the mechanical properties of the composites. RESULTS: Fluoride was successfully incorporated into the PILP-mineralization of rat tail tendon and resulted in collagen-mineral composite systems with the mineral phase of hydroxyapatite containing various levels of fluoridation. As the fluoride concentration increased, the crystals became larger and more rod-like, with an increasing tendency to form on the fibril surfaces rather than the interior. Nanomechanical testing of the mineralized tendons revealed that fluoride addition did not increase modulus over PILP mineralization alone. This likely resulted from the separated nature of collagen fibrils that comprise tendon, which does not provide lateral reinforcement and therefore may not be suited for the compressive loads of nanoindentation. SIGNIFICANCE: This work contributes to the development of minimally invasive approaches to caries treatment by determining if collagen can be functionally mineralized.

The tooth attachment mechanism defined by structure, chemical composition and mechanical properties of collagen fibers in the periodontium.

In this study, a comparison between structure, chemical composition and mechanical properties of collagen fibers at three regions within a human periodontium, has enabled us to define a novel tooth attachment mechanism. The three regions include, (1) the enthesis region: insertion site of periodontal ligament (PDL) fibers (collagen fibers) into cementum at the root surface, (2) bulk cementum, and (3) the cementum-dentin junction (CDJ). Structurally, continuity in collagen fibers was observed from the enthesis, through bulk cementum and CDJ. At the CDJ the collagen fibers split into individual collagen fibrils and intermingled with the extracellular matrix of mantle dentin. Under wet conditions, the collagen fibers at the three regions exhibited significant swelling suggesting a composition rich in polyanionic molecules such as glycosaminoglycans. Additionally, site-specific indentation illustrated a comparable elastic modulus between collagen fibers at the enthesis (1-3 GPa) and the CDJ (2-4 GPa). However, the elastic modulus of collagen fibers within bulk cementum was higher (4-7 GPa) suggesting presence of extrafibrillar mineral. It is known that the tooth forms a fibrous joint with the alveolar bone, which is termed a gomphosis. Although narrower in width than the PDL space, the hygroscopic CDJ can also be termed as a gomphosis; a fibrous joint between cementum and root dentin capable of accommodating functional loads similar to that between cementum and alveolar bone. From an engineering perspective, it is proposed that a tooth contains two fibrous joints that accommodate the masticatory cyclic loads. These joints are defined by the attachment of dissimilar materials via graded stiffness interfaces, such as: (1) alveolar bone attached to cementum with the PDL; and (2) cementum to root dentin with the CDJ. Thus, through variations in concentrations of basic constituents, distinct regions with characteristic structures and graded properties allow for attachment and the load bearing characteristics of a tooth.

Bioactive glass coatings affect the behavior of osteoblast-like cells.

Functionally graded coatings (FGCs) of bioactive glass on titanium alloy (Ti6Al4V) were fabricated by the enameling technique. These innovative coatings may be an alternative to plasma-sprayed, hydroxyapatite-coated implants. Previously we determined that a preconditioning treatment in simulated body fluid (SBF) helped to stabilize FGCs [Foppiano S et al. Acta Biomater 2006;2(2):133-42]. The primary goal of this work was to assess the in vitro cytocompatibility of preconditioned FGCs with MC3T3-E1.4 mouse pre-osteoblastic cells. We evaluated cell adhesion, proliferation and mineralization on FGCs in comparison to uncoated Ti6Al4V and tissue culture polystyrene (TCPS). No difference in cell adhesion was identified, whereas proliferation was significantly different on all materials, being highest on FGCs followed by TCPS and Ti6Al4V. Qualitative and quantitative mineralization assays indicated that mineralization occurred on all materials. The amount of inorganic phosphate released by the mineralizing layers was significantly different, being highest on TCPS, followed by FGC and uncoated Ti6Al4V. The secondary objective of this work was to assess the ability of the FGCs to affect gene expression, indirectly, by means of their dissolution products, which was assessed by real-time reverse-transcription polymerase chain reaction. The FGC dissolution products induced a 2-fold increase in the expression of Runx-2, and a 20% decrease in the expression of collagen type 1 with respect to TCPS extract. These genes are regulators of osteoblast differentiation and mineralization, respectively. The findings of this study indicate that preconditioned FGCs are cytocompatible and suggest that future work may allow composition changes to induce preferred gene expression.