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Introduction and aims: The gaps at the margins of restorative composite resin can increase as the carious process occurs underneath the materials, causing further demineralization along the tooth cavity wall. The aim of this study was to evaluate the effects of restorative resin composite containing hydrated calcium silicate (hCS) filler on enamel protection against demineralization by simulating microleakage between the test material and teeth in a cariogenic environment. Methods: The experimental resin composites were composed of 70 wt.% filler, which was mixed with a glass filler and hCS in a weight ratio of 70.0% glass (hCS 0), 17.5% hCS + 52.5% glass (hCS 17.5), 35.0% hCS + 35.0% glass (hCS 35.0), and 52.5% hCS + 17.5% glass (hCS 52.5). A light-cured experimental resin composite disk was positioned over a polished bovine enamel disk, separated by a 30-µm gap, and immersed in artificial saliva with pH 4.0 for 15, 30, and 60 days. After the immersion period, the enamel disk was separated from the resin composite disk and evaluated using a microhardness tester, atomic force microscopy, and polarized light microscopy. The opposing sides of the enamel and resin composite disks were observed using scanning electron microscopy/energy dispersive X-ray spectrometry. Results: The enamel surface showed a significant increase in microhardness, decreased roughness, and remineralization layer as the proportion of hCS increased (P < .05). In the scanning electron microscopy image, the enamel surface with hCS 35.0 and 52.5 after all experimental immersion periods, showed a pattern similar to that of a sound tooth. Conclusions: The results demonstrated that increasing the hCS filler level of restorative resin composites significantly decreased enamel demineralization. Clinical relevance: Hydrated calcium silicate laced restorative resin composites may be a promising dental biomaterial for protecting teeth against demineralization and preventing secondary caries around restorations.

Abstract Cerium oxide nanoparticles are known for their antibacterial effects resulting from Ce3+ to Ce4+ conversion. Application of such cerium oxide nanoparticles in dentistry has been previously considered but limited due to deterioration of mechanical properties. Hence, this study aimed to examine mesoporous silica (MCM-41) coated with cerium oxide nanoparticles and evaluate the antibacterial effects and mechanical properties when applied to dental composite resin. Cerium oxide nanoparticles were coated on the MCM-41 surface using the sol–gel method by adding cerium oxide nanoparticle precursor to the MCM-41 dispersion. The samples were tested for antibacterial activity against Streptococcus mutans via CFU and MTT assays. The mechanical properties were assessed by flexural strength and depth of cure according to ISO 4049. Data were analyzed using a t-test, one-way ANOVA, and Tukey’s post-hoc test (p = 0.05). The experimental group showed significantly increased antibacterial properties compared to the control groups (p

Background/purpose: The retrograde filling material, particularly mineral trioxide aggregate (MTA) employed in apicoectomy, should possess high antibacterial efficacy and osteogenic potential. We evaluated the antibacterial efficacy, biocompatibility, and osteogenic potential following the addition of silver nanoparticles (AgNPs) and calcium fluoride (CaF2) in retrograde filling material of MTA. Materials and methods: MTA was mixed with four different solvents. Group 1 (G1): distilled water, Group 2 (G2): 50 ppm AgNPs, Group 3 (G3): 1 wt% CaF2, and Group 4 (G4): 50 ppm AgNPs and 1 wt% CaF2. The pH variation of each group was monitored, while the surface roughness was measured. The antibacterial efficacy against Enterococcus faecalis (E. faecalis) and the viability of murine pre-osteoblast (MC3T3) were evaluated for each group using colorimetric assays. The gene expression levels of osteogenic potential marker (OCN, ALPL, and RUNX2) in MC3T3 cells for each group were quantified using real-time-qPCR. Statistical analysis was performed at α = 0.05 level of significance. Results: When comparing the levels of antibacterial efficacy, the order of effectiveness was G4>G2>G3>G1 (P

Background/purpose: In the field of conservative dentistry and endodontics, mineral trioxide aggregate (MTA), commonly used, possesses advantages such as biocompatibility, antimicrobial properties and osteogenic potential. This study investigated the feasibility of utilizing membrane form mineral trioxide aggregate (MTA) as a barrier membrane in guided bone regeneration (GBR) procedures. Materials and methods: Membranes were electrospun from three different formulations: 15 w/v% Polycaprolactone (PCL), 13 w/v% PCL + 2 w/v% MTA (2MTA), and 11 w/v% PCL + 4 w/v% MTA (4MTA). Physicochemical and mechanical properties of the electrospun membrane were compared, encompassing parameters such as surface morphology, fiber diameter distribution, chemical composition, phase identification, tensile stress, pH variation, and water contact angle. Moreover, the antimicrobial properties against of the electrospun membranes were assessed through direct exposure to streptococcus aureus (S. aureus) and candida albicans (C. albicans). Additionally, on the 7th day, biocompatibility and cell attachment were investigated with respect to L929 (fibroblast) and MC3T3 (pre-osteoblast) cells. Inhibition of L929 cell infiltration and the expression of osteogenic related genes including osteocalcin (OCN), alkaline phosphatase (ALP), and runt related transcription factor 2 (RUNX2) in MC3T3 cells on 7th and 14th days were also investigated. Results: PCL, 2MTA, and 4MTA exhibited no statistically differences in fiber diameter distribution and tensile stress. However, as the MTA content increased, wettability and pH also increased. Due to the elevated pH, 4MTA demonstrated the lowest viability S.aureus and C.albicans. All membranes were highly biocompatibility and promoted cell attachment, while effectively preventing L929 cell infiltration. Lastly 4MTA showed increase in OCN, ALP, and RUNX2 expression on both 7th and 14th day. Conclusion: The membrane form MTA possessed characteristics essential for a novel barrier membrane.

Abstract Background White Portland cement is a calcium silicate material. It exhibits antibacterial properties and is biocompatible. In addition, calcium silicate-based materials are known to release calcium ions and form apatite. The purpose of this study was to develop a novel bioactive restorative resin composite with antibacterial and apatite forming properties to prevent tooth caries at the interface of teeth and restorative materials, by incorporation of hydrated calcium silicate (hCS) derived from white Portland cement. Methods To prepare the experimental composite resins, a 30 wt% light-curable resin matrix and 70 wt% filler, which was mixed with hCS and silanized glass powder were prepared in following concentrations: 0, 17.5, 35.0, and 52.5 wt% hCS filler. The depth of cure, flexural strength, water sorption, solubility, and antibacterial effect were tested. After immersion in artificial saliva solution for 15, 30, 60, and 90 days, ion concentration by ICP-MS and apatite formation using SEM-EDS, Raman spectroscopy and XRD from experimental specimens were analyzed. Results All experimental groups showed clinically acceptable depths of cure and flexural strength for the use as the restorative composite resin. Water sorption, solubility, released Ca and Si ions increased with the addition of hCS to the experimental composite resin. Experimental groups containing hCS showed greater antibacterial effects compared with the 0 wt% hCS filler group (p

Aim or Purpose: The aim of this study was to measure the amount of mercury vapor from one pre-capsulated dental amalgam according to the storage temperature and to investigate whether the storage temperature suggested by the manufacturer or ISO is appropriate for the storage. Materials and Methods: GK Amalgam and Ultracaps+ were used in this study. One pre-capsulated dental amalgam was placed in a Tedlar bag and vacuumed, and the Tedlar bag was filled with 2 L of (4±2)°C air. The Tedler bag was then stored at one of the three different temperature conditions; (4±2)°C, (23±2)°C or (30±2)°C for 24 hours to obtain air containing mercury vapor. By applying Ontario hydro method, elemental mercury vapor in the Tedlar bag was oxidized in KMnO4-H2SO4 solvent and pre-treated, followed by analyses using the CVAAS method. Total of 5 measurements were obtained from each group. Results: There was a significant difference depending on the storage temperature (P

Polyalkenoate cement (PAC) is a promising material for regenerative hard tissue therapy. The ionically rich glass component of PAC encourages bioactive interaction via. the release of essential ions. However, PAC bioactivity is restricted owing to (i) structurally inherent cationic network formers and (ii) surface bacterial biofilm formation. These two factors cause a deficiency in ion release, further complicated by secondary infections and premature therapeutic failure. Here, a multivalent zwitterionic network modifier (mZM) is presented for upregulation of ionic exchange and bioactivity enhancement. By introducing a non-zero charged mZM into PACs, an increase in the proportion of non-bridging oxygen occurs. The network modification promotes ion channel formation, causing a multiple-fold increase in ion release and surface deposition of hydroxy-carbonate apatite (ca. 74%). Experiments ex vivo and animal models also demonstrate the efficient remineralization ability of the mZM. Furthermore, divalent cationic interaction results in bacterial biofilm reduction (ca. 68%) while also influencing a shift in the biofilm species composition, which favors commensal growth. Therefore, PAC modification with mZM offers a promising solution for upregulation of bioactivity, even aiding in customization by targeting site-specific regenerative therapy in future applications.

Demineralized white lesions are a common problem when using orthodontic resin cement, which can be prevented with the addition of antibacterial substances. However, the addition of antibacterial substances such as zinc oxide alone may result in the deterioration of the resin cement’s functions. Halloysite nanotubes (HNTs) are known to be biocompatible without adversely affecting the mechanical properties of the material while having the ability to load different substances. The purpose of this study was to prepare orthodontic resin cement containing HNT fillers loaded with ZnO (ZnO/HNTs) and to investigate its mechanical, physical, chemical, and antibacterial properties. A group without filler was used as a control. Three groups containing 5 wt.% of HNTs, ZnO, and ZnO/HNTs were prepared. TEM and EDS measurements were carried out to confirm the morphological structure of the HNTs and the successful loading of ZnO onto the HNTs. The mechanical, physical, chemical, and antibacterial properties of the prepared orthodontic resin cement were considered. The ZnO group had high flexural strength and water absorption but a low depth of cure (p < 0.05). The ZnO/HNTs group showed the highest shear bond strength and film thickness (p < 0.05). In the antibacterial test, the ZnO/HNTs group resulted in a significant decrease in the biofilm’s metabolic activity compared to the other groups (p < 0.05). ZnO/HNTs did not affect cell viability. In addition, ZnO was cytotoxic at a concentration of 100% in the extract. The nanocomposite developed in this study exhibited antimicrobial activity against S. mutans while maintaining the mechanical, physical, and chemical properties of orthodontic resin cement. Therefore, it has the potential to be used as an orthodontic resin cement that can prevent DWLs.

Calcium silicate cement (CSC) is widely used as an endodontic material in clinical applications such as direct pulp capping, pulpotomy, or root canal. CSC has good biocompatibility, sealing properties, and the ability to enhance hard tissue regeneration. However, the disadvantage of CSC is the difficulty in handling when placing it into endodontic tissue due to the long setting time. Several attempts have been made to improve handling of CSC; however, these methods were limited by osteogenic properties. To overcome such a disadvantage, this study investigated the use of Pluronic F127 (F127) for the development easy-to-handle novel endodontic CSCs with osteogenic properties. In this case, different concentrations of F127 (5%, 10%, 20%, 30%, and 40%) were implemented to generate CSC specimens H5, H10, H20, H30, and H40, respectively. Calcium ion was continuously released for 28 days. In addition, each group resulted in apatite formation for 28 days corresponding to calcium ion release. The concentration of F127 showed opposite relationships with water solubility and compressive strength. The H20 group showed a high level of osteogenic activity compared to other groups at 14 days. Mineralization of the H20 group was higher than that of the other groups. This study indicates that the novel F127-based hydrogel with CSC can potentially be used as endodontic filler.

Abstract We evaluated the efficacy of light-curable fluoride varnish (LCFV) that contains 2-methacryloyloxyethyl phosphorylcholine (MPC) in terms of anti-biofouling properties and prevention of tooth enamel demineralization. MPC was mixed with and incorporated into LCFV at 0 (control), 1.5, 3.0, 5.0, 10.0, 20.0, and 40.0 weight percentage (wt%). Addition of high wt% of MPC resulted in increased film thickness and decreased the degree of conversion, indicating loss of the advantageous properties of LCFV. Addition of 1.5, 3, or 5 wt% MPC significantly reduced the amount of bovine serum albumin adsorbed from a solution and proteins adsorbed from brain heart infusion medium compared to the control (P

Biocompatibility is important for the 3D printing of resins used in medical devices and can be affected by photoinitiators, one of the key additives used in the 3D printing process. The choice of ingredients must be considered, as the toxicity varies depending on the photoinitiator, and unreacted photoinitiator may leach out of the polymerized resin. In this study, the use of ethyl (2,4,6-trimethylbenzoyl) phenylphosphinate (TPO-L) as a photoinitiator for the 3D printing of resin was considered for application in medical device production, where the cytotoxicity, colour stability, dimensional accuracy, degree of conversion, and mechanical/physical properties were evaluated. Along with TPO-L, two conventional photoinitiators, phenylbis (2,4,6-trimethylbenzoyl) phosphine oxide (BAPO) and diphenyl (2,4,6-trimethylbenzoyl) phosphine oxide (TPO), were considered. A total of 0.1 mol% of each photoinitiator was mixed with the resin matrix to prepare a resin mixture for 3D printing. The specimens were printed using a direct light processing (DLP) type 3D printer. The 3D-printed specimens were postprocessed and evaluated for cytotoxicity, colour stability, dimensional accuracy, degree of conversion, and mechanical properties in accordance with international standards and the methods described in previous studies. The TPO-L photoinitiator showed excellent biocompatibility and colour stability and possessed with an acceptable dimensional accuracy for use in the 3D printing of resins. Therefore, the TPO-L photoinitiator can be sufficiently used as a photoinitiator for dental 3D-printed resin.

Changes in intraoral pH can cause changes in the chemical decomposition and surface properties of treated resin-based pits and fissure sealants (sealant). The purpose of this study is to evaluate the release of bisphenol A (BPA) from sealants under three different pH conditions over time. The test specimen was applied with 6 sealants 5 mg each on a glass plate (10 × 10 mm) and photopolymerized. The samples were immersed for 10 min, 1 h, and 24 h in solutions of pH 3.0, 6.5, and 10.0 at 37 °C. BPA release was measured using a gas chromatography-mass spectrometer. A statistical analysis was performed by two-way ANOVA and one-way ANOVA to verify the effect of pH conditions and time on BPA release. The BPA concentration in the pH 3.0 group was higher at all points than with pH 6.5 and pH 10.0 (p < 0.05), and gradually increased over time (p < 0.05). As a result, it was confirmed that low pH negatively influences BPA release. Therefore, frequent exposure to low pH due to the consumption of various beverages after sealant treatment can negatively affect the sealant’s chemical stability in the oral cavity.

Due to high demand but limited supply, there has been an increase in the need to replace autologous bone grafts with alternatives that fulfill osteogenic requirements. In this study, two different types of bone grafts were tested for their drug carrying abilities along with their osteogenic properties. Two different types of alendronate-loaded bone grafts, Bio-Oss (bovine bone graft) and InRoad (biphasic synthetic bone graft) were observed to see how different concentrations of alendronate would affect the sustained release to enhance osteogenesis. In this study, defected ovariectomize-induced osteoporotic rat calvarias were observed for 28 days with three different concentrations of alendronate (0 mg, 1 mg, 5 mg) for both Bio-Oss and InRoad. A higher concentration (5 mg) allowed for a more controlled and sustained release throughout the 28-day comparison to those of lower concentrations (0 mg, 1 mg). When comparing Bio-Oss and InRoad through histology and Micro-CT, InRoad showed higher enhancement in osteogenesis. Through this study, it was observed that alendronate not only brings out robust osteogenesis with InRoad bone grafts, but also enhances bone regeneration in an alendronate-concentration-dependent manner. The combination of higher concentration of alendronate and multiple porous bone graft containing internal micro-channel structure of InRoad resulted in higher osteogenesis with a sustained release of alendronate.

The aim of this study is to investigate the resistance of various fluoride-releasing restorative materials against the demineralization and remineralization of enamel surfaces, including those that have been recently introduced to the market. Three different fluoride-releasing restorative materials were considered: glass ionomer (FI), resin-modified glass ionomer (RL), and an alkasite restorative material (CN). The acid neutralization ability was investigated using pH measurement, and the concentrations of released fluoride and calcium ions were measured. Finally, the demineralization resistance and remineralization effects of enamel were observed using a microhardness tester and SEM. CN showed an initial substantial increase in pH followed by a steady increase, with values higher than those of the other groups (p < 0.05). All three groups released fluoride ions, and the CN group released more calcium ions than the other groups (p < 0.05). In the acid resistance test, from the microhardness and SEM images, the CN group showed effective resistance to demineralization. In the remineralization test, the microhardness results showed that the FI and CN groups recovered the microhardness from the values of the demineralized enamel surface (p < 0.05). This was confirmed by the SEM images from remineralization tests; the CN group showed a recovered demineralized surface when immersed in artificial saliva for 7 days. In conclusion, alkasite restorative material can be an effective material when used in cariogenic environments.

Abstract Although various oral pathogens are inactivated by non-thermal atmospheric pressure plasma (NTAPP), the in vivo effects of NTAPP are poorly understood. The first aim of this study was to examine the antibacterial activity of microwave-pulsed NTAPP against Staphylococcus aureus in artificial saliva to mimic oral environmental conditions. The second aim was to determine the influence of microwave-pulsed NTAPP on human gingival fibroblasts (HGFs). The microwave-pulsed NTAPP reduced bacterial viability (as measured by colony forming units [CFU]) to a greater extent in artificial saliva than in saline. Extending the post-treatment incubation time increased bacterial inactivation in artificial saliva compared to saline. HGFs viability was unaffected by microwave-pulsed NTAPP for bacterial inactivation. Rather, HGFs proliferation increased after a 5-min microwave-pulsed NTAPP. Less tumor necrosis factor alpha was released by microwave-pulsed NTAPP-treated HGFs stimulated with lipopolysaccharide (LPS) than by untreated, LPS-stimulated HGFs; thus, plasma appeared to suppress the inflammatory response. Our study suggests that microwave-pulsed NTAPP may have stronger in vivo antibacterial activity than in vitro activity, and that microwave-pulsed NTAPP may have the additional advantage of suppressing gingival inflammatory responses.

Abstract We evaluated whether the biological activity of the surface of titanium, when stored in an aqueous solution after ultraviolet (UV) treatment, is comparable to that of the surface immediately after UV treatment. We subjected Grade IV titanium discs with machined surfaces to UV radiation for 15 min and then tested them immediately and after storage for 28 days, with and without distilled H2O (dH2O). We evaluated the surface characteristics using surface profiling, contact angle analysis, X-ray photoelectron spectroscopy, and in terms of the surface zeta-potential. We determined the level of biological activity by analysing albumin adsorption, MC3T3-E1 and human mesenchymal cell adhesion and cytoskeleton development, as well as the production of intracellular reactive oxygen species between groups. The surface characteristics produced by the UV irradiation were maintained in dH2O for 28 days. We found that titanium stored in dH2O for 28 days after UV treatment exhibited enhanced protein adsorption, cell attachment, and cytoskeleton development. Titanium stored in dH2O for 28 days after UV irradiation exhibited a lower level of oxidative stress, comparable to that of the titanium immediately after UV treatment. UV treatment combined with wet storage can be used as a means of overcoming the biological aging of titanium.

Calcium silicate-based cements (CSCs) are commonly used for endodontic procedures; however, their antibacterial effects are limited. The objective of this study was to develop a 2-methacryloyloxyethyl phosphorylcholine (MPC)-incorporated CSC with improved antibacterial properties, while maintaining the original advantageous features of CSC. MPC was incorporated into a commercial CSC (Endocem MTA) at 0 wt% (control), 1.5%, 3.0 wt%, 5.0 wt%, 7.5 wt%, and 10 wt%. The setting time, compressive strength, water sorption, and glycerol contact angle were measured. Protein absorption was measured and bacterial adhesion on the surface was evaluated using Enterococcus faecalis. The bactericidal effect was examined by the disc diffusion test. Mineralization ability was assessed based on calcium ion deposition, as assessed by alizarin red staining, after immersion into Hank's balanced salt solution for 7 days. High concentrations of MPC in CSC (7.5 wt% and 10 wt%) increased the setting time, reduced compressive strength, and reduced wettability. MPC (3 wt%) had greater protein repellent and anti-biofouling effects than those of control and test materials (P < 0.001). However, no bactericidal effect was observed for any control or test materials. There was greater calcium ion deposition on the surface of MPC-supplemented CSC than on the control (P < 0.001). The addition of 3 wt% MPC polymer to CSC confers protein-repellent properties and reduced bacterial attachment, with the potential for improved mineralization.

Commercial mineral trioxide aggregate (MTA) materials such as Endocem MTA (EC), Dia-Root Bio MTA (DR), RetroMTA (RM), and ProRoot MTA (PR) are increasingly used as root-end filling materials. The aim of this study was to assess and compare the physicochemical and mechanical properties and cytotoxicity of these MTAs. The film thicknesses of EC and DR were considerably less than that of PR; however, RM’s film thickness was greater than that of PR. In addition, the setting times of EC, DR, and RM were shorter than that of PR (p < 0.05). The solubility was not significantly different among all groups. The three relatively new MTA groups (EC, DR, and RM) exhibited a significant difference in pH variation and calcium ion release relative to the PR group (p < 0.05). The radiopacity of the three new MTAs was considerably less than that of PR. The mechanical strength of RM was not significantly different from that of PR (p > 0.05); however, the EC and DR groups were not as strong as PR (p < 0.05). All MTA groups revealed cytocompatibility. In conclusion, the results of this study confirmed that EC, RM, DR, and PR exhibit clinically acceptable physicochemical and mechanical properties and cell cytotoxicity.

The aim of this study was to investigate the element composition and grain size of commercial dental instruments used for ultrasonic scaler tips, which are composed of stainless-steel materials. The differences in mechanical properties and wear resistances were compared. The samples were classified into 4 groups in accordance with the manufacturer, Electro Medical Systems, 3A MEDES, DMETEC and OSUNG MND, and the element compositions of each stainless-steel ultrasonic scaler tip were analyzed with micro-X-ray fluorescence spectrometry (μXRF) and field-emission scanning electron microscopy (FE-SEM) with energy-dispersive X-ray spectroscopy (EDS). One-way ANOVA showed that there were significant differences in shear strength and Vickers hardness among the stainless-steel ultrasonic scaler tips depending on the manufacturer (p < 0.05). The mass before and after wear were found to have no significant difference among groups (p > 0.05), but there was a significant difference in the wear volume loss (p < 0.05). The results were then correlated with μXRF results as well as observations of grain size with optical microscopy, which concluded that the Fe content and the grain size of the stainless steel have significant impacts on strength. Additionally, stainless-steel ultrasonic scaler tips with higher Vickers hardness values showed greater wear resistance, which would be an important wear characteristic for clinicians to check.

Despite numerous advantages of using porous hydroxyapatite (HAp) scaffolds in bone regeneration, the material is limited in terms of osteoinduction. In this study, the porous scaffold made from nanosized HAp was coated with different concentrations of osteoinductive aqueous methylsulfonylmethane (MSM) solution (2.5, 5, 10, and 20%) and the corresponding MH scaffolds were referred to as MH2.5, MH5, MH10, and MH20, respectively. The results showed that all MH scaffolds resulted in burst release of MSM for up to 7 d. Cellular experiments were conducted using MC3T3-E1 preosteoblast cells, which showed no significant difference between the MH2.5 scaffold and the control with respect to the rate of cell proliferation (p > 0.05). There was no significant difference between each group at day 4 for alkaline phosphatase (ALP) activity, though the MH2.5 group showed higher level of activity than other groups at day 10. Calcium deposition, using alizarin red staining, showed that cell mineralization was significantly higher in the MH2.5 scaffold than that in the HAp scaffold (p < 0.0001). This study indicated that the MH2.5 scaffold has potential for both osteoinduction and osteoconduction in bone regeneration.

Flowable resins used for dental restoration are subject to biofilm formation. Zinc has antibacterial properties. Thus, we prepared a zinc-doped phosphate-based glass (Zn-PBG) to dope a flowable resin and evaluated the antibacterial activity of the composite against Streptococcus mutans (S. mutans) to extrapolate the preventative effect toward secondary caries. The composites were prepared having 0 (control), 1.9, 3.8, and 5.4 wt.% Zn-PBG. The flexural strength, elastic modulus, microhardness, depth of cure, ion release, inhibition zone size, and number of colony-forming units were evaluated and analyzed using ANOVA. The flexural strength of the control was significantly higher than those of Zn-PBG samples (p < 0.05). However, all samples meet the International Standard, ISO 4049. The microhardness was not significantly different for the control group and 1.9 and 3.8 wt.% groups, but the 5.4 wt.% Zn-PBG group had a significantly lower microhardness (p < 0.05). Further, the composite resins increasingly released P, Ca, Na, and Zn ions with an increase in Zn-PBG content (p < 0.05). The colony-forming unit count revealed a significant reduction in S. mutans viability (p < 0.05) with increase in Zn-PBG content. Therefore, the addition of Zn-PBG to flowable composite resins enhances antibacterial activity and could aid the prevention of secondary caries.

The increasing demand for orthodontic treatment over recent years has led to a growing need for the retrieval and reuse of titanium-based miniscrews to reduce the cost of treatment, especially in patients with early treatment failure due to insufficient primary stability. This in vitro study aimed to evaluate differences in the primary stability between initially inserted and re-inserted miniscrews within different cortical bone densities. Artificial bone was used to simulate cortical bone of different densities, namely 20, 30, 40, and 50 pound per cubic foot (pcf), where primary stability was evaluated based on maximum insertion torque (MIT), maximum removal torque (MRT), horizontal resistance, and micromotion. Scanning electron microscopy was used to evaluate morphological changes in the retrieved miniscrews. The MIT, MRT, horizontal resistance, and micromotion was better in samples with higher cortical bone density, thereby indicating better primary stability (P < 0.05). Furthermore, a significant reduction of MIT, MRT, and horizontal resistance was observed during re-insertion compared with the initial insertion, especially in the higher density cortical bone groups. However, there was no significant change in micromotion. While higher cortical bone density led to better primary stability, it also caused more abrasion to the miniscrews, thereby decreasing the primary stability during re-insertion.

The surface molecular chemistry, such as amine functionality, of biomaterials plays a crucial role in the osteogenic activity of relevant cells and tissues during hard tissue regeneration. Here, we examined the possibilities of creating amine functionalities on the surface of titanium by using the nonthermal atmospheric pressure plasma jet (NTAPPJ) method with humidified ammonia, and the effects on human mesenchymal stem cell (hMSC) were investigated. Titanium samples were subjected to NTAPPJ treatments using nitrogen (N-P), air (A-P), or humidified ammonia (NA-P) as the plasma gas, while control (C-P) samples were not subjected to plasma treatment. After plasma exposure, all treatment groups showed increased hydrophilicity and had more attached cells than the C-P. Among the plasma-treated samples, the A-P and NA-P showed surface oxygen functionalities and exhibited greater cell proliferation than the C-P and N-P. The NA-P additionally showed surface amine-related functionalities and exhibited a higher level of alkaline phosphatase activity and osteocalcin expression than the other samples. The results can be explained by increases in fibronectin absorption and focal adhesion kinase gene expression on the NA-P samples. These findings suggest that NTAPPJ technology with humidified ammonia as a gas source has clinical potential for hard tissue generation.

The nanotubular surface of titanium implants is known to have superior osteogenic activity but is also vulnerable to failure because of induced bacterial attachment and consequent secondary infection. Here, the problem was attempted to be solved by depositing nanosized tetracycline (TC)-loaded particles in poly(lactic-co-glycolic acid) on titania nanotubes (TNTs) using the electrospray deposition method. The antibacterial effect of the newly formed TNT surface was considered using the common pathogen Staphylococcus aureus. Maintenance of the biocompatibility and osteogenic characteristics of TNTs has been tested through cytotoxicity tests and osteogenic gene expression/extra-cellular matrix mineralization, respectively. The results showed that TNTs were successfully formed by anodization, and the characterization of TC deposited on the TNTs was controlled by varying the spraying parameters such as particle size and coating time. The TC nanoparticle-coated TNTs showed antibacterial activity against Staphylococcus aureus and biocompatibility with MC3T3-E1 pre-osteoblasts, while the osteogenic activity of the TNT structure was preserved, as demonstrated by osteocalcin and osteopontin gene expression, as well as Alizarin red staining. Hence, this study concluded that the electrosprayed TC coating of TNTs is a simple and effective method for the formation of bactericidal implants that can maintain osteogenic activity.

The objective of this study was to investigate the effects of hydrated calcium silicate filler (hCS) on resin-based pit and fissure sealants’ acid neutralization, calcium ion release, and mechanical and physical properties. To produce the hCS filler, Portland cement (CS) was mixed with distilled water and ground into fine particles. The particles were then mixed with silanized glass filler and added to a photo-activated resin matrix. To evaluate the acid neutralization and calcium ion release properties, the specimens were immersed in a pH 4.0 lactic acid solution and distilled water for 28 days. Also, the flexural strength, depth of cure, water sorption, and solubility were tested. All of the groups containing hCS and CS required less than one minute to increase the pH from 4.0 to 5.5. With 50% hCS, the calcium ion release was higher than 50% CS in the distilled water at the initial time. The flexural strength and depth of cure decreased according to the increasing proportion of hCS added. The water sorption and solubility had an increasing trend as increasing proportions of hCS were added. These findings showed that pit and fissure sealant containing hCS exhibit superior acid neutralization and calcium release properties, and may be promising for caries-inhibiting dental material.

The purpose of the study was to evaluate the adhesion between dental core resin and epoxy resin-based fiber post after treatment with non-thermal atmospheric pressure plasma (NTAPP) and compare with conventional methods of epoxy resin-based fiber post treatments. Contact angle was measured on the surface of epoxy resin before and after NTAPP treatment and X-ray photoelectron spectroscopy was used to analyze the surface chemistry. Finally, two shear bond strength tests were carried out; shear bond strength between core resin and epoxy resin for comparison between NTAPP treated and untreated sample, and push-out shear bond strength between core resin and NTAPP treated commercially available epoxy resin-based fiber post for comparison between NTAPP treated samples with conventionally treated samples. Contact angle on the surface of epoxy resin generally decreased with increasing NTAPP treatment time with presence of surface chemical changes. Also, there was significantly higher shear bond strength and push-out shear bond strength between epoxy resin and core resin for NTAPP treated epoxy resin, even to the conventionally treated epoxy resin-based fiber post with hydrofluoric acid or silane. In conclusion, new technology of NTAPP has potential for application on the epoxy resin-based fiber post to improve endodontic restoration success rate.

Based on three-dimensional scanning and computer-aided design and computer-aided manufacturing (CAD/CAM) techniques, customized bracket systems are increasingly used. However, data remain limited regarding customized bracket design, characteristics, and stability. This study was undertaken to evaluate the design, bond strength, and residual adhesives of four different CAD/CAM customized brackets that were attached to human tooth specimens by indirect bonding. Thirty extracted human upper premolars were divided into five groups: Group 1, preadjusted self-ligating labial metal bracket; Group 2, lingual self-ligating metal injection molding customized bracket; Group 3, gold-casted lingual customized bracket; Group 4, labial self-ligating milled customized bracket; Group 5, labial customized resin base bracket. Except in Group 1, premolar specimens were scanned via model scanner, and the images were sent to each manufacturing company to fabricate customized brackets and transfer trays/jigs. Debonding force (DF; N) was measured by Instron universal testing machine and shear bond strength (SBS; MPa) was calculated via dividing DF by bonding area. Adhesive remnants were analyzed via stereo microscopic images. Group 2 (196.90±82.75 N) exhibited significantly higher DF than Group 1 (62.77±12.65 N); other groups exhibited similar DFs, compared with Group 1. No customized bracket groups exhibited significant differences in SBS, relative to Group 1 (6.73±1.36 MPa). However, SBS in Group 5 (11.46±7.22 MPa) was significantly higher than in Group 3 (3.58±2.14 MPa). Group 3 had significantly lower ARI scores than other groups (P

Dental luting cements are commonly used in dentistry for cementation of prosthetic restoration. Many previous studies focused on the measurement of the cell viability as the method of cytotoxicity evaluation during biocompatibility study for the material. In this study, the biocompatibility of various dental luting cements were evaluated using the new method of cytokine release measurement in order to better simulate inflammatory reactions in animal or clinical model using two different oral cells; immortalized human gingival fibroblast and immortalized human oral keratinocytes. Cells were exposed to extractions of various commercially available dental luting cements for different durations. Cytokines of IL-1α and IL-8 were measured from the supernatants of the cells and the results were then compared to the conventional MTT viability test. The result from the conventional cell viability study showed a relatively simple and straight forward indication that only one of the dental luting cements tested in this study was cytotoxic with increasing duration of exposure for both cells. Meanwhile, the result from the cytokine measurement study was much more complex at the time point they were measured, type of cells used for the study and the type of cytokines measured, all of which influenced the interpretation of the results. Hence, the better understanding of the cytokine release would be required for the application in biocompatibility evaluation.

Despite numerous attempts to use human mesenchymal stem cells (hMSCs) in the field of tissue engineering, the control of their differentiation remains challenging. Here, we investigated possible applications of a non-thermal atmospheric pressure plasma jet (NTAPPJ) to control the differentiation of hMSCs. An air- or nitrogen-based NTAPPJ was applied to hMSCs in culture media, either directly or by media treatment in which the cells were plated after the medium was exposed to the NTAPPJ. The durations of exposure were 1, 2, and 4 min, and the control was not exposed to the NTAPPJ. The initial attachment of the cells was assessed by a water-soluble tetrazolium assay, and the gene expression in the cells was assessed through reverse-transcription polymerase chain reaction and immunofluorescence staining. The results showed that the gene expression in the hMSCs was generally increased by the NTAPPJ exposure, but the enhancement was dependent on the conditions of the exposure, such as the source of the gas and the treatment method used. These results were attributed to the chemicals in the extracellular environment and the reactive oxygen species generated by the plasma. Hence, it was concluded that by applying the best conditions for the NTAPPJ exposure of hMSCs, the control of hMSC differentiation was possible, and therefore, exposure to an NTAPPJ is a promising method for tissue engineering.

The purpose of this study was to evaluate the change in the retentive forces of four different titanium-based implant attachment systems during the simulation of insert−removal cycles in an artificial oral environment. Five types of titanium-based dental implant attachment systems (Locator, Kerator, O-ring, EZ-Lock, and Magnetic) were studied (n = 10). The specimens underwent insert−removal cycles in artificial saliva, and the retentive force was measured following 0, 750, 1500, and 2250 cycles. Significant retention loss was observed in all attachment systems, except the magnetic attachments, upon completion of 2250 insertion and removal cycles, compared to the initial retentive force (p < 0.05). A comparison of the initial retentive forces revealed the highest value for Locator, followed by the Kerator, O-ring, EZ-Lock, and Magnetic attachments. Furthermore, Kerator demonstrated the highest retentive loss, followed by Locator, O-ring, EZ-Lock, and Magnetic attachments after 2250 cycles (p < 0.05). In addition, the Locator and Kerator systems revealed significant decrease in retentive forces at all measurement points (p < 0.05). The retention force according to the insert−removal cycles were significantly different according to the types of dental implant attachment systems.

The aim of this study was to fabricate bioresorbable polylactide (PLA) membranes by 3D printing and compare their properties to those of the membranes fabricated by the conventional method and compare the effect of different pore sizes on the properties of the 3D-printed membranes. PLA membranes with three different pore sizes (large pore-479 μm, small pore-273 μm, and no pore) were 3D printed, and membranes fabricated using the conventional solvent casting method were used as the control group. Scanning electron microscopy (SEM) and micro-computed tomography (µ-CT) were taken to observe the morphology and obtain the porosity of the four groups. A tensile test was performed to compare the tensile strength, elastic modulus, and elongation at break of the membranes. Preosteoblast cells were cultured on the membranes for 1, 3 and 7 days, followed by a WST assay and SEM, to examine the cell proliferation on different groups. As a result, the 3D-printed membranes showed superior mechanical properties to those of the solvent cast membranes, and the 3D-printed membranes exhibited different advantageous mechanical properties depending on the different pore sizes. The various fabrication methods and pore sizes did not have significantly different effects on cell growth. It is proven that 3D printing is a promising method for the fabrication of customized barrier membranes used in GBR/GTR.

This study was performed to standardize a dentin barrier test with the substitute and evaluate the cytotoxicity of one-step self-etching bonding agents. Each of the natural bovine dentin and polyurethane discs were 500-μm thick and were tested using a perfusion device. Following the treatment with 0.05% phenol on the natural bovine disc or three kinds of polyurethane discs—30, 40, and 50 pcf (pounds per cubic foot)—cell viability of L-929 was measured by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and expressed as percentages of non-treated group, respectively. A substitute showing permeability similar to that of bovine dentin was determined based on this result. Cytotoxicity test of bonding agents was performed by the selected substitute, the results of which were expressed as percentages of the control. In addition, SEM images were taken after the tests. The cell viability by 40-pcf polyurethane disc was not statistically different from that by bovine dentin disc (P > 0.05). Futurabond DC resulted in the highest cell viability and Bond force the lowest by the 40-pcf polyurethane disc (P < 0.05). The adhesives on the 40-pcf polyurethane disc changed cellular morphology with different degrees on the SEM images. This standardized test might be useful for assessing the cytotoxicity of dental materials applied to dentin before clinical applications.

The aim of this study is to investigate the effects of cold atmospheric pressure plasma (CAP)-induced radicals on the epidermal growth factor receptor (EGFR), which is overexpressed by oral squamous cell carcinoma, to determine the underlying mechanism of selective killing. CAP-induced highly reactive radicals were observed in both plasma plume and cell culture media. The selective killing effect was observed in oral squamous cell carcinoma compared with normal human gingival fibroblast. Degradation and dysfunction of EGFRs were observed only in the EGFR-overexpressing oral squamous cell carcinoma and not in the normal cell. Nitric oxide scavenger pretreatment in cell culture media before CAP treatment rescued above degradation and dysfunction of the EGFR as well as the killing effect in oral squamous cell carcinoma. CAP may be a promising cancer treatment method by inducing EGFR dysfunction in EGFR-overexpressing oral squamous cell carcinoma via nitric oxide radicals.

Dental light-cured resins can undergo different degrees of polymerization when applied in vivo. When polymerization is incomplete, toxic monomers may be released into the oral cavity. The present study assessed the cytotoxicity of different materials, using sample preparation methods that mirror clinical conditions. Composite and bonding resins were used and divided into four groups according to sample preparation method: uncured; directly cured samples, which were cured after being placed on solidified agar; post-cured samples were polymerized before being placed on agar; and “removed unreacted layer” samples had their oxygen-inhibition layer removed after polymerization. Cytotoxicity was evaluated using an agar diffusion test, MTT assay, and confocal microscopy. Uncured samples were the most cytotoxic, while removed unreacted layer samples were the least cytotoxic (p < 0.05). In the MTT assay, cell viability increased significantly in every group as the concentration of the extracts decreased (p < 0.05). Extracts from post-cured and removed unreacted layer samples of bonding resin were less toxic than post-cured and removed unreacted layer samples of composite resin. Removal of the oxygen-inhibition layer resulted in the lowest cytotoxicity. Clinicians should remove unreacted monomers on the resin surface immediately after restoring teeth with light-curing resin to improve the restoration biocompatibility.

The surface topography and chemistry of titanium implants are important factors for successful osseointegration. However, chemical modification of an implant surface using currently available methods often results in the disruption of topographical features and the loss of beneficial effects during the shelf life of the implant. Therefore, the aim of this study was to apply the recently highlighted portable non-thermal atmospheric pressure plasma jet (NTAPPJ), elicited from one of two different gas sources (nitrogen and air), to TiO2 nanotube surfaces to further improve their osteogenic properties while preserving the topographical morphology. The surface treatment was performed before implantation to avoid age-related decay. The surface chemistry and morphology of the TiO2 nanotube surfaces before and after the NTAPPJ treatment were determined using a field-emission scanning electron microscope, a surface profiler, a contact angle goniometer, and an X-ray photoelectron spectroscope. The MC3T3-E1 cell viability, attachment and morphology were confirmed using calcein AM and ethidium homodimer-1 staining, and analysis of gene expression using rat mesenchymal stem cells was performed using a real-time reverse-transcription polymerase chain reaction. The results indicated that both portable nitrogen- and air-based NTAPPJ could be used on TiO2 nanotube surfaces easily and without topographical disruption. NTAPPJ resulted in a significant increase in the hydrophilicity of the surfaces as well as changes in the surface chemistry, which consequently increased the cell viability, attachment and differentiation compared with the control samples. The nitrogen-based NTAPPJ treatment group exhibited a higher osteogenic gene expression level than the air-based NTAPPJ treatment group due to the lower atomic percentage of carbon on the surface that resulted from treatment. It was concluded that NTAPPJ treatment of TiO2 nanotube surfaces results in an increase in cellular activity. Furthermore, it was demonstrated that this treatment leads to improved osseointegration in vitro.

Bone morphogenetic protein-2 (BMP-2)-containing bone grafts are useful regenerative materials for oral and maxillofacial surgery; however, several in vitro and in vivo studies previously reported cancer progression-related adverse effects caused by BMP-2. In this study, by quantifying the rhBMP-2 content released from bone grafts, the rhBMP-2 concentration that did not show cytotoxicity in each cell line was determined and applied to the in vitro monoculture or coculture model in the invasion assay. Our results showed that 1 ng/ml rhBMP-2, while not affecting cancer cell viability, significantly increased the invasion ability of the cancer cells cocultured with fibroblasts. Cocultured medium with rhBMP-2 also contained increased levels of matrix metalloproteinases. rhBMP-2-treated cocultured fibroblasts did not show a prominent difference in mRNA expression profile. Some cytokines, however, were detected in the conditioned medium by a human cytokine antibody array. Among them, the cancer invasion-related factor CCL5 was quantified by ELISA. Interestingly, CCL5 neutralizing antibodies significantly reduced the invasion of oral cancer cells. In conclusion, our results suggest that 1 ng/ml rhBMP-2 may induce invasion of oral squamous cell carcinoma (OSCC) cells by CCL5 release in coculture models. Therefore, we propose that a careful clinical examination before the use of rhBMP-2-containing biomaterials is indispensable for using rhBMP-2 treatment to prevent cancer progression.

This study evaluated the physical and mechanical properties of resin matrices in dental adhesives with two photoinitiator systems. Resin matrix specimens were made with five different kinds of photoinitiators. Neat resin consisted of 60% 2,2-bis[4-2(2-hydroxy-3-methacryloxypropoxy)phenyl]propane (Bis-GMA) and 40% hydroxyethyl methacrylate (HEMA) by weight, along with camphorquinone (CQ, 1 mol %) and additional components (1 mol % each) as follows: Group 1, 2-(dimethylamino)ethyl methacrylate (DMAEMA); Group 2, ethyl-4-(dimethylamino) benzoate (EDMAB); Group 3, diphenyliodonium hexafluorphosphate (DPIHFP); Group 4, DMAEMA+DPIHFP; Group 5, EDMAB+DPIHFP. The degree of conversion (DC), flexural strength, flexural modulus, microhardness, and ultimate tensile strength were tested. The contribution of each photoinitiator to the DC in a selected group was analyzed with contour plots. One-way ANOVA and Tukey tests (p < 0.05) were used for statistical analyses. The DC of Groups 2, 4, and 5 was similar. The flexural strength was similar in all groups, but flexural modulus was significantly different. Group 3 had the lowest values for all physical and mechanical properties. Among all methods, the microhardness test revealed the greatest degree of difference among the five specimens. CQ, EDMAB, and DPIHFP were the most effective photoinitiators and CQ was the most influential factor for the DC rate.

The objective of the study was to compare the acid neutralizing ability and shear bond strength (SBS) of three different types of orthodontic adhesives containing bioactive glasses (BAGs). 45S5, 45S5F and S53P4 BAGs were prepared using the melting technique and ground to fine particles. Orthodontic adhesives containing three types of BAGs were prepared as follows: 52.5% 45S5 BAG + 17.5% glass (45S5_A); 61.25% 45S5 BAG + 8.75% glass (45S5_B); 52.5% 45S5F BAG + 17.5% glass (45S5F_A); 61.25% 45S5F BAG + 8.75% glass (45S5F_B); 52.5% S53P4 BAG + 17.5% glass (S53P4_A); 61.25% S53P4 BAG + 8.75% glass (S53P4_B); and 70.0% glass (BAG_0). To evaluate the acid neutralizing properties, specimens were immersed in lactic acid solution, and pH changes were measured. SBS was measured with a universal testing machine. For all of the BAG-containing adhesives, the one with 61.25% of BAG showed a significantly greater increase of pH than the one with 52.5% of BAG (p < 0.05). Groups with 61.25% of BAG showed lower SBS than samples with 52.5% of BAG. 45S5F_A showed no significant difference of SBS compared to BAG_0 (p > 0.05). The adhesive containing 61.25% of 45S5F BAG exhibited clinically acceptable SBS and acid neutralizing properties. Therefore, this composition is a suitable candidate to prevent white spot lesions during orthodontic treatment.

The demand of bone graft materials has been increasing. Among various origins of bone graft materials, natural coral composed of up to 99% calcium carbonate was chosen and converted into hydroxyapatite (HA); silicon was then substituted into the HA. Then, the Si-HA was mixed with β-tricalcium phosphate (TCP) in the ratios 100:0 (S100T0), 70:30 (S70T30), 60:40 (S60T40), and 50:50 (S50T50). The materials were implanted for four and eight weeks in a rat calvarial bone defect model (8 mm). The MBCPTM (HA:β-TCP = 60:40, Biomatalante, Vigneux de Bretagne, France) was used as a control. After euthanasia, the bone tissue was analyzed by making histological slides. From the results, S60T40 showed the fastest bone regeneration in four weeks (p < 0.05). In addition, S60T40, S50T50, and MBCPTM showed significant new bone formation in eight weeks (p < 0.05). In conclusion, Si-HA/TCP showed potential as a bone graft material.