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The objective of this study is to evaluate the impact of the thickness and translucency of various computer-aided design/computer-aided manufacturing (CAD/CAM) materials on the polymerization of dual-cure resin cement in endocrown restorations. Three commercially available CAD/CAM materials—lithium disilicate glass (e.max CAD), resin composite (CERASMART), and a polymer-infiltrated ceramic network (ENAMIC)—were cut into plates with five different thicknesses (1.5, 3.5, 5.5, 7.5, and 9.5 mm) in both high-translucency (HT) and low-translucency (LT) grades. Panavia V5, a commercial dual-cure resin cement, was polymerized through each plate by light irradiation. Post-polymerization treatment was performed by aging at 37 °C for 24 h under light-shielding conditions. The degree of conversion and Vickers hardness measurements were used to characterize the polymerization of the cement. The findings revealed a significant decrease in both the degree of conversion and Vickers hardness with increasing thickness across all CAD/CAM materials. Notably, while the differences in the degree of conversion and Vickers hardness between the HT and LT grades of each material were significant immediately after photoirradiation, these differences became smaller after post-polymerization treatment. Significant differences were observed between samples with a 1.5 mm thickness (conventional crowns) and those with a 5.5 mm or greater thickness (endocrowns), even after post-polymerization treatment. These results suggest that dual-cure resin cement in endocrown restorations undergoes insufficient polymerization. [ABSTRACT FROM AUTHOR]

Hydrofluoric acid (HF) is commonly used as an etchant for the pretreatment of dental computer-aided design/computer-aided manufacturing (CAD-CAM) materials, such as glass-ceramics and resin composites. Despite its effectiveness, the harmful and hazardous nature of HF has raised significant safety concerns. In contrast, ammonium fluoride (AF) is known for its relatively low toxicity but has limited etching capability. This study explored the potential of ammonium hydrogen sulfate (AHS), a low-toxicity and weak acid, to enhance the etching ability of aqueous AF solutions for the bonding pretreatment of CAD-CAM materials. This study investigated five types of aesthetic CAD-CAM materials: lithium disilicate glass, feldspathic porcelain, polymer-infiltrated ceramic networks, resin composites, and zirconia. Seven experimental etchants were prepared by varying the amount of AHS added to aqueous AF solutions, with each etchant used to etch the surfaces of the respective CAD-CAM materials. The treated surfaces were analyzed using scanning electron microscopy and confocal laser scanning microscopy. Additionally, the shear bond strength (SBS) of the CAD-CAM materials treated with a luting agent (resin cement) was evaluated. The results indicated that the AF1/AHS3 (weight ratio AF:AHS = 1:3) etchant had the most substantial etching effect on the surfaces of silica-containing materials (lithium disilicate glass, feldspathic porcelain, polymer-infiltrated ceramic networks, and resin composites) but not on zirconia. The SBS of the materials treated with the AF1/AHS3 etchant was comparable to that of the commercial HF etchant. Hence, an AF/AHS mixed solution could effectively etch silica-containing CAD-CAM materials, thereby enhancing their bonding capabilities. [ABSTRACT FROM AUTHOR]

Researchers have increasingly concentrated on loneliness in the workplace as a crucial factor influencing the mental health of employees and the viability of telework. In contrast, the current understanding of the strategies mitigating workplace loneliness and how leaders utilize their behaviors to impact followers' loneliness remains limited. Since servant leadership values the emotional needs of followers and displays a high level of empathy, this study investigated the direct and indirect effects of servant leadership on workplace loneliness. In this study, 267 employees (mean age = 31.5 years) from 28 provinces in China were recruited to participate in this survey. We proposed that servant leaders motivate their own empathic communication and other followers' empathic communication to reduce lonely followers' workplace loneliness. This research further examined the relationship between the leader's and colleagues' empathic communication, and the two jointly mediate the connection between servant leadership and followers' workplace loneliness. We constructed a serial mediation model to examine the relationships between servant leadership, leader's empathic communication, colleagues' empathic communication, and workplace loneliness. The results indicate that servant leadership creates a cycle of empathy and provides insights into building a culture of empathy to improve employee well-being. [ABSTRACT FROM AUTHOR]

The use of dental resin composites adapted to computer-aided design/computer-aided manufacturing (CAD/CAM) processes for indirect tooth restoration has increased. A key factor for a successful tooth restoration is the bond between the CAD/CAM composite crown and abutment tooth, achieved using resin-based cement. However, the optimal pairing of the resin cement and CAD/CAM composites remains unclear. This study aimed to identify the optimal combination of a CAD/CAM composite and resin cement for bonding. A commercial methyl methacrylate (MMA)-based resin cement (Super-Bond (SB)) and four other composite-based resin cements (PANAVIA V5; PV, Multilink Automix (MA), ResiCem EX (RC), and RelyX Universal Resin Cement (RX)) were tested experimentally. For the CAD/CAM composites, a commercial polymer-infiltrated ceramic network (PICN)-based composite (VITA ENAMIC (VE)) and two dispersed filler (DF)-based composites (SHOFU BLOCK HC (SH) and CERASMART300 (CE)) were used. Each composite block underwent cutting, polishing, and alumina sandblasting. This was followed by characterization using scanning electron microscopy, inorganic content measurement, surface free energy (SFE) analysis, and shear bond strength (SBS) testing. The results demonstrated that the inorganic content and total SFE of the VE composite were the highest among the examined composites. Furthermore, it bonded highly effectively to all the resin cements. This indicated that PICN-based composites exhibit unique bonding features with resin cements. Additionally, the SBS test results indicated that MMA-based resin cement bonds effectively with both DF- and PICN-based composites. The combination of the PICN-based composite and MMA-based resin cement showed the best bonding performance. [ABSTRACT FROM AUTHOR]

Poly-ether-ether-ketone (PEEK) is commonly employed in dental prostheses owing to its excellent mechanical properties; however, it is limited by its low bond strength with dental resin cement. This study aimed to clarify the type of resin cement most suitable for bonding to PEEK: methyl methacrylate (MMA)-based resin cement or composite-based resin cement. For this purpose, two MMA-based resin cements (Super-Bond EX and MULTIBOND II) and five composite-based resin cements (Block HC Cem, RelyX Universal Resin Cement, G-CEM LinkForce, Panavia V5, and Multilink Automix) were used in combination with appropriate adhesive primers. A PEEK block (SHOFU PEEK) was initially cut, polished, and sandblasted with alumina. The sandblasted PEEK was then bonded to resin cement with adhesive primer according to the manufacturer's instructions. The resulting specimens were immersed in water at 37 °C for 24 h, followed by thermocycling. Subsequently, the tensile bond strengths (TBSs) of the specimens were measured; the TBSs of the composite-based resin cements after thermocycling were found to be zero (G-CEM LinkForce, Panavia V5, and Multilink Automix), 0.03 ± 0.04 (RelyX Universal Resin Cement), or 1.6 ± 2.7 (Block HC Cem), whereas those of Super-Bond and MULTIBOND were 11.9 ± 2.6 and 4.8 ± 2.3 MPa, respectively. The results demonstrated that MMA-based resin cements exhibited stronger bonding to PEEK than composite-based resin cements. [ABSTRACT FROM AUTHOR]

Polymer-infiltrated ceramic network materials (PICNs) have high mechanical compatibility with human enamel. However, the wear properties of PICN against natural human enamel have not yet been clarified. We investigated the in vitro two-body wear behaviors of PICNs and an enamel antagonist. Two PICNs were used: Experimental PICN (EXP) prepared via the infiltration of methacrylate-based resin into the porous silica ceramic network and commercial Vita Enamic (ENA). Two commercial dental ceramics, lithium disilicate glass (LDS) and zirconia (ZIR), were also characterized, and their wear performance was compared to PICNs. The samples were subjected to Vickers hardness tests and two-body wear tests that involve the samples being cyclically impacted by enamel antagonists underwater at 37 °C. The results reveal that the Vickers hardness of EXP (301 ± 36) was closest to that of enamel (317 ± 17). The volumetric wear losses of EXP and ENA were similar to those of LDS but higher than that of zirconia. The volumetric wear loss of the enamel antagonist impacted against EXP was moderate among the examined samples. These results suggest that EXP has wear behavior similar to that of enamel. Therefore, PICNs are mechanically comparable to enamel in terms of hardness and wear and are excellent tooth-restoration materials. [ABSTRACT FROM AUTHOR]

Poly(methyl methacrylate) (PMMA)-based resins have been conventionally used in dental prostheses owing to their good biocompatibility. However, PMMA-based resins have relatively poor mechanical properties. In the present study, a novel nanoporous silica filler was developed and introduced into PMMA-based resins to improve their mechanical properties. The filler was prepared by sintering a green body composed of silica and an organic binder, followed by grinding to a fine powder and subsequent silanization. The filler was added to photocurable PMMA-based resin, which was prepared from MMA, PMMA, ethylene glycol dimethacrylate, and a photo-initiator. The filler was characterized by scanning electron microscopy (SEM), X-ray diffraction analysis, nitrogen sorption porosimetry, and Fourier transform infrared (FT-IR) spectroscopy. The PMMA-based resins were characterized by SEM and FT-IR, and the mechanical properties (Vickers hardness, flexural modulus, and flexural strength) and physicochemical properties (water sorption and solubility) were evaluated. The results suggested that the filler consisted of microparticles with nanopores. The filler at 23 wt % was well dispersed in the PMMA-based resin matrix. The mechanical and physicochemical properties of the PMMA-based resin improved significantly with the addition of the developed filler. Therefore, such filler-loaded PMMA-based resins are potential candidates for improving the strength and durability of polymer-based crown and denture base. [ABSTRACT FROM AUTHOR]

SiO2-poly(2-hydroxyethyl methacrylate) (pHEMA)-based composites have been widely used as biomaterials owing to their biocompatibility. However, they have not yet been applied as tooth restorative materials because of their poor mechanical properties. In the present paper, we develop a novel SiO2/pHEMA-based composite with a polymer-infiltrated network (PICN) structure for use in dental restorative materials. A mixture of SiO2 nanoparticles and a poly(vinyl alcohol) binder was sintered at 950 °C to fabricate a porous SiO2 block. A monomer mixture containing 70 wt%-HEMA/30 wt%-ethylene glycol dimethacrylate and a benzoyl peroxide initiator was infiltrated into the porous SiO2 block and heat-polymerized to fabricate the SiO2/pHEMA-based composite with a PICN structure. The composite was characterized according to its mechanical properties, surface free energy, and bonding properties with a dental adhesive. The flexural strength was 112.5 ± 18.7 MPa, the flexural modulus was 13.6 ± 3.4 GPa, and the Vickers hardness was 168.2 ± 16.1, which are similar values to human teeth. The surface free energy of the polar component of the composite was 19.6 ± 2.5 mN/m, suggesting that this composite has an active surface for bonding with the adhesive. The composite bonded well to the adhesive, in the presence of a silane coupling agent. The SiO2/pHEMA-based composite was demonstrated to be a potential candidate for dental restorative materials. [ABSTRACT FROM AUTHOR]

Poly(methyl methacrylate) (PMMA) is widely used in dental applications. However, PMMA specialized for stereolithography (SLA) additive manufacturing (3D-printing) has not been developed yet. This study aims to develop a novel PMMA-based resin for SLA 3D-printing by mixing methyl methacrylate (MMA), ethylene glycol dimethacrylate (EGDMA), and PMMA powder in various mixing ratios. The printability and the viscosity of the PMMA-based resins were examined to determine their suitability for 3D-printing. The mechanical properties (flexural strength and Vickers hardness), shear bond strength, degree of conversion, physicochemical properties (water sorption and solubility), and cytotoxicity for L929 cells of the resulting resins were compared with those of three commercial resins: one self-cured resin and two 3D-print resins. EGDMA and PMMA were found to be essential components for SLA 3D-printing. The viscosity increased with PMMA content, while the mechanical properties improved as EGDMA content increased. The shear bond strength tended to decrease as EGDMA increased. Based on these characteristics, the optimal composition was determined to be 30% PMMA, 56% EGDMA, 14% MMA with flexural strength (84.6 ± 7.1 MPa), Vickers hardness (21.6 ± 1.9), and shear bond strength (10.5 ± 1.8 MPa) which were comparable to or higher than those of commercial resins. The resin's degree of conversion (71.5 ± 0.7%), water sorption (19.7 ± 0.6 μg/mm3), solubility (below detection limit), and cell viability (80.7 ± 6.2% at day 10) were all acceptable for use in an oral environment. The printable PMMA-based resin is a potential candidate material for dental applications. [ABSTRACT FROM AUTHOR]

There has recently been growing interest worldwide in biological therapies such as platelet-rich plasma injection for the treatment of knee osteoarthritis. However, predicting the effectiveness of platelet-rich plasma therapy remains uncertain. Therefore, this retrospective cohort study was performed to assess a range of predictors for the effectiveness of platelet-rich plasma therapy in treating knee osteoarthritis. The study included 517 consecutive patients who underwent three injections of leucocyte-poor platelet-rich plasma therapy from 2016 to 2019 at a single institution. The treatment outcomes, including patient-oriented outcomes (visual analogue scale score and Knee Injury and Osteoarthritis Outcome Score), were analyzed and compared according to the severity of knee osteoarthritis based on Kellgren–Lawrence (KL) grading using standing plain radiographs. Fisher's exact test, univariate regression, and multivariate regression were used for data analysis. Patient-oriented outcomes were significantly improved 6 and 12 months after platelet-rich plasma therapy. The overall responder rate in patients who met the Outcome Measures in Rheumatology (OMERACT)–Osteoarthritis Research Society International (OARSI) responder criteria was 62.1%. The responder rate was significantly lower in patients with severe knee osteoarthritis (KL4, 50.9%) than in those with mild (KL2, 75.2%) and moderate (KL3, 66.5%) knee osteoarthritis. The multivariate logistic regression analysis revealed that deterioration of the knee osteoarthritis grade (increased KL grade) was a significant predictor of a worse clinical outcome (odds ratio, 0.58; 95% confidence interval, 0.45–0.75; p < 0.001). The relative risk for non-responders in severe (KL4) KOA was 2.1 (95% CI, 1.5–3.0) at 6 months and 2.3 (1.6–3.2) at 12 months compared with mild-to-moderate (KL2-3) KOA. The efficacy of platelet-rich plasma therapy was not affected by age, sex, body weight, or platelet count. This study revealed that the effectiveness of platelet-rich plasma therapy for the treatment of knee osteoarthritis is approximately 60% and that the effectiveness depends on the severity of knee osteoarthritis. This observation is useful not only for physicians but also for patients with knee osteoarthritis. [ABSTRACT FROM AUTHOR]