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Pulp capping is a necessary procedure for preserving the vitality and health of the dental pulp, playing a crucial role in preventing the need for root canal treatment or tooth extraction. Here, we developed an electrospun gelatin methacryloyl (GelMA) fibrous scaffold incorporating beta-tricalcium phosphate (TCP) particles for pulp capping. A comprehensive morphological, physical-chemical, and mechanical characterization of the engineered fibrous scaffolds was performed. In vitro bioactivity, cell compatibility, and odontogenic differentiation potential of the scaffolds in dental pulp stem cells (DPSCs) were also evaluated. A pre-clinical in vivo model was used to determine the therapeutic role of the GelMA/TCP scaffolds in promoting hard tissue formation. Morphological, chemical, and thermal analyses confirmed effective TCP incorporation in the GelMA nanofibers. The GelMA+20%TCP nanofibrous scaffold exhibited bead-free morphology and suitable mechanical and degradation properties. In vitro , GelMA+20%TCP scaffolds supported apatite-like formation, improved cell spreading, and increased deposition of mineralization nodules. Gene expression analysis revealed upregulation of ALPL, RUNX2, COL1A1, and DMP1 in the presence of TCP-laden scaffolds. In vivo , analyses showed mild inflammatory reaction upon scaffolds' contact while supporting mineralized tissue formation. Although the levels of Nestin and DMP1 proteins did not exceed those associated with the clinical reference treatment (i.e., mineral trioxide aggregate), the GelMA+20%TCP scaffold exhibited comparable levels, thus suggesting the emergence of differentiated odontoblast-like cells capable of dentin matrix secretion. Our innovative GelMA/TCP scaffold represents a simplified and efficient alternative to conventional pulp-capping biomaterials. Vital pulp therapy (VPT) aims to preserve dental pulp vitality and avoid root canal treatment. Biomaterials that bolster mineralized tissue regeneration with ease of use are still lacking. We successfully engineered gelatin methacryloyl (GelMA) electrospun scaffolds incorporated with beta-tricalcium phosphate (TCP) for VPT. Notably, electrospun GelMA-based scaffolds containing 20% (w/v) of TCP exhibited favorable mechanical properties and degradation, cytocompatibility, and mineralization potential indicated by apatite-like structures in vitro and mineralized tissue deposition in vivo, although not surpassing those associated with the standard of care. Collectively, our innovative GelMA/TCP scaffold represents a simplified alternative to conventional pulp capping materials such as MTA and Biodentine™ since it is a ready-to-use biomaterial, requires no setting time, and is therapeutically effective. [Display omitted] [ABSTRACT FROM AUTHOR]

For nearly three decades, tissue engineering strategies have been leveraged to devise effective therapeutics for dental, oral, and craniofacial (DOC) regenerative medicine and treat permanent deformities caused by many debilitating health conditions. In this regard, additive manufacturing (AM) allows the fabrication of personalized scaffolds that have the potential to recapitulate native tissue morphology and biomechanics through the utilization of several 3D printing techniques. Among these, melt electrowriting (MEW) is a versatile direct electrowriting process that permits the development of well-organized fibrous constructs with fiber resolutions ranging from micron to nanoscale. Indeed, MEW offers great prospects for the fabrication of scaffolds mimicking tissue specificity, healthy and pathophysiological microenvironments, personalized multi-scale transitions, and functional interfaces for tissue regeneration in medicine and dentistry. Excitingly, recent work has demonstrated the potential of converging MEW with other AM technologies and/or cell-laden scaffold fabrication (bioprinting) as a favorable route to overcome some of the limitations of MEW for DOC tissue regeneration. In particular, such convergency fabrication strategy has opened great promise in terms of supporting multi-tissue compartmentalization and predetermined cell commitment. In this review, we offer a critical appraisal on the latest advances in MEW and its convergence with other biofabrication technologies for DOC tissue regeneration. We first present the engineering principles of MEW and the most relevant design aspects for transition from flat to more anatomically relevant 3D structures while printing highly-ordered constructs. Secondly, we provide a thorough assessment of contemporary achievements using MEW scaffolds to study and guide soft and hard tissue regeneration, and draw a parallel on how to extrapolate proven concepts for applications in DOC tissue regeneration. Finally, we offer a combined engineering/clinical perspective on the fabrication of hierarchically organized MEW scaffold architectures and the future translational potential of site-specific, single-step scaffold fabrication to address tissue and tissue interfaces in dental, oral, and craniofacial regenerative medicine. Melt electrowriting (MEW) techniques can further replicate the complexity of native tissues and could be the foundation for novel personalized (defect-specific) and tissue-specific clinical approaches in regenerative dental medicine. This work presents a unique perspective on how MEW has been translated towards the application of highly-ordered personalized multi-scale and functional interfaces for tissue regeneration, targeting the transition from flat to anatomically-relevant three-dimensional structures. Furthermore, we address the value of convergence of biofabrication technologies to overcome the traditional manufacturing limitations provided by multi-tissue complexity. Taken together, this work offers abundant engineering and clinical perspectives on the fabrication of hierarchically MEW architectures aiming towards site-specific implants to address complex tissue damage in regenerative dental medicine. [Display omitted] [ABSTRACT FROM AUTHOR]

This review aimed to provide a critical appraisal of alternative antimicrobial strategies in lieu of traditional triple antibiotic paste (TAP). This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The literature search was performed in 8 databases (PubMed/Medline, Embase, LILACS, Web of Science, Scopus, BVS, SciELO, and the Cochrane Library), selecting clinical, in vitro , in vivo , and in situ studies that evaluated antimicrobial alternatives to TAP in regenerative endodontics. Studies lacking an experimental TAP group were excluded. A total of 1705 potentially relevant records were initially identified. From the 38 studies retrieved for full-text reading, 16 fulfilled all selection criteria and were included in the qualitative analysis. According to the study design, 11 studies were solely in vitro , 1 study was both in vitro and in vivo (animal model), 2 studies were solely animal experiments, and 2 studies were clinical trials. The alternative antimicrobial agents to TAP consisted of modified TAP formulations (eg, a combination of TAP with chitosan); TAP-eluting nanofibers; propolis; chlorhexidine (CHX) gels/solutions; double antibiotic pastes composed of distinct combinations of antibiotics; Ca(OH) 2 -based formulations; and sodium hypochlorite. Overall, most of the alternative agents performed similarly to TAP, although some strategies (eg, Ca(OH) 2 - and CHX-based formulations) seemed to present dubious importance in the control of infection. TAP still remains an excellent option in terms of the complete elimination of microorganisms. This review points to the use of electrospun fibers as a drug delivery system to offer a controlled release of the antimicrobial agent, as well as the use of natural compounds, deserving future investigation. [ABSTRACT FROM AUTHOR]

One of the most damaging pathologies that affects the health of both soft and hard tissues around the tooth is periodontitis. Clinically, periodontal tissue destruction has been managed by an integrated approach involving elimination of injured tissues followed by regenerative strategies with bone substitutes and/or barrier membranes. Regrettably, a barrier membrane with predictable mechanical integrity and multifunctional therapeutic features has yet to be established. Herein, we report a fiber-reinforced hydrogel with unprecedented tunability in terms of mechanical competence and therapeutic features by integration of highly porous poly(ε-caprolactone) fibrous mesh(es) with well-controlled 3D architecture into bioactive amorphous magnesium phosphate-laden gelatin methacryloyl hydrogels. The presence of amorphous magnesium phosphate and PCL mesh in the hydrogel can control the mechanical properties and improve the osteogenic ability, opening a tremendous opportunity in guided bone regeneration (GBR). Results demonstrate that the presence of PCL meshes fabricated via melt electrowriting can delay hydrogel degradation preventing soft tissue invasion and providing the mechanical barrier to allow time for slower migrating progenitor cells to participate in bone regeneration due to their ability to differentiate into bone-forming cells. Altogether, our approach offers a platform technology for the development of the next-generation of GBR membranes with tunable mechanical and therapeutic properties to amplify bone regeneration in compromised sites. In this study, we developed a fiber-reinforced hydrogel platform with unprecedented tunability in terms of mechanical competence and therapeutic features for guided bone regeneration. We successfully integrated highly porous poly(ε-caprolactone) [PCL] mesh(es) into amorphous magnesium phosphate-laden hydrogels. The stiffness of the engineered hydrogel was significantly enhanced, and this reinforcing effect could be modulated by altering the number of PCL meshes and tailoring the AMP concentration. Furthermore, the fiber-reinforced hydrogel showed favorable cellular responses, significantly higher rates of mineralization, upregulation of osteogenic-related genes and bone formation. In sum, these fiber-reinforced membranes in combination with therapeutic agent(s) embedded in the hydrogel offer a robust, highly tunable platform to amplify bone regeneration not only in periodontal defects, but also in other craniomaxillofacial sites. Image, graphical abstract [ABSTRACT FROM AUTHOR]

Curcumin incorporation into polymeric fibers was tested for its antimicrobial properties and potential use in root canal disinfection. Curcumin-modified fibers were processed via electrospinning and tested against a 7-day old established Actinomyces naeslundii biofilm. The medicaments tested were as follows: curcumin-modified fibers at 2.5 and 5.0 mg/mL, curcumin-based irrigant at 2.5 and 5.0 mg/mL, saline solution (negative control), and the following positive controls: 2% chlorhexidine, 1% sodium hypochlorite, and triple antibiotic paste (TAP, 1 mg/mL). All medicaments, except for the positive controls, were allocated according to the light exposure protocol (ie, photoactivation with a light-emitting diode every 30 seconds for 4 minutes or without photoactivation). After treatment, the medicaments were removed, and 1 mL saline solution was added; the biofilm was scraped from the well and used to prepare a 1:2000 dilution. Spiral plating was performed using anaerobic blood agar plates. After 24 hours, colony-forming units (colony-forming units/mL, n = 11/group) were counted to determine the antimicrobial effects. Data exhibited significant antimicrobial effects on the positive control groups followed by the curcumin irrigants and, lastly, the photoactivated curcumin-modified fibers. There was a significant reduction of viable bacteria in curcumin-based irrigants, which was greater than the TAP-treated group. Curcumin-free fibers, saline, and the nonphotoactivated curcumin-modified fibers did not display antimicrobial activity. Curcumin seems to be a potential alternative to TAP when controlling infection, but it requires a minimal concentration (2.5 mg/mL) to be effective. Photoactivation of curcumin-based medicaments seems to be essential to obtain greater antibiofilm activity. [ABSTRACT FROM AUTHOR]

This study aimed to compare the cytocompatibility and angiogenic potential of 2 antibiotics (clindamycin [CLIN] and minocycline [MINO]) at distinct concentrations on dental pulp stem cells (DPSCs) and human umbilical vein endothelial cells (HUVECs). DPSCs and HUVECs were exposed to cell culture media modified with CLIN or MINO at concentrations ranging from 30 μg/mL–1000 μg/mL. Cell toxicity and proliferation were investigated using the lactate dehydrogenase and tetrazolium reduction assays, respectively. A capillarylike tube formation in vitro assay was conducted to determine the angiogenic potential associated with each antibiotic. Additionally, selected morphometric angiogenesis parameters were determined using dedicated software (WimTube; Onimagin Technologies SCA, Córdoba, Spain). All statistical analyses were performed using 1-way analysis of variance and the Tukey post hoc test (α=.05). The collected data showed that compared with the control (cell culture media, alpha-minimum essential medium Eagle) increasing the antibiotic concentration significantly decreased cell viability and proliferation of both DPSCs and HUVECs. In terms of angiogenic potential, when tested at 30 μg/mL and 50 μg/mL, CLIN significantly amplified tube formation when compared with MINO with angiogenesis parameters (ie, tube length and tube number) similar to the effect promoted by exogenous vascular endothelial growth factor (50 ng/mL). CLIN was less cytotoxic when compared with MINO at higher concentrations. Of note, CLIN did not hinder the proangiogenic activity induced by vascular endothelial growth factor to the same extent as MINO, suggesting that the replacement of MINO by CLIN might translate into positive implications in the overall regenerative outcome. • Minocycline (MINO) and clindamycin (CLIN) displayed dose-dependent cytotoxicity. • CLIN is less cytotoxic when compared with MINO. • CLIN enhanced HUVEC proliferation and capillarylike tube formation. • CLIN (30 and 50 μg/mL) displayed angiogenic effects similar to exogenous VEGF. [ABSTRACT FROM AUTHOR]

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

Introduction Root canal disinfection and the establishment of an intracanal microenvironment conducive to the proliferation/differentiation of stem cells play a significant role in regenerative endodontics. This study was designed to (1) investigate the antimicrobial efficacy of triple antibiotic–containing nanofibers against a dual-species biofilm and (2) evaluate the ability of dental pulp stem cells (DPSCs) to adhere to and proliferate on dentin upon nanofiber exposure. Methods Seven-day-old dual-species biofilm established on dentin specimens was exposed for 3 days to the following: saline (control), antibiotic-free nanofibers (control), and triple antibiotic–containing nanofibers or a saturated triple antibiotic paste (TAP) solution (50 mg/mL in phosphate buffer solution). Bacterial viability was assessed using the LIVE/DEAD assay (Molecular Probes, Inc, Eugene, OR) and confocal laser scanning microscopy. For cytocompatibility studies, dentin specimens after nanofiber or TAP (1 g/mL in phosphate buffer solution) exposure were evaluated for cell adhesion and spreading by actin-phalloidin staining. DPSC proliferation was assessed on days 1, 3, and 7. Statistics were performed, and significance was set at the 5% level. Results Confocal laser scanning microscopy showed significant bacterial death upon antibiotic-containing nanofiber exposure, differing significantly ( P < .05) from antibiotic-free fibers and the control (saline). DPSCs showed enhanced adhesion/spreading on dentin specimens treated with antibiotic-containing nanofibers when compared with its TAP counterparts. The DPSC proliferation rate was similar on days 1 and 3 in antibiotic-free nanofibers, triple antibiotic–containing nanofibers, and TAP-treated dentin. Proliferation was higher (9-fold) on dentin treated with antibiotic-containing nanofibers on day 7 compared with TAP. Conclusions Triple antibiotic–containing polymer nanofibers led to significant bacterial death, whereas they did not affect DPSC attachment and proliferation on dentin. [ABSTRACT FROM AUTHOR]

Fused Filament Fabrication (FFF)-based 3D printing is an efficient technique for developing medical implants, but it is not very useful in developing small yet mechanically robust design-specific fixtures such as dental implants (<15 mm). Specifically, it is challenging to 3D print robust Polyetheretherketone (PEEK) small implants due to PEEK's high melting temperature and melt viscosity. However, in this study, we efficiently utilize high-temperature FFF to develop the first-of-its-kind patient-specific robust PEEK dental implants with high print resolution. Specifically, we explore the effects of critical FFF processing conditions on the mechanical properties of the implants and subsequently determine an optimized set of processing conditions that are essential in developing durable dental implant systems. Our results indicate that the 3D printed dental implants exhibit good fatigue properties and suffice the clinical and industrial requirements for dental implants. Furthermore, we prove that the 3D printed implants exhibit adequate mechanical durability even after simulated (accelerated) aging of 30 years. [Display omitted] • This is the first-ever study on Fused Filament Fabrication (FFF) of realistic dental implants. • The effect of critical FFF parameters on dental implants' mechanical strength was analyzed. • A detailed optimized set of FFF parameters was determined to develop mechanically robust implants. • The fatigue properties of the 3D printed implants' were clinically and industrially relevant. • Implants' long-term durability (simulating 30 years in vivo performance) was validated. [ABSTRACT FROM AUTHOR]

Introduction: Although intracanal application of the triple antibiotic paste (TAP) may offer advantages (eg, disinfection), this practice has been associated with significant drawbacks, including tooth discoloration. In this study, the color change of dentin was monitored during treatment with distinct TAP pastes and novel tubularshaped 3-dimensional electrospun scaffolds containing minocycline (MINO) or doxycycline (DOX). Methods: Two TAP pastes (TAPM|NO [MINO, metronidazole, and ciprofloxacin] and TAPDOX [DOX, metronidazole, and ciprofloxacin]), 4 scaffold-based groups containing MINO or DOX at distinct concentrations, 1 antibioticfree scaffold, and 1 untreated group (control) were investigated. Human canines were sectioned at the cementoenamel junction and tubular-shaped scaffolds or paste were placed into the root canals and sealed. Color measurements (CIEL*a*b* parameters) were performed at baseline and after 1, 3, 7, 14, 21, and 28 days. Color changes were expressed as DE* values. In addition, scanning electron microscopy and energydispersive X-ray spectroscopy were also performed on the specimens after treatment. Data were analyzed using repeated measures analysis of variance (alpha = 0.05). Results: All antibiotic-containing groups led to greater discoloration than the antibiotic-free groups. A severe discoloration occurred after 1 day. At the end of the experiment, antibiotic-treated samples exhibited crusts/agglomerates over the dentin surface, which totally or partially obliterated the dentinal tubules. The presence of MINO resulted in a greater color change than DOX. Conclusions: Scaffolds containing MINO or DOX produced similar color change to dentin when compared with their respective TAP systems, although DOX-related discoloration was less pronounced. [ABSTRACT FROM AUTHOR]

This study evaluated the effects of etching with increasing hydrofluoric (HF) acid concentrations on the roughness and flexural strength of a feldspathic ceramic. One hundred and fifty ceramic specimens (14×4×1.2 mm 2 ) were produced from ceramic blocks (VitaBlocks Mark II). All specimens were polished, chamfered and sonically cleaned in isopropyl alcohol. Specimens were randomly divided into 5 groups ( n =30): SC (control) no ceramic surface etching; HF1, HF3, HF5 and HF10 ceramic surface etching for 60 s with 1%, 3%, 5% and 10% HF acid concentrations, respectively. Profilometry was performed in all specimens to evaluate roughness prior to flexural strength testing. Data were analyzed using one-way ANOVA and Tukey׳s test ( α =0.05). Weibull module ( m ) and characteristic stress ( σ c ) were also determined. HF acid etching, regardless of the concentration used, led to significantly rougher surfaces than the control ( p <0.05). However, the mean flexural strength values were not statistically different among the etched groups (106.47 to 102.02 MPa). Acid etching significantly reduced the mean flexural strength when compared with the control (143.3 MPa). Weibull modulus of the groups was similar, except for the HF5 group that was higher compared to HF3. Flexural strength was similarly affected by the different HF acid concentrations tested, but roughness increased higher the acid concentration. Ceramic etching led to a significant reduction in strength when compared to the untreated ceramic, regardless of its concentration. [ABSTRACT FROM AUTHOR]

The aims of this study were (1) to synthesize and characterize random and aligned nanocomposite fibers of multi-walled carbon nanotubes (MWCNT)/nylon-6 and (2) to determine their reinforcing effects on the flexural strength of a dental resin composite. Nylon-6 was dissolved in hexafluoropropanol (10 wt%), followed by the addition of MWCNT (hereafter referred to as nanotubes) at two distinct concentrations (i.e., 0.5 or 1.5 wt%). Neat nylon-6 fibers (without nanotubes) were also prepared. The solutions were electrospun using parameters under low- (120 rpm) or high-speed (6000 rpm) mandrel rotation to collect random and aligned fibers, respectively. The processed fiber mats were characterized by scanning (SEM) and transmission (TEM) electron microscopies, as well as by uni-axial tensile testing. To determine the reinforcing effects on the flexural strength of a dental resin composite, bar-shaped (20×2×2 mm 3 ) resin composite specimens were prepared by first placing one increment of the composite, followed by one strip of the mat, and one last increment of composite. Non-reinforced composite specimens were used as the control. The specimens were then evaluated using flexural strength testing. SEM was done on the fractured surfaces. The data were analyzed using ANOVA and the Tukey׳s test ( α =5%). Nanotubes were successfully incorporated into the nylon-6 fibers. Aligned and random fibers were obtained using high- and low-speed electrospinning, respectively, where the former were significantly ( p <0.001) stronger than the latter, regardless of the nanotubes׳ presence. Indeed, the dental resin composite tested was significantly reinforced when combined with nylon-6 fibrous mats composed of aligned fibers (with or without nanotubes) or random fibers incorporated with nanotubes at 0.5 wt%. [ABSTRACT FROM AUTHOR]

Introduction Actinomyces naeslundii has been recovered from traumatized permanent teeth diagnosed with necrotic pulps. In this work, a triple antibiotic paste (TAP)–mimic scaffold is proposed as a drug-delivery strategy to eliminate A. naeslundii dentin biofilm. Methods Metronidazole, ciprofloxacin, and minocycline were added to a polydioxanone (PDS) polymer solution and spun into fibrous scaffolds. Fiber morphology, mechanical properties, and drug release were investigated by using scanning electron microscopy, microtensile testing, and high-performance liquid chromatography, respectively. Human dentin specimens (4 × 4 × 1 mm 3 , n = 4/group) were inoculated with A. naeslundii (ATCC 43146) for 7 days for biofilm formation. The infected dentin specimens were exposed to TAP-mimic scaffolds, TAP solution (positive control), and pure PDS (drug-free scaffold). Dentin infected (7-day biofilm) specimens were used for comparison (negative control). Confocal laser scanning microscopy was done to determine bacterial viability. Results Scaffolds displayed a submicron mean fiber diameter (PDS = 689 ± 312 nm and TAP-mimic = 718 ± 125 nm). Overall, TAP-mimic scaffolds showed significantly ( P ≤ .040) lower mechanical properties than PDS. Within the first 24 hours, a burst release for all drugs was seen. A sustained maintenance of metronidazole and ciprofloxacin was observed over 4 weeks, but not for minocycline. Confocal laser scanning microscopy demonstrated complete elimination of all viable bacteria exposed to the TAP solution. Meanwhile, TAP-mimic scaffolds led to a significant ( P < .05) reduction in the percentage of viable bacteria compared with the negative control and PDS. Conclusions Our findings suggest that TAP-mimic scaffolds hold significant potential in the eradication/elimination of bacterial biofilm, a critical step in regenerative endodontics. [ABSTRACT FROM AUTHOR]

Introduction Antibiotic-containing polymer-based nanofibers (hereafter referred to as scaffolds) have demonstrated great potential for their use in regenerative endodontics from both an antimicrobial and cytocompatibility perspective. This study sought to evaluate in vitro the effects of ciprofloxacin (CIP)-containing polymer scaffolds against Enterococcus faecalis biofilms. Methods Human mandibular incisors were longitudinally sectioned to prepare radicular dentin specimens. Sterile dentin specimens were distributed in 24-well plates and inoculated with E. faecalis for biofilm formation. Infected dentin specimens were exposed to 3 groups of scaffolds, namely polydioxanone (PDS) (control), PDS + 5 wt% CIP, and PDS + 25 wt% CIP for 2 days. Colony-forming units (CFU/mL) ( n = 10) and scanning electron microscopy (SEM) ( n = 2) were performed to quantitatively and qualitatively assess the antimicrobial effectiveness, respectively. Results PDS scaffold containing CIP at 25 wt% showed maximum bacteria elimination with no microbial growth, differing statistically ( P < .05) from the control (PDS) and from PDS scaffold containing CIP at 5 wt%. Statistical differences ( P < .05) were also seen for the CFU/mL data between pure PDS (5.92–6.02 log CFU/mL) and the PDS scaffold containing CIP at 5 wt% (5.39–5.87 log CFU/mL). SEM images revealed a greater concentration of bacteria on the middle third of the dentin specimen after 5 days of biofilm formation. On scaffold exposures, SEM images showed similar results when compared with the CFU/mL data. Dentin specimens exposed to PDS + 25 wt% CIP scaffolds displayed a practically bacteria-free surface. Conclusions On the basis of the data presented, newly developed antibiotic-containing electrospun scaffolds hold promise as an intracanal medicament to eliminate biofilm/infection before regenerative procedures. [ABSTRACT FROM AUTHOR]

Statement of problem The influence of yttria-stabilized tetragonal zirconia polycrystal surface treatment on veneering porcelain shear bond strength after cyclic loading is not fully understood. Purpose The purpose of this study was to investigate the influence of yttria-stabilized tetragonal zirconia polycrystal surface treatment on veneering porcelain shear bond strength and cyclic loading on the shear bond strength between the 2 materials. Material and methods A total of 48 cylinder-shaped yttria-stabilized tetragonal zirconia polycrystal specimens were fabricated with computer-aided design and computer-aided manufacturing (CAD/CAM), sintered for 8 hours at 1500°C, ground with 320-grit diamond paper, and divided into 4 groups (n=12) according to surface treatment as follows: no treatment/control; heat treatment of 650°C to 1000°C at 55°C/min; airborne-particle abrasion with 50-μm alumina at 0.4 MPa pressure for 10 seconds; or heat treatment after abrasion. A veneering porcelain cylinder was built and fired on the prepared yttria-stabilized tetragonal zirconia polycrystal specimens. The shear bond strength was tested with a universal testing machine. Six specimens from each group were subjected to cyclic loading (10 000 cycles, 1.5 Hz, 10 N load) before testing. Results The mean ±SD ranged from 10.7 ±15.4 to 34.1 ±10.0. Three-way ANOVA found no statistically significant ( P >.05) effect of surface treatment and cyclic loading on shear bond strength. The Sidak multiple comparisons procedure found that cyclic loading specimens had significantly lower shear bond strength than noncyclic loading specimens after airborne-particle abrasion without heat treatment ( P =.013). Conclusions Within the limitations of this study, the shear bond strength between yttria-stabilized tetragonal zirconia polycrystal and veneering porcelain was not significantly affected by surface treatment. Airborne-particle abrasion without subsequent heat treatment should be avoided as a surface treatment in fabrication methods. [ABSTRACT FROM AUTHOR]

Introduction Eliminating and/or inhibiting bacterial growth within the root canal system has been shown to play a key role in the regenerative outcome. The aim of this study was to synthesize and determine in vitro both the antimicrobial effectiveness and cytocompatibility of bimix antibiotic-containing polydioxanone-based polymer scaffolds. Methods Antibiotic-containing (metronidazole [MET] and ciprofloxacin [CIP]) polymer solutions (distinct antibiotic weight ratios) were spun into fibers as a potential mimic to the double antibiotic paste (DAP, a MET/CIP mixture). Fiber morphology, chemical characteristics, and tensile strength were evaluated by scanning electron microscopy, Fourier transform infrared spectroscopy, and tensile testing, respectively. Antimicrobial efficacy was tested over time (aliquot collection) against Enterococcus faecalis (Ef), Porphyromonas gingivalis (Pg), and Fusobacterium nucleatum (Fn). Similarly, cytotoxicity was evaluated in human dental pulp stem cells. Data were statistically analyzed ( P < .05). Results Scanning electron microscopy and Fourier transform infrared spectroscopy confirmed that electrospinning was able to produce antibiotic-containing fibers with a diameter mostly in the nanoscale. The tensile strength of 1:1MET/CIP scaffolds was significantly ( P < .05) higher than pure polydioxanone (control). Meanwhile, all other groups presented similar strength as the control. Aliquots obtained from antibiotic-containing scaffolds inhibited the growth of Ef, Pg, and Fn, except pure MET, which did not show an inhibitory action toward Pg or Fn. Antibiotic-containing aliquots promoted slight human dental pulp stem cell viability reduction, but none of them were considered to be cytotoxic. Conclusions Our data suggest that the incorporation of multiple antibiotics within a nanofibrous scaffold holds great potential toward the development of a drug delivery system for regenerative endodontics. [ABSTRACT FROM AUTHOR]

Purpose: To synthesize polydioxanone (PDS)-based drug delivery systems (hereafter referred to as “matrices”) containing vancomycin (VANC) and/or rifampicin (RIF) and investigate their effect on the inhibition of biofilm growth containing osteomyelitis (OM)-associated pathogens. Materials and Methods: PDS matrices were prepared by electrostatic spinning, and the drugs were incorporated as follows: group (G)1, 5wt%VANC; G2, 10wt%VANC; G3, 5wt%RIF; G4, 10wt%RIF; G5, 5wt%VANC+RIF; and G6, 10wt%VANC+RIF. A control group of pure PDS was also electrospun (G7). Biofilms formed by Staphylococcus aureus and S. epidermidis were grown on the electrospun matrices for 24 hours. The counts of viable cells were assessed after biofilm formation. The fiber morphology and biofilms were imaged using a scanning electron microscope. Results: G5 and G6 and pure PDS (G7) had the lowest and highest mean number of viable cell counts, respectively (P < .05). Small and isolated clusters of bacteria with no mature biofilm present were found on G6. Conclusions: The results of the present study have provided evidence for the potential use of PDS-based matrices as an effective drug delivery system that could inhibit biofilm formation from OM-associated pathogens. [Copyright &y& Elsevier]

Abstract: Objective: The aim of this study was to investigate the effect of aluminosilicate clay nanotubes (Halloysite, HNT) incorporated into the adhesive resin of a commercially available three-step etch and rinse bonding system (Adper Scotchbond Multi-Purpose/SBMP) on dentin bond strength, as well as the effect on several key physicochemical properties of the modified adhesive. Methods: Experimental adhesives were prepared by adding five distinct HNT amounts (5–30wt.%) into the adhesive resin (w/v) of the SBMP dentin bonding system. Bond strength to human dentin, microhardness, and degree of conversion (DC) of the modified adhesives were assessed. Results: From the shear bond strength data, it was determined that HNT incorporation at a concentration of 30wt.% resulted in the highest bond strength to dentin that was statistically significant (p =0.025) when compared to the control. Even though a significant increase in microhardness (p <0.001) was seen for the 30wt.% HNT-incorporated group, a significantly lower DC (p <0.001) was recorded when compared to the control. Significance: It was concluded that HNT can be incorporated up to 20wt.% without jeopardizing important physicochemical properties of the adhesive. The modification of the SBMP dentin bonding agent with 20wt.% HNT appears to hold great potential toward contributing to a durable dentin bond; not only from the possibility of strengthening the bond interface, but also due to HNT intrinsic capability of encapsulating therapeutic agents such as matrix metalloproteinase (MMP) inhibitors. [Copyright &y& Elsevier]

Abstract: Periodontitis is a major chronic inflammatory disorder that can lead to the destruction of the periodontal tissues and, ultimately, tooth loss. To date, flap debridement and/or flap curettage and periodontal regenerative therapy with membranes and bone grafting materials have been employed with distinct levels of clinical success. Current resorbable and non-resorbable membranes act as a physical barrier to avoid connective and epithelial tissue down-growth into the defect, favoring the regeneration of periodontal tissues. These conventional membranes possess many structural, mechanical, and bio-functional limitations and the “ideal” membrane for use in periodontal regenerative therapy has yet to be developed. Based on a graded-biomaterials approach, we have hypothesized that the next-generation of guided tissue and guided bone regeneration (GTR/GBR) membranes for periodontal tissue engineering will be a biologically active, spatially designed and functionally graded nanofibrous biomaterial that closely mimics the native extra-cellular matrix (ECM). Objective: This review is presented in three major parts, including (1) a brief overview of the periodontium and its pathological conditions, (2) currently employed therapeutics used to regenerate the distinct periodontal tissues, and (3) a review of commercially available GTR/GBR membranes as well as the recent advances on the processing and characterization of GTR/GBR membranes from a materials perspective. Significance: Studies of spatially designed and functionally graded membranes (FGM) and in vitro antibacterial/cell-related research are addressed. Finally, as a future outlook, the use of hydrogels in combination with scaffold materials is highlighted as a promising approach for periodontal tissue engineering. [Copyright &y& Elsevier]

Abstract: A periodontal membrane with a graded structure allows tailoring of the layer properties to design a material system that will retain its physical, chemical and mechanical characteristics for a period long enough to optimize periodontal regeneration. In this work a novel functionally graded membrane (FGM) was designed and fabricated via sequential multilayer electrospinning. The FGM consists of a core layer (CL) and two functional surface layers (SLs) interfacing with bone (nano-hydroxyapatite, n-HAp) and epithelial (metronidazole, MET) tissues. The CL comprises a neat poly(dl-lactide-co-ε-caprolactone) (PLCL) layer surrounded by two composite layers composed of a protein/polymer ternary blend (PLCL:PLA:GEL). Electrospinning parameters involved in fabrication of the individual layers (i.e. neat PLCL, ternary blend, PLA:GEL+10%n-HAp and PLA:GEL+25%MET) were optimized to obtain fibrous layers free of beads. Morphology, structure and mechanical property studies were carried out on each electrospun layer. The individual fiber morphology and roughness of the functional SLs, which are the n-HAp containing and drug-incorporating layers were evaluated by atomic force microscopy. The CL structure demonstrated higher strength (8.7MPa) and a more elastic behavior (strain at break 357%) compared with the FGM (3.5MPa, 297%). Incorporation of n-HAp to enhance osteoconductive behavior and MET to combat periodontal pathogens led to a novel FGM that holds promise at solving the drawbacks of currently available membranes. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To test the effect of rehydration time over the range prescribed in the manufacturer''s protocol on (1) the biomechanical properties and on (2) the recovery and stabilization of the collagenous matrix of AlloDerm®. Methods: A sterile dish containing warm saline solution was prepared, and samples rehydrated for 5min. Subsequently, three other dishes with the solution were prepared and samples assigned into three groups according to the total rehydration time: 10min (G1), 20min (G2), and 40min (G3). Uni-axial tensile testing was used to assess the biomechanical properties of the different groups and the control (dry condition). Physico-chemical properties were examined by Fourier transform infrared spectroscopy (FT-IR), and differential scanning calorimetry (DSC) as a function of rehydration time. Results: ANOVA revealed a significant change in tensile strength (p =0.0269) and in elastic modulus (p =0.0306) for AlloDerm following different rehydration times. The lowest tensile strength was in the dry condition, whereas the highest was achieved after a 40min rehydration. The shortest rehydration periods did not result in a statistically significant (p >0.05) change in elastic modulus. However, after 40min the elastic modulus increased significantly when compared to the shortest periods. FT-IR confirmed the protein backbone recovery of the graft matrix after rehydration. DSC scans of rehydrated samples showed visible shifts in the denaturation temperature to higher values compared to as-received sample (dry) suggesting stronger polymer–water bridge formation, supporting the increase in the biomechanical properties. Significance: The current study suggests that there are major changes on the biomechanical properties of the collagenous graft as rehydration time increases, which were also structurally confirmed by the physico-chemical analyses. Clinicians must be aware that the rehydration times of the manufacturer''s protocol result in a significant range in mechanical and physico-chemical properties. Therefore, a rehydration time of at least 20min guarantees not only better handling and mechanical properties but, most importantly, supplies a material that closely resembles the natural tissue. [Copyright &y& Elsevier]

Abstract: Objectives: (1) To synthesize 3mol% yttria-stabilized zirconia (3Y-TZP) powders via coprecipitation route, (2) to obtain zirconia ceramic specimens, analyze surface characteristics, and mechanical properties, and (3) to compare the processed material with three reinforced dental ceramics. Methods: A coprecipitation route was used to synthesize a 3mol% yttria-stabilized zirconia ceramic processed by uniaxial compaction and pressureless sintering. Commercially available alumina or alumina/zirconia ceramics, namely Procera AllCeram (PA), In-Ceram Zirconia Block (CAZ) and In-Ceram Zirconia (IZ) were chosen for comparison. All specimens (6mm×5mm×5mm) were polished and ultrasonically cleaned. Qualitative phase analysis was performed by XRD and apparent densities were measured on the basis of Archimedes principle. Ceramics were also characterized using SEM, TEM and EDS. The hardness measurements were made employing Vickers hardness test. Fracture toughness (K IC) was calculated. Data were analyzed using one-way analysis of variance (ANOVA) and Tukey''s test (α =0.05). Results: ANOVA revealed that the Vickers hardness (p <0.0001) and fracture toughness (p <0.0001) were affected by the ceramic materials composition. It was confirmed that the PA ceramic was constituted of a rhombohedral alumina matrix, so-called α-alumina. Both CAZ and IZ ceramics presented tetragonal zirconia and α-alumina mixture of phases. The SEM/EDS analysis confirmed the presence of aluminum in PA ceramic. In the IZ and CAZ ceramics aluminum, zirconium and cerium in grains involved by a second phase containing aluminum, silicon and lanthanum were identified. PA showed significantly higher mean Vickers hardness values (H V) (18.4±0.5GPa) compared to vitreous CAZ (10.3±0.2GPa) and IZ (10.6±0.4GPa) ceramics. Experimental Y-TZP showed significantly lower results than that of the other monophased ceramic (PA) (p <0.05) but it showed significantly higher fracture toughness (6.0±0.2MPam1/2) values when compared to the other tested ceramics (p <0.05). Significance: The coprecipitation method used to synthesize zirconia powders and the adopted ceramic processing conditions led to ceramics with mechanical properties comparable to commercially available reinforced ceramic materials. [Copyright &y& Elsevier]

Abstract: Objectives: Titanium alloys are considered the material of choice when used as endosteal part of implants. However, they are not able to bond directly to bone. The objective of this study was to suggest a chemical surface treatment for Ti–13Nb–13Zr to initiate the formation of hydroxy carbonated apatite (HCA) during in vitro bioactivity tests in simulated body fluid (SBF). Methods: Titanium, niobium, and zirconium hydride powders were blended, compacted and sintered. Sintered Ti–13Nb–13Zr samples were etched in HCl, H3PO4, and in a mixture of HF+HNO3, respectively, and subsequently pretreated in NaOH. The influence of acid etching conditions on the microstructure of the Ti–13Nb–13Zr alloys as well as on the rate of HCA formation was evaluated using SEM-EDS, FTIR, and gravimetric analyses. Results: Sintered Ti–13Nb–13Zr alloys consist of a Widmannstätten (α+β) microstructure. Exposure of chemically etched and NaOH activated samples to SBF for 1 week leads to the formation of a HCA layer on the surface of HCl as well as H3PO4 treated samples. No HCA formation was found on HNO3 treated samples. After 2 weeks in SBF the mass increase, that can be correlated to the HCA formation rate, was the highest for HCl pretreated samples (2.4mg/cm2) followed by H3PO4 (0.8mg/cm2) and HNO3 pretreated ones (0.2mg/cm2). Significance: Since the in vitro HCA formation from SBF is generally accepted as a typical feature for bioactive materials, it is supposed that HCl etching with subsequent NaOH treatment might enhance the in vivo bone-bonding ability of Ti–13Nb–13Zr. [Copyright &y& Elsevier]

The aim of this investigation was to engineer metformin (MF)-loaded mesoporous silica nanospheres (MSNs)-laden gelatin methacryloyl (GelMA) photocrosslinkable hydrogels and test their effects on the mechanical properties, swelling ratio, drug release, cytocompatibility, and osteogenic differentiation of stem cells from human exfoliated deciduous teeth (SHEDs). As-received and carboxylated MSNs (MSNs-COOH) were characterized by scanning and transmission electron microscopies (SEM and TEM), as well as Fourier-transform infrared spectroscopy (FTIR) prior to hydrogel modification. MF-MSNs-COOH were obtained by loading MF into MSNs at a 1:1 mass ratio. Upon MSNs-COOH laden-hydrogels fabrication, the mechanical properties, swelling ratio and MF release were evaluated. SHEDs were seeded on the hydrogels and cytocompatibility was examined. The effects of the MF-MSNs-COOH/GelMA on the osteogenic differentiation of SHEDs were measured by ALP activity, Alizarin Red assay, and Real-time PCR. Statistics were performed using one-way ANOVA (α = 0.05). Morphological (SEM and TEM) analyses of pristine and carboxylated MSNs revealed a mean particle size of 200 nm and 218 nm, respectively. Importantly, an intrinsic nanoporous structure was noticed. Incorporation of MSNs-COOH at 1.5 mg/mL in GelMA led to the highest compressive modulus and swelling ratio. The addition of MSNs-COOH (up to 3 mg/mL) in GelMA did not impact cell viability. The presence of MF in MSNs-COOH/GelMA significantly promoted cell proliferation. Significant upregulation of osteogenic-related genes (except OCN) were seen for modified (MSNs-COOH and MF-MSNs-COOH) hydrogels when compared to GelMA. Altogether, the engineered MF-MSNs-COOH/GelMA shows great promise in craniomaxillofacial applications as an injectable, cell-free and bioactive therapeutics for bone regeneration. Image 1 • Mesoporous silica nanospheres were successfully carboxylated to obtain MSNs-COOH. • Incorporation of MSNs-COOH in GelMA led to cytocompatible hydrogels. • MSNs-COOH/GelMA allows the controlled release of metformin. • MSNs–COOH– and MF-MSNs–COOH–laden hydrogels promote osteo-differentiation of SHEDs. [ABSTRACT FROM AUTHOR]

This study aimed to synthesize and characterize non-woven acrylonitrile butadiene styrene (ABS), polyamide-6 (P6), and polystyrene (PS) nanofibers, and evaluate their effects on the flexural strength and fracture resistance of fiber-modified polymethyl methacrylate (PMMA) resin. ABS, P6, and PS polymer solutions were prepared and electrospun into fiber mats, which were characterized by means of morphological, chemical, physical, and mechanical analyses. The fiber mats were then used to modify a thermally-activated PMMA resin, resulting in four testing groups: one unmodified group (control) and three fiber-modified groups incorporated with ABS, P6, or PS fiber mats. Flexural strength, work of fracture, and fractographic analysis were performed for all groups. Data were analyzed using Kruskal-Wallis or ANOVA tests (α = 0.05). The fiber diameter decreased, respectively, as follows: ABS > P6 > PS. Only the P6 fiber mats demonstrated a crystalline structure. Wettability was similar among the distinct fiber mats, although tensile strength was significantly greater for P6, followed by ABS, and then PS mats. Flexural strength of the fiber-modified PMMA resins was similar to the control, except for the weaker P6-based material. The work of fracture seemed to be greater and lower when the P6 and PS fibers were used, respectively. The fiber-modified groups exhibited a rougher pattern in the fractured surfaces when compared to the control, which may suggest that the presence of fibers deviates the direction of crack propagation, making the fracture mechanism of the PMMA resin more dynamic. While the neat PMMA showed a typical brittle response, the fiber-modified PMMA resins demonstrated a ductile response, combined with voids, suggesting large shear deformation during fracture. Altogether, despite the lack of direct reinforcement in the mechanical strength of the PMMA resin, the use of electrospun fibers showed promising application for the improvement of fracture behavior of PMMA resins, turning them into more compliant materials, although this effect may depend on the fiber composition. [ABSTRACT FROM AUTHOR]

Customization and the production of patient-specific devices, tailoring the unique anatomy of each patient's jaw and facial structures, are the new frontiers in dentistry and maxillofacial surgery. As a technological advancement, additive manufacturing has been applied to produce customized objects based on 3D computerized models. Therefore, this paper presents advances in additive manufacturing strategies for patient-specific devices in diverse dental specialties. This paper overviews current 3D printing techniques to fabricate dental and maxillofacial devices. Then, the most recent literature (2018–2023) available in scientific databases reporting advances in 3D-printed patient-specific devices for dental and maxillofacial applications is critically discussed, focusing on the major outcomes, material-related details, and potential clinical advantages. The recent application of 3D-printed customized devices in oral prosthodontics, implantology and maxillofacial surgery, periodontics, orthodontics, and endodontics are presented. Moreover, the potential application of 4D printing as an advanced manufacturing technology and the challenges and future perspectives for additive manufacturing in the dental and maxillofacial area are reported. Additive manufacturing techniques have been designed to benefit several areas of dentistry, and the technologies, materials, and devices continue to be optimized. Image-based and accurately printed patient-specific devices to replace, repair, and regenerate dental and maxillofacial structures hold significant potential to maximize the standard of care in dentistry. [ABSTRACT FROM AUTHOR]

The elimination of microbial flora in cases of immature permanent teeth with necrotic pulp is both key and a challenging goal for the long-term success of regenerative therapy. Recent research has focused on the development of cell-friendly intracanal drug delivery systems. This in vitro study aimed to investigate the antimicrobial action of 3-dimensional (3D) tubular-shaped triple antibiotic–eluting nanofibrous constructs against a multispecies biofilm on human dentin. Polydioxanone polymer solutions, antibiotic-free or incorporated with metronidazole, ciprofloxacin, and minocycline, were electrospun into 3D tubular-shaped constructs. A multispecies biofilm consisting of Actinomyces naeslundii , Streptococcus sanguinis , and Enterococcus faecalis was forced inside the dentinal tubules via centrifugation in a dentin slice in vitro model. The infected specimens were exposed to 2 experimental groups (ie, 3D tubular-shaped triple antibiotic–eluting constructs and triple antibiotic paste [TAP]) and 2 control groups (7-day biofilm untreated and antibiotic-free 3D tubular-shaped constructs). Biofilm elimination was quantitatively analyzed with confocal laser scanning microscopy. Confocal laser scanning microscopic (CLSM) analysis showed a dense population of viable (green) bacteria adhered to dentin and penetrated into the dentinal tubules. Upon 3D tubular-shaped triple antibiotic–eluting nanofibrous construct exposure, nearly complete elimination of viable bacteria on the dentin surface and inside the dentinal tubules was shown in the CLSM images, which was similar ( P < .05) to the bacterial death promoted by the TAP group but significantly greater when compared with both the antibiotic-free 3D tubular-shaped constructs and the control (saline). The proposed 3D tubular-shaped antibiotic-eluting construct showed pronounced antimicrobial effects against the multispecies biofilm tested and therefore holds significant clinical potential as a disinfection strategy before regenerative endodontics. [ABSTRACT FROM AUTHOR]

The current standard for treating irreversibly damaged dental pulp is root canal therapy, which involves complete removal and debridement of the pulp space and filling with an inert biomaterial. A regenerative approach to treating diseased dental pulp may allow for complete healing of the native tooth structure and enhance the long-term outcome of once-necrotic teeth. The aim of this paper is, therefore, to highlight the current state of dental pulp tissue engineering and immunomodulatory biomaterials properties, identifying exciting opportunities for their synergy in developing next-generation biomaterials-driven technologies. An overview of the inflammatory process focusing on immune responses of the dental pulp, followed by periapical and periodontal tissue inflammation are elaborated. Then, the most recent advances in treating infection-induced inflammatory oral diseases, focusing on biocompatible materials with immunomodulatory properties are discussed. Of note, we highlight some of the most used modifications in biomaterials' surface, or content/drug incorporation focused on immunomodulation based on an extensive literature search over the last decade. We provide the readers with a critical summary of recent advances in immunomodulation related to pulpal, periapical, and periodontal diseases while bringing light to tissue engineering strategies focusing on healing and regenerating multiple tissue types. Significant advances have been made in developing biomaterials that take advantage of the host's immune system to guide a specific regenerative outcome. Biomaterials that efficiently and predictably modulate cells in the dental pulp complex hold significant clinical promise for improving standards of care compared to endodontic root canal therapy. [Display omitted] • Immunomodulatory biomaterials represent the next-generation dental pulp treatment. • M1 to M2 macrophage phenotype shift is vital for dental pulp healing/regeneration. • Biomaterials design is a crucial aspect of manipulating macrophage phenotype. [ABSTRACT FROM AUTHOR]

Electrospun scaffolds are a versatile biomaterial platform to mimic fibrillar structure of native tissues extracellular matrix, and facilitate the incorporation of biomolecules for regenerative therapies. Self-assembling peptide P 11 -4 has emerged as a promising strategy to induce mineralization; however, P 11 -4 application has been mostly addressed for early caries lesions repair on dental enamel. Here, to investigate P 11 -4′s efficacy on bone regeneration, polymeric electrospun scaffolds were developed, and then distinct concentrations of P 11 -4 were physically adsorbed on the scaffolds. P 11 -4-laden and pristine (P 11 -4-free) electrospun scaffolds were immersed in simulated body fluid and mineral precipitation identified by SEM. Functional groups and crystalline phases were analyzed by FTIR and XRD, respectively. Cytocompatibility, mineralization, and gene expression assays were conducted using stem cells from human exfoliated deciduous teeth. To investigate P 11 -4-laden scaffolds potential to induce in vivo mineralization, an established rat calvaria critical-size defect model was used. Results. We successfully synthesized nanofibrous (∼ 500 nm fiber diameter) scaffolds and observed that functionalization with P 11 -4 did not affect the fibers' diameter. SEM images indicated mineral precipitation, while FTIR and XRD confirmed apatite-like formation and crystallization for P 11 -4-laden scaffolds. In addition, P 11 -4-laden scaffolds were cytocompatible, highly stimulated cell-mediated mineral deposition, and upregulated the expression of mineralization-related genes compared to pristine scaffolds. P 11 -4-laden scaffolds led to enhanced in vivo bone regeneration after 8 weeks compared to pristine PCL. Electrospun scaffolds functionalized with P 11 -4 are a promising strategy for inducing mineralized tissues regeneration in the craniomaxillofacial complex. [Display omitted] • Self-assembly peptide P 11 -4-laden scaffolds induces mineral precipitation. • P 11 -4-laden scaffolds stimulate stem cells to mineral deposition. • P 11 -4-laden scaffolds upregulate osteogenic markers. • P 11 -4-laden scaffolds induces bone formation in vivo. [ABSTRACT FROM AUTHOR]

This work sought to formulate photocrosslinkable chlorhexidine (CHX)-laden methacrylated gelatin (CHX/GelMA) hydrogels with broad spectrum of action against endodontic pathogens as a clinically viable cell-friendly disinfection therapy prior to regenerative endodontics procedures. CHX/GelMA hydrogel formulations were successfully synthesized using CHX concentrations between 0.12 % and 5 % w/v. Hydrogel microstructure was evaluated by scanning electron microscopy (SEM). Swelling and enzymatic degradation were assessed to determine microenvironmental effects. Compression test was performed to investigate the influence of CHX incorporation on the hydrogels' biomechanics. The antimicrobial and anti-biofilm potential of the formulated hydrogels were assessed using agar diffusion assays and a microcosms biofilm model, respectively. The cytocompatibility was evaluated by exposing stem cells from human exfoliated deciduous teeth (SHEDs) to hydrogel extracts (i.e. , leachable byproducts obtained from overtime hydrogel incubation in phosphate buffer saline). The data were analyzed using One- and Two-way ANOVA and Tukey's test (α = 0.05). CHX/GelMA hydrogels were effectively prepared. NMR spectroscopy confirmed the incorporation of CHX into GelMA. The addition of CHX did not change the micromorphology (pore size) nor the swelling profile (p > 0.05). CHX incorporation reduced the degradation rate of the hydrogels (p < 0.001); whereas, it contributed to increased compressive modulus (p < 0.05). Regarding the antimicrobial properties, the incorporation of CHX showed a statistically significant decrease in the number of bacteria colonies at 0.12 % and 0.5 % concentration (p < 0.001) and completely inhibited the growth of biofilm at concentration levels 1 %, 2 %, and 5 %. Meanwhile, the addition of CHX, regardless of the concentration, did not lead to cell toxicity, as cell viability values were above 70 %. The addition of CHX into GelMA showed significant antimicrobial action against the pathogens tested, even at low concentrations, with the potential to be used as a cell-friendly injectable drug delivery system for root canal disinfection prior to regenerative endodontics. [Display omitted] • Chlorhexidine-laden gelatin methacrylate hydrogel (CHX/GelMA) was synthesized. • CHX/GelMA showed significant antimicrobial action against endodontic pathogens. • CHX/GelMA holds potential for infection eradication prior to regenerative procedures. [ABSTRACT FROM AUTHOR]

Objective A combination of antibiotics, including but not limited to metronidazole (MET) and ciprofloxacin (CIP), has been indicated to eradicate bacteria in necrotic immature permanent teeth prior to regenerative procedures. It has been shown clinically that antibiotic pastes may lead to substantial stem cell death. The aim of this study was to synthesise scaffolds containing various concentrations of CIP to enhance cell viability while preserving antimicrobial properties . Design Polydioxanone (PDS)-based electrospun scaffolds were processed with decreasing CIP concentrations (25–1 wt.%) and morphologically evaluated using scanning electron microscopy (SEM). Cytotoxicity assays were performed to determine whether the amount of CIP released from the scaffolds would lead to human dental pulp stem cell (hDPSC) toxicity. Similarly, WST-1 assays were performed to evaluate the impact of CIP release on hDPSC proliferation. Pure PDS scaffolds and saturated double antibiotic solution MET/CIP (DAP) served as both positive and negative controls, respectively. Antibacterial efficacy against E. faecalis ( Ef ) was tested. Results A significant decrease in hDPSC’ viability at concentrations 5–25 wt.% was observed. However, concentrations below 5 wt.% did not impair cell viability. Data from the WST-1 assays indicated no detrimental impact on cell proliferation for scaffolds containing 2.5 wt.% CIP or less. Significant antimicrobial properties were seen for CIP-scaffolds at lower concentrations ( i.e. , 1 and 2.5 wt.%). Conclusion The obtained data demonstrated that a reduced concentration of CIP incorporated into PDS-based scaffolds maintains its antimicrobial properties while enhancing viability and proliferation of dental pulp stem cells. [ABSTRACT FROM AUTHOR]

Alveolar bone defects can be highly variable in their morphology and, as the defect size increases, they become more challenging to treat with currently available therapeutics and biomaterials. This investigation sought to devise a protocol for fabricating customized clinical scale and patient-specific, bioceramic scaffolds for reconstruction of large alveolar bone defects. Two types of calcium phosphate (CaP)-based bioceramic scaffolds (alginate/β-TCP and hydroxyapatite/α-TCP, hereafter referred to as hybrid CaP and Osteoink™, respectively) were designed, 3D printed, and their biocompatibility with alveolar bone marrow stem cells and mechanical properties were determined. Following scaffold optimization, a workflow was developed to use cone beam computed tomographic (CBCT) imaging to design and 3D print, defect-specific bioceramic scaffolds for clinical-scale bone defects. Osteoink™ scaffolds had the highest compressive strength when compared to hybrid CaP with different infill orientation. In cell culture medium, hybrid CaP degradation resulted in decreased pH (6.3) and toxicity to stem cells; however, OsteoInk™ scaffolds maintained a stable pH (7.2) in culture and passed the ISO standard for cytotoxicity. Finally, a clinically feasible laboratory workflow was developed and evaluated using CBCT imaging to engineer customized and defect-specific CaP scaffolds using OsteoInk™. It was determined that printed scaffolds had a high degree of accuracy to fit the respective clinical defects for which they were designed (0.27 mm morphological deviation of printed scaffolds from digital design). From patient to patient, large alveolar bone defects are difficult to treat due to high variability in their complex morphologies and architecture. Our findings shows that Osteoink™ is a biocompatible material for 3D printing of clinically acceptable, patient-specific scaffolds with precision-fit for use in alveolar bone reconstructive procedures. Collectively, emerging digital technologies including CBCT imaging, 3D surgical planning, and (bio)printing can be integrated to address this unmet clinical challenge. [ABSTRACT FROM AUTHOR]

This study examined how range concentrations of Fibroblast Growth Factor-2 (FGF-2) influence the differentiation and activity of human-derived periodontal ligament (hPDLSCs) and alveolar bone-derived stem cells (haBMSCs). hPDLSCs and haBMSCs were cultured with varying concentrations of FGF-2 (0, 1, 2.5, 5, 10, 20 ng/mL) and monitored for osteogenic differentiation through alkaline phosphatase (ALP) activity and quantification of gene expression (qRT-PCR) for osteogenesis markers. Additionally, alizarin red staining and a hydroxyproline colorimetric assay evaluated and quantified osteogenic matrix mineralization and collagen deposition. Statistical analyses were performed using one-way ANOVA or two-way ANOVA for multiple comparisons between groups. At low FGF-2 concentrations, hPDLSCs differentiated toward an osteogenic lineage, whereas higher concentrations of FGF-2 inhibited osteogenesis and promoted fibroblastic differentiation. The effect of FGF-2 at the lowest concentration tested (1 ng/mL) led to significantly higher ALP activity than osteogenically induced positive controls at early time points and equivalent RUNX2 expression at early and later time points. FGF-2 supplementation of haBMSC cultures was sufficient, at all concentrations, to increase ALP activity at an earlier time point. Mineralization of haBMSC cultures increased significantly within 5–20 ng/mL FGF-2 concentrations under basal growth media conditions (α-minimal essential medium supplemented with 15 % fetal bovine serum and 1 % penicillin/streptomycin). FGF-2 has a dual capacity in promoting osteogenic and fibroblastic differentiation within hPDLSCs contingent upon the dosage and timing of administration, alongside supporting osteogenic differentiation in haBMSCs. These findings underscore the need for precision growth factors dosing when considering the design of biomaterials for periodontal regeneration. • Low levels of FGF-2 boost early-stage osteogenic response in PDLSCs. • High levels of FGF-2 impede the osteogenic response in PDLSCs. • FGF-2 enhances mineralization capacity in cultured aBMSCs. [ABSTRACT FROM AUTHOR]

• The composite filaments were successfully developed via melt-blending technique. • AMP-PEEK filaments can serve as feedstock for 3D printing of patient-specific implants. • The bioactivity of the composites significantly increased cell adhesion and proliferation. • AMP-PEEK facilitate in vivo osseointegration and suitable bone regeneration capabilities. The aim of this study was to develop bioactive and osseointegrable polyetheretherketone (PEEK)-based composite filaments melt-blended with novel amorphous magnesium phosphate (AMP) particles for 3D printing of dental and orthopedic implants. A series of materials and biological analyses of AMP-PEEK were performed. Thermal stability, thermogravimetric and differential scanning calorimetry curves of as-synthesized AMP were measured. Complex viscosity, elastic modulus and viscous modulus were determined using a rotational rheometer. In vitro bioactivity was analyzed using SBF immersion method. SEM, EDS and XRD were used to study the apatite-forming ability of the AMP-PEEK filaments. Mouse pre-osteoblasts (MC3T3-E1) were cultured and analyzed for cell viability, proliferation and gene expression. For in vivo analyses, bare PEEK was used as the control and 15AMP-PEEK was chosen based on its in vitro cell-related results. After 4 or 12 weeks, animals were euthanized, and the femurs were collected for micro-computed tomography (μ-CT) and histology. The collected findings confirmed the homogeneous dispersion of AMP particles within the PEEK matrix with no phase degradation. Rheological studies demonstrated that AMP-PEEK composites are good candidates for 3D printing by exhibiting high zero-shear and low infinite-shear viscosities. In vitro results revealed enhanced bioactivity and superior pre-osteoblast cell function in the case of AMP-PEEK composites as compared to bare PEEK. In vivo analyses further corroborated the enhanced osseointegration capacity for AMP-PEEK implants. Collectively, the present investigation demonstrated that AMP-PEEK composite filaments can serve as feedstock for 3D printing of orthopedic and dental implants due to enhanced bioactivity and osseointegration capacity. [ABSTRACT FROM AUTHOR]

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

This study evaluated the effect of distinct bonding strategies on the retention of full-contour zirconia ceramic (Y-TZP, FCZ) crowns, and it characterized some physicochemical and mechanical properties of FCZ ceramic and its corresponding glazing system. To evaluate retention strength, dies were made with a dentin-analogue material to simulate a prepared tooth. FCZ crowns were manufactured using CAD-CAM technology and allocated into groups according to the bonding strategy: no ceramic treatment (PF – Panavia F cementation), glaze (GL), tribochemical silica coating (CJ), CJ + GL, and piranha solution followed by glaze (PS + GL). The specimens were subjected to thermocycling and storage in distilled water for 100 days before the retention tests. FCZ presented a porosity volume fraction of 0.2%, an apparent density of 6.06 g/cm 3 , Vickers hardness of 12.4 ± 0.07 GPa, and fracture toughness of 5.54 ± 0.24 MPa m 1/2 . SEM revealed a homogeneous microstructure composed of submicron-sized grains. XRD identified mainly zirconia's tetragonal phase. Glaze powder morphology was observed to be irregular, with a nanometric particle size, and a diffraction pattern characteristic of an amorphous material with several peaks of leucite. The PF and GL groups had higher retention values. The majority of the groups presented pre-test bonding failures, and two catastrophic failures of the FCZ-crown (GL and PF groups) were noted. The use of an MDP-containing resin cement or glaze application might improve retention of the FCZ crowns. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the effect of various zirconia surface pretreatments on the adhesion between full contour 3Y-TZP zirconia and glaze, and the shear bond strength (SBS) between glazed/3Y-TZP and resin cement. Specimens were allocated into groups: GL-glaze; AL+GL-sandblasting with Al 2 O 3 +GL; CJ+GL-tribochemical silica coating (Cojet ® /CJ)+GL; PS+GL-piranha solution+GL; and CJ. Adhesion between 3Y-TZP and GL was evaluated using the scratch test. Surface topography and glaze thickness were evaluated by using a scanning electron microscope (SEM). For SBS, glazed/3Y-TZP surface was etched with hydrofluoric acid and a silane was applied. For CJ only the silane was applied. Samples were tested after 24 h (24 h wet) or after 15,000 thermal cycles and 90 days storage (thermocycled). After SBS, the type of failure was classified as: adhesive, mixed or cohesive. The data were analyzed using two-way ANOVA and Tukey's test. SEM analysis after scratch test revealed circular cracks in the GL group and conformal cracks in the others groups. SEM micrographs suggested that zirconia specimens submitted to airborne-particle abrasion presents rougher and porous surface when compared to surfaces treated with GL and PS. The glaze layer was approximately 1.86 µm thick in all groups. After 24 h, SBS test showed highest values for AL+GL and CJ+GL and were significantly higher when compared to the GL group. Differences were not significant between PS+GL and the other groups. After aging (thermocycling+storage), groups GL and CJ presented no statistically significant difference compared to 24 h and aged AL+GL, CJ+GL and PS+GL groups. The predominant type of failure was mixed. 3Y-TZP surface treatment with glaze application could be considered as an alternative treatment, since it yielded a similar resin bond strength without the need for airborne-particle abrasion. [ABSTRACT FROM AUTHOR]

To evaluate the effect of surface treatments, finishing condition (polished vs. ground) and aging on the microtensile bond strength of a CAD/CAM resin composite to resin cement. CAD/CAM resin composite blocks (Tetric CAD HT) were sectioned (7 × 12 × 4 mm), randomly divided according to finishing condition (polished or ground) and surface treatment groups (Ctrl: no treatment; AA: air-abrasion with 110 μm Al 2 O 3 powder; TBS: tribochemical silica coating). A coupling agent corresponding to each surface treatment was applied for cementation (Ctrl and AA groups: ExciTE F DSC; TBS group: RelyX Ceramic Primer) and each block was adhesively cemented (Variolink N) with another one from the same conditioning. Next, 1 mm2 cross-section beams were produced after sectioning, with half being tested under microtensile test after 24 h, while the other half was aged (25,000 cycles of thermocycling + 90 days of storage) (n = 50). Contact angle and Scanning Electron Microscopy (SEM) analysis were performed. Bond strength data (MPa) were statistically analyzed using Three-way ANOVA and Tukey tests (α = 0.05). The failure types were examined and classified as predominantly adhesive, cohesive or mixed under stereomicroscopy. The surface treatments (AA and TBS) promoted higher bond strength than the Ctrl group. Grinding finishing improved the bond strength only when no treatment was performed (Ctrl group), having a negative effect for the TBS treatment. The long-term aging damaged the resin bond, independent of the condition. The failure analysis showed that 92% of the failures were classified as adhesive in the baseline conditions, and 94.7% in aged specimens. TBS showed the lowest contact angle among the tested groups for both conditions (baseline and aged). Surface conditioning with alumina particle air-abrasion or tribochemical silica coating improves the bond strength. CAD/CAM milling roughness induces better surface condition for adhesion, in particular when no treatment is performed. Bond degradation occurs after long-term aging for all the test conditions. When luting CAD/CAM resin composite restorations, the surface treatment and roughness due to the grinding by burs in the manufacturing process influence the adhesion of restoration to resin cement. • The machining roughness simulation influences the bond strength of the CAD-CAM resin composite to resin cement. • Alumina particle air-abrasion lead to the higher bond strength for a milled composite resin surface. • Treated polished surfaces has higher reduction in bond strength after long-term aging. • Tribochemical surface treatment has the lowest reduction in bond strength after aging. [ABSTRACT FROM AUTHOR]

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

Objectives This study reports on the synthesis, materials characterization, antimicrobial capacity, and cytocompatibility of novel ZnO-loaded membranes for guided tissue/bone regeneration (GTR/GBR). Methods Poly(ɛ-caprolactone) (PCL) and PCL/gelatin (PCL/GEL) were dissolved in hexafluoropropanol and loaded with ZnO at distinct concentrations: 0 (control), 5, 15, and 30 wt.%. Electrospinning was performed using optimized parameters and the fibers were characterized via scanning and transmission electron microscopies (SEM/TEM), energy dispersive X-ray spectroscopy (EDS), Fourier transform infrared spectroscopy (FTIR), contact angle (CA), mechanical testing, antimicrobial activity against periodontopathogens, and cytotoxicity test using human dental pulp stem cells (hDPSCs). Data were analyzed using ANOVA and Tukey ( α = 5%). Results ZnO nanoparticles were successfully incorporated into the overall submicron fibers, which showed fairly good morphology and microstructure. Upon ZnO nanoparticles’ incorporation, the PCL and PCL/GEL fibers became thicker and thinner, respectively. All GEL-containing membranes showed lower CA than the PCL-based membranes, which were highly hydrophobic. Overall, the mechanical properties of the membranes were reduced upon ZnO incorporation, except for PCL-based membranes containing ZnO at the 30 wt.% concentration. The presence of GEL enhanced the stretching ability of membranes under wet conditions. All ZnO-containing membranes displayed antibacterial activity against the bacteria tested, which was generally more pronounced with increased ZnO content. All membranes synthesized in this study demonstrated satisfactory cytocompatibility, although the presence of 30 wt.% ZnO led to decreased viability. Significance Collectively, this study suggests that PCL- and PCL/GEL-based membranes containing a low content of ZnO nanoparticles can potentially function as a biologically safe antimicrobial GTR/GBR membrane. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of polishing techniques on the surface roughness of Y-TZP ceramic and on the wear behavior of synthetic hydroxyapatite (HA). Methods: Thirty-two full-contour Y-TZP (Diazir®) sliders (φ =2mm×1.5mm in height) were manufactured using CAD/CAM, embedded in acrylic resin using brass holders, and randomly allocated into four groups (n =8): according to the finishing/polishing procedure: G1-as-machined, G2-glazed, G3-diamond bur finishing and G4−G3+OptraFine® polishing kit. Thirty-two sintered HA disks (φ =13mm×2.9mm in height) were similarly mounted in brass holders. Y-TZP sliders baseline surface roughness values (Ra and Rq, in μm) were recorded using a non-contact profilometer (Proscan 2000). A two-body pin-on-disc wear test was performed. HA height (μm) and volume (mm3) losses were measured. Y-TZP height loss was measured using a digital micrometer. One-way ANOVA was used to determine the effect of the polishing techniques on the surface roughness. Comparisons between groups for differences in antagonist height loss/volume, and slider height loss were performed using one-way ANOVA. Statistical significance was set at α =0.05. Results: Roughness measurements showed significant differences (p =0.0001) among the surface treatments with G1 (Ra=0.84, Rq=1.13μm) and G3 (Ra=0.89, Rq=1.2μm) being the roughest, and G2 (Ra=0.42, Rq=0.63μm) the smoothest (p =0.0001). Y-TZP slider height loss was highest for the glazed group (35.39μm), and was lowest for the polished group (6.61μm) (p =0.0001). Antagonist volume and height losses for groups (G1–G3) were similar, while the polished group (1.3mm3, 14.7μm) showed significant lower values (p =0.0001). Significance: Although glazed zirconia provides an initially smooth surface, significantly increased antagonist wear was observed compared to the polished Y-TZP zirconia surface. [ABSTRACT FROM AUTHOR]

• A drug delivery system to afford sustained release of DEX was achieved by CD-IC. • DEX/CD-IC was successfully incorporated into PLGA fibers via electrospinning. • UPLC revealed the solubility enhancement and sustained release of DEX by CD-IC. • Cell compatibility and proliferation was more favorable in DEX/CD-IC fibers. • Odonto/osteogenic differentiation was enhanced in DEX/CD-IC electrospun fibers. Beta-cyclodextrin (β-CD) is an oligosaccharide commonly used to improve the aqueous solubility of lipophilic drugs (e.g., dexamethasone, DEX). Here we present the development of a drug delivery system to provide sustained release of DEX by β-CD-inclusion complex (IC) to amplify the mineralization capacity of stem cells from human-extracted deciduous teeth (SHEDs) as a potential direct pulp capping strategy. First, IC of DEX (DEX-CD-IC) was synthesized with β-CD. To confirm DEX-CD-IC complex formation, X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR) analyses were performed. XRD data indicated that IC formation was achieved due to formation of a new crystalline structure, whereas FTIR revealed the presence of the IC from the shifting of the peaks of each component in DEX-CD-IC. Then, electrospun poly(lactic-co-glycolic acid, PLGA) fibers (PLGA/DEX-CD-IC) were processed by varying the concentration of DEX-CD-IC (5%, 10 %, and 15 %). The release of DEX from fibers was determined by ultraperformance liquid chromatography for 28 days. Thanks to the solubility enhancement of DEX by IC, electrospun PLGA/DEX-CD-IC fibers released DEX in a more sustained fashion compared to PLGA/DEX fibers. No deleterious effect was found in terms of SHEDs' proliferation when cultured with or on electrospun fibers, regardless of the IC presence. Importantly, a more pronounced odontogenic differentiation was stimulated by electrospun fibers loaded with the lowest DEX-CD-IC concentration (5%), as a result of the sustained DEX release. In sum, PLGA/DEX-CD-IC fibers have great potential in vital dental pulp therapy, owing to its sustained DEX release, cytocompatibility, and odontogenic differentiation capacity. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To evaluate the null hypotheses that hydrofluoric (HF) acid etching time would neither decrease the biaxial flexural strength of a glass-based veneering ceramic nor enhance it after silane and unfilled resin (UR) applications. Methods: Disc-shaped IPS e.max ZirPress specimens were allocated into 12 groups: G1-control (no-etching), G2-30s, G3-60s, G4-90s, G5-120s, G6-60s+60s. Groups (G7–G12) were treated in the same fashion as G1–G6, but followed by silane and UR applications. Surface morphology and roughness (Ra and Rq) of the ceramics were assessed by means of scanning electron microscopy (SEM) and profilometry, respectively. Flexural strength was determined by biaxial testing. Data were analyzed by two-way ANOVA and the Sidak test (α =0.05). Weibull statistics were estimated and finite element analysis (FEA) was carried out to verify the stress concentration end areas of fracture. Results: The interaction (etching time vs. surface treatment) was significant for Ra (p =0.008) and Rq (0.0075). Resin-treated groups presented significantly lower Ra and Rq than non-treated groups, except for the 60s group (p <0.005). SEM revealed that etching affected the ceramic microstructure and that the UR was able to penetrate into the irregularities. A significant effect of etching time (p =0.029) on flexural strength was seen. G7–G12 presented higher strength than G1–G6 (p <0.0001). None of experimental groups failed to show 95% confidence intervals of σ 0 and m overlapped. FEA showed lower stress concentration after resin treatment. Significance: HF acid etching time did not show a damaging effect on the ceramic flexural strength. Moreover, the flexural strength could be enhanced after UR treatment. [Copyright &y& Elsevier]