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BACKGROUND Endodontically treated teeth usually can reveal an extensive loss of dental structure and require the use of intraradicular posts to provide adequate support and retention. Retention of the post depends on the surface treatment of the endodontic post itself and on the root canal dentin as well as on the type of resin-matrix cement. PURPOSE The main aim of this study was to conduct an integrative review on the influence of different surface treatment methods of glass fiber-reinfored resin composite (GFRC) posts on their push-out bond strength to resin-matrix cements in endodontically treated teeth rehabiliation. METHOD A literature search was performed on PubMed (via National Library of Medicine) regarding articles published within the last 10 years, using the following combination of search terms: "intracanal post" OR "endodontic post" OR "root canal post" OR "intraradicular post" OR "glass fiber" AND "resin cement" AND "adhesion" OR "bond strength" OR "shear bond strength" OR "push out". RESULTS Results from the selected studies recorded the highest push-out bond strength around 22.5 MPa) on GFRC posts to resin-matrix cements when the surfaces were pre-treated by grit-blasting with silicate followed by silane conditioning. However, high values of push-out bond strength (21.5 MPa) were also noticed for GFRC posts after etching with hydrogen peroxide followed by silance conditioning. Thus, the highest values of bond strength of endodontic posts to the resin-matrix cements were recorded when a combined physico-chemical approach was assessed. Non-treated surfaces showed the lowest bond strength values between 5 to and 9 MPa. Surface analyses of GFRC posts showed an increased roughness after grit-blasting or etching that promoted a mechanical interlocking of the adhesive and resin-matrix cements. CONCLUSION The combined treatment of glass fiber-reinforced resin composite post surfaces by physical and chemical methods can promote the increase in roughness and chemical functionalization of the surfaces prior to cementation., That results in a high mechanical interlocking of the resin-matrix cements and a stable retention of the teeth root intracanal posts. CLINICAL RELEVANCE Combining chemical and physical modification methods of surfaces can provide the most promising adhesion-enhancing pathways of GFRC posts to resin-matrix cements, that can decrease the risk of clinical failures by fracture and detachment of endodontic posts.

The aim of this study was to perform an integrative review on the layer thickness and microstructure of resin-matrix cements around custom-made or standard teeth root intracanal posts. An electronic search was conducted on the PubMed using a combination of the following scientific terms: intraradicular post, root intracanal post, resin cement, thickness, adaptation, endodontic post, layer thickness, fit, shape, and endodontic core. The literature selection criteria accepted articles published in the English language, up to May 2021, involving in vitro analyses, meta-analyses, randomized controlled trials, and prospective cohort studies. The search identified 154 studies, of which 24 were considered relevant to this study. The selected studies provided important data considering cement layer thickness, tooth preparation, endodontic post, and type of resin-matrix cement. The anatomical variability of root canal systems, such as the oval- or C-shaped, represents a challenge in dental restoration with tooth root intracanal posts. The fitting of intracanal posts to different root regions is variable resulting in thick and irregular layers of resin-matrix cement. Defects like pores, micro-cracks, and micro-gaps were detected in the resin-matrix cement microstructure and represent spots of stress concentration and fracture. Custom-made tooth root intracanal posts provide a proper fitting and decrease the layer thickness of resin-matrix cement. In fact, the layer thickness of resin-matrix cements depends on the fitting of endodontic posts to tooth root canals. An increase of resin cement thickness causes the appearance of defects like pores, micro-cracks, and micro-gaps that can induce stress concentration and fractures at interfaces. The fitting of the endodontic post into the teeth root canal determine the layer thickness of the resin-matrix cement to establish an adequate retention. However, the increase in the thickness of the resin-matrix cement layer can lead to a high number of defects like pores or cracks and therefore decrease the strength of the interface.

This work aimed to assess the biomechanics, using the finite element method (FEM), of traditional titanium Morse taper (MT) dental implants compared to one-piece implants composed of zirconia, polyetheretherketone (PEEK), carbon fiber-reinforced PEEK (CFR-PEEK), or glass fiber-reinforced PEEK (GFR-PEEK). MT and one-piece dental implants were modeled within a mandibular bone section and loaded on an oblique force using FEM. A MT implant system involving a Ti6Al4V abutment and a cp-Ti grade IV implant was compared to one-piece implants composed of cp-Ti grade IV, zirconia (3Y-TZP), PEEK, CFR-PEEK, or GFR-PEEK. Stress on bone and implants was computed and analyzed while bone remodeling prediction was evaluated considering equivalent strain. In comparison to one-piece implants, the traditional MT implant revealed higher stress peak (112 MPa). The maximum stresses on the one-piece implants reached ~80 MPa, regardless their chemical composition. MT implant induced lower bone stimulus, although excessive bone strain was recorded for PEEK implants. Balanced strain levels were noticed for reinforced PEEK implants of which CFR-PEEK one-piece implants showed proper biomechanical behavior. Balanced strain levels might induce bone remodeling at the peri-implant region while maintaining low risks of mechanical failures. However, the strength of the PEEK-based composite materials is still low for long-term clinical performance.

Temporomandibular joint (TMJ) prostheses can be a stock or custom-made replacement of the related maxillomandibular structures such as condyle and fossa. In the last years, several materials and design have been assessed in an attempt to improve the mechanical performance of TMJ prostheses. This study aims to report literature data on the wear of temporomandibular joint prostheses and potential biological risks to the patients. Studies reported a significant deterioration of the sliding contact surfaces of TMJ prostheses. Material loss as a result of wear causes condyle/fossa mismatch and the modification of contact pressure and chewing forces loading. As a further consequence of wear, metal particles are released to the surrounding tissues with a high risk of local tissue toxicity and systemic toxicity through the bloodstream. The presence of particles induces the stimulation of inflammatory reactions depending on the concentration and size of debris.

The objective of this study was to develop a replica method for producing zirconia-reinforced bioactive glass (ZRBG) porous structures for bone repair. Four different types of porous structures were produced: zirconia (G1), 58S BG-coated zirconia (G2), zirconia-reinforced BG (G3) and 58S BG-coated zirconia-reinforced BG (G4). A complete characterization of the specimens was performed via SEM-EDS, Archimedes method, 3D X-ray micro-tomography, micro-indentation, compressive strength tests and SBF immersion tests. G3 and G4 specimens presented a BG matrix (~ 33% glassy phase) with dispersed zirconia particles. The porosity of the specimens ranged from 86% up to 93%. BG58S-zirconia groups G3 and G4) exhibited lower YM (38.76 ± 11.20 GPa and 43.49 ± 2.16 GPa) than that of G1 monolithic zirconia specimens (94.39 ± 12.62 GPa), which were more compatible to that of the bone. No significant difference in compressive strength between BG58S-zirconia (G3: 0.41 ± 0.20 MPa; G4: 0.45 ± 0.11 MPa) and zirconia (G1: 0.32 ± 0.11 MPa) was detected observed (p > 0.05). In vitro SBF tests showed a potential bioactivity for ZRBG porous structures.

The main aim of this study was to conduct an integrative review on the influence of the zirconia veneer thickness on the degree of conversion of resin-matrix cements. An electronic search was performed on PubMed using a combination of the following search items: zirconia, thickness, veneer, degree of conversion, resin cement, light curing, and polymerization. Articles published in the English language, up to July 2020, were included regarding the influence of ceramic veneer thickness on the degree of conversion of resin-matrix cements. Randomized controlled trials and prospective cohort studies were also evaluated. Of the 21 selected studies, 9 investigated the light-curing effect, while five other articles evaluated the ceramic translucency. Three studies evaluated the degree of conversion of the resin-matrix cement while four articles assessed the veneer thickness. Results revealed a significant decrease of light transmission through the zirconia with a thickness ranging from 0.1 up to 1.5 mm. However, the ultra-thin thickness around 0.1 and 0.3 mm allowed a full polymerization of the dual-curing resin-matrix cement resulting in the integrity of the interface properties. The light-curing process of resin-matrix cements is also affected by the shade, chemical composition, and microstructure of zirconia and resin cement. Optimal conditions of light-curing are required to reach the threshold intensity of light and energy for polymerization of resin-matrix cements. The increase in zirconia veneer thickness negatively affects the degree of conversion of resin-matrix cements. Also, shade and microstructure are key factor to improve the light curing of resin cements. Clinicians should consider the zirconia thickness on resin-based cementation since a higher veneer thickness can negatively affect the light irradiation intensity towards the dual-curing resin-matrix cement. Thus, the degree of conversion of the resin-matrix cement can decrease leading to a low chemical stability (e.g., color instability) and poor mechanical properties.

OBJECTIVE: This integrative review aimed to report the toxic effect of submicron and nano-scale commercially pure titanium (cp Ti) debris on cells of peri-implant tissues. MATERIALS AND METHODS: A systematic search was carried out on the PubMed electronic platform using the following key terms: Ti "OR" titanium "AND" dental implants "AND" nanoparticles "OR" nano-scale debris "OR" nanometric debris "AND" osteoblasts "OR "cytotoxicity" OR "macrophage" OR "mutagenic" OR "peri-implantitis". The inclusion criteria involved articles published in the English language, until December 26, 2020, reporting the effect of nano-scale titanium particles as released from dental implants on the toxicity and damage of osteoblasts. RESULTS: Of 258 articles identified, 14 articles were selected for this integrative review. Submicron and nano-scale cp Ti particles altered the behavior of cells in culture medium. An inflammatory response was triggered by macrophages, fibroblasts, osteoblasts, mesenchymal cells, and odontoblasts as indicated by the detection of several inflammatory mediators such as IL-6, IL-1β, TNF-α, and PGE2. The formation of a bioactive complex composed of calcium and phosphorus on titanium nanoparticles allowed their binding to proteins leading to the cell internalization phenomenon. The nanoparticles induced mutagenic and carcinogenic effects into the cells. CONCLUSIONS: The cytotoxic effect of debris released from dental implants depends on the size, concentration, and chemical composition of the particles. A high concentration of particles on nanometric scale intensifies the inflammatory responses with mutagenic potential of the surrounding cells. CLINICAL RELEVANCE: Titanium ions and debris have been detected in peri-implant tissues with different size, concentration, and forms. The presence of metallic debris at peri-implant tissues also stimulates the migration of immune cells and inflammatory reactions. Cp Ti and TiO2 micro- and nano-scale particles can reach the bloodstream, accumulating in lungs, liver, spleen, and bone marrow. ispartof: CLINICAL ORAL INVESTIGATIONS vol:25 issue:4 pages:1627-1640 ispartof: location:Germany status: published

The main aim of this study was to assess the effect of ns-Nd:YAG laser structuring over zirconia green compacts on the adhesion of sintered zirconia to resin-matrix cements. Zirconia (3Y-TZP) compacts were divided according to the type of surface modification: GB – alumina grit-blasted sintered specimens; G8L – laser structured zirconia green compacts (square pattern 8 lines); G16L - laser structured zirconia green compacts (square pattern 16 lines); G8L/GB – alumina grit-blasted G8L specimens after sintering. Specimens of same group were cleaned, cemented using a dual cure resin-matrix cement and aged in distilled water for 24 h (37 °C). Afterwards, the tensile bond strength was measured using a universal test machine. Specimens were analyzed by field emission guns scanning electron microscopy (FEGSEM) and white light interferometry (WLI). Laser-structured surfaces showed higher roughness values and improved morphological aspects for adhesion to resin-matrix cements. Higher tensile bond strength mean values of zirconia to resin-matrix cements were recorded for G8L (16.7 ± 3.8 MPa) and G16L (13.6 ± 3.0 MPa) groups when compared to those recorded for ordinary grit-blasted zirconia surfaces to resin-matrix cements (10 ± 3.1 MPa). The highest tensile bond strength results were recorded for the G8L/GB group (24.2 ± 7.6 MPa). The laser texturing of green zirconia surfaces promoted an increase in roughness and changes in morphological aspects of sintered zirconia for improved adhesion to resin-matrix cements.

Considerando o desempenho a longo prazo dos dentes tratados endodonticamente, são vários os fatores que podem conduzir ao insucesso, especialmente em estruturas dentárias com perda tecidual severa. O objetivo do presente trabalho foi realizar uma revisão narrativa da literatura relativa aos diferentes retentores intracanalares para reconstrução coronária de dentes tratados endodonticamente. Os resultados encontrados apontam para a importância da manutenção de estrutura dentária a nível coronário no sucesso clínico a longo prazo. O tratamento endodôntico e a seleção de retentor intracanalar são determinantes para o prognóstico a longo prazo. Apesar da evolução dos materiais e técnicas adesivas nos últimos anos, há limitações mecânicas e geométricas dos materiais retentores intracanalares para compensar a perda de estrutura dentária. Como consequência, falhas clínicas levam a situações de re-tratamento ou perda de elementos dentários com desconforto e maior custo aos pacientes.

The purpose of this study was to evaluate the color stability of aesthetic restorative resin-matrix materials after their immersion in different dietary and therapeutic solutions. Thirty disc-shaped specimens (10 × 2 mm) were prepared from three different types of resin-matrix composites used in dentistry (BE, FS, AF). The color coordinates (L*a*b*, ΔL*, Δa*, Δa*, Δb* and ΔE*) were measured using a VITA Easyshade 3D-Master (VITA Zahnfabrik, Bad Säckingen, Germany) before and after the immersion of the specimens in coffee, red wine, Coca-Cola®, Eludril Care®, and distilled water solutions for 40 h. The color change (ΔE*) was calculated and analyzed by the Kolmogorov -Smirnov test and the Kruskal -Wallis multiple-comparison test. All the restorative materials showed significant color (ΔE*) changes after their exposure to red wine, followed by coffee and Coca-Cola®; however, one nanohybrid resin-matrix composite showed a high color stability in such colored test solutions. The chemical composition and content of the organic matrix played a key role in the color stability of the resin-matrix composites. Clinicians should advise their patients about the chemical interaction between dietary substances and different resin-matrix composites., This work was supported by IINFACTS-Institute of Research and Advanced Training in Health Sciences and Technologies, in the scope of OrthoAlignPI-4RL-IINFACTS-2019. The authors express gratitude to Ana Vanessa F. Carvalho for her helpful participation in specific stepsof thein vitro experiments. The authors would like to thank VOCO GmbH (Cuxhaven, Germany),Coltene-Whaledent (Switzerland), and 3M (ESPE, USA) for supplying the materials tested in this study.

Peri-implant diseases are one of the main causes of dental implant failure. New strategies for dental implants manufacturing have been developed to prevent the accumulation of bacteria and related inflammatory reactions. The main aim of this work was to develop laser-treated titanium surfaces covered with silver that generate a electrical dipole to inhibit the oral bacteria accumulation. Two approaches were developed for that purpose. In one approach a pattern of different titanium dioxide thickness was produced on the titanium surface, using a Q-Switched Nd:YAG laser system operating at 1064 nm. The second approach was to incorporate silver particles on a laser textured titanium surface. The incorporation of the silver was performed by laser sintering and hot-pressing approaches. The anti-biofilm effect of the discs were tested against biofilms involving 14 different bacterial strains growth for 24 and 72 hr. The morphological aspects of the surfaces were evaluated by optical and field emission guns scanning electronical microscopy (FEGSEM) and therefore the wettability and roughness were also assessed. Physicochemical analyses revealed that the test surfaces were hydrophilic and moderately rough. The oxidized titanium surfaces showed no signs of antibacterial effects when compared to polished discs. However, the discs with silver revealed a decrease of accumulation of Porphyromonas gingivalis and Prevotella intermedia strains. Thus, the combination of Nd:YAG laser irradiation and hot-pressing was effective to produce silver-based patterns on titanium surfaces to inhibit the growth of pathogenic bacterial species. The laser parameters can be optimized to achieve different patterns, roughness, and thickness of the modified titanium layer regarding the type and region of the implant. ispartof: JOURNAL OF BIOMEDICAL MATERIALS RESEARCH PART B-APPLIED BIOMATERIALS vol:109 issue:10 pages:1588-1600 ispartof: location:United States status: published

O objetivo do presente trabalho foi realizar uma revisão da literatura sobre o uso de biomateriais de origem animal (xenógeno) e sintética para o reparo do tecidual. Diferentes materiais cerâmicos e poliméricos sintéticos e xenógenos são aplicados para o reparo ósseo. Dentre os cerâmicos, a mistura de hidroxiapatite e ?-TCP (60-70/40-30 wt%), apatite carbonada e hidroxiapatite de origem bovina ou suína são comumente aplicados, no entanto a taxa de absorção dos materiais sintéticos é lenta quando comparado ao processo de cicatrização na presença dos xenógenos. Além disso, a resposta biológica de materiais sintéticos ainda é inferior à resposta aos materiais xenógenos. Tendo em consideração os diversos polímeros, os materiais xenógenos (ex. colagénio, quitosana) têm apresentado uma resposta biológica mais adequada quando comparado aos sintéticos (ex. PLGA, PLDLA). A cicatrização tecidual óssea é um processo que envolve fases de migração celular, deposição de proteínas e minerais, formação vascular, e desenvolvimento de tecidos conectivo e ósseo. O desenvolvimento de polímeros sintéticos com taxa de absorção adequada ao processo de reparo tecidual associada a uma alta bioatividade e promoção da angiogénese tem sido o alvo de estudos recentes. Além disso, combinação de sintéticos e xenógenos também torna-se uma alternativa com alto potencial de sucesso clínico.

The aim of this study was to manufacture zirconia periodic open cellular structures (POCS) (39%–57% porosity) and evaluate their mechanical properties. Zirconia POCS with 39%, 47% and 57% porosity were obtained from a CAD/CAM blank using a CNC milling machine. Specimens with a feldspar-based porcelain infiltrated in the porosities were also produced and tested. The elastic and inelastic properties of the all samples were obtained by compression strength tests. The structures were analyzed using XRD and SEM. FEA was also performed to evaluate the porous structures and for optimization. Zirconia POCS were successfully produced using a CAD/CAM technique. Porous size and distribution can be easily modified to tailor the desired POCS mechanical properties. Elastics and inelastic properties were well fitted by the Gibson-Ashby model, which allows designing POCS with predictable results.

The main aim of this review study was to report the state of art on the nano-scale technological advancements of titanium implant surfaces to enhance the osseointegration process. Several methods of surface modification are chronologically described bridging ordinary methods (e.g. grit blasting and etching) and advanced physicochemical approaches such as 3D-laser texturing and biomimetic modification. Functionalization procedures by using proteins, peptides, and bioactive ceramics have provided an enhancement in wettability and bioactivity of implant surfaces. Furthermore, recent findings have revealed a combined beneficial effect of micro- and nano-scale modification and biomimetic functionalization of titanium surfaces. However, some technological developments of implant surfaces are not commercially available yet due to costs and a lack of clinical validation for such recent surfaces. Further in vitro and in vivo studies are required to endorse the use of enhanced biomimetic implant surfaces. STATEMENT OF SIGNIFICANCE: Grit-blasting followed by acid-etching is currently used for titanium implant modifications, although recent technological biomimetic physicochemical methods have revealed enhanced osteoconductive and anti-microbial outcomes. An improvement in wettability and bioactivity of titanium implant surfaces has been accomplished by combining micro and nano-scale modification and functionalization with protein, peptides, and bioactive compounds. Such morphological and chemical modification of the titanium surfaces induce the migration and differentiation of osteogenic cells followed by an enhancement of the mineral matrix formation that accelerate the osseointegration process. Additionally, the incorporation of bioactive molecules into the nanostructured surfaces is a promising strategy to avoid early and late implant failures induced by the biofilm accumulation.

The goal of this paper is to review the advantages and disadvantages of the various treatment options of temporomandibular joint (TMJ) total joint replacement (TJR). TMJ articles published within the last 20 years were reviewed to collect the information on non-invasive and invasive TMD treatment methods. Recent technological advancements helped the evolution of treatment methods and offered significant value to TMD patients and surgeons. Considering the TMD levels, the therapeutic procedures can involve general health examiniations, physical therapy, medication, oral rehabilation or as an end stage clinical invention, temporomandibular joint replacement. In fact when intra-articular TMD is present, the effective treatment method appears to be TJR. However, concern for infection, material hypersensitivity, device longevity and screws loosening issues still exists. Further combined research utilizing the knowledge and expertise of, surgeons, material scientists, and bioengineers is needed for the development of improved TMD therapeutic treatment.

Objectives: The aim of this study was to evaluate the use of dual-cure resin cement to promote the bonding between a veneering PEEK and zirconia or titanium surfaces.Materials and methods: The surf...

The aim of this study was to perform an integrative systematic review on the damage of dental resin-matrix composite and amalgam surfaces after exposure to bleaching agents composed of hydrogen or urea (carbamide) peroxide. An electronic search on PubMed was carried out using the following selected terms: amalgam” OR “resin composite” AND “bleaching treatment” AND “corrosion” OR “erosion”, “roughness” OR “AFM” OR “profilometry” OR “SEM”. The search identified 127 articles, of which 32 were considered relevant to this study. The results revealed a significant increase in roughness values of the dental amalgam within a micro-scale damage after contact with the bleaching agents. The roughness of the resin–matrix composites was altered at a lower extent that was dependent on their organic matrix content and time of exposure to the bleaching agents. As a consequence of the morphological changes, a release of Hg, Ag, and Cu ions was measured after contact of the amalgam with bleaching agents that can promote localized and systemic toxicity. The degradation products of the organic matrix of the resin-matrix composites consisted in methacrylate monomers which can also be toxic to the surrounding cells and tissues. The findings showed evidences of the degradation of dental amalgam and resin–matrix composite surfaces after contact with bleaching agents. Degradation was severe for amalgam and the consequent release of ions can induce localized and systemic adverse biological response to the patients.

The aim of this work was to perform a short scoping review on the degradation of tooth occlusal fissure and pit sealants by wear and corrosion processes occurring in the oral cavity or in simulated saliva solutions. A Medline search was conducted for related scientific articles published within the last twenty years reporting the wear rate and corrosion of tooth occlusal fissure sealant. The wear volume, elastic modulus, and strength values were also provided for the different sealants and correlated with their chemical composition regarding inorganic fillers and organic matrix. Resin–matrix sealants with high volume content of micro/nano-scale inorganic fillers revealed a higher strength and wear resistance when compared to glass ionomer-based sealants. The dominant wear mechanisms consisted of abrasion, corrosion, and surface fatigue under reciprocating sliding tests. Thus, the content, shape, and size of inorganic fillers in the microsctruture play a key role on the degradation behavior of occlusal fissure sealants. The selection of materials determine the performance and successful clinical outcomes of tooth occlusal fissure and pits sealants.

OBJECTIVE: The purpose of this study was to evaluate the sterilization effectiveness against biofilms on retrieved healing abutments used in implant dentistry. BACKGROUND: A large number of clinicians reuse healing abutments to decrease treatment costs although it can promote infection due to the presence of remnant biofilm biomass. METHODS: One hundred and eighty-five titanium healing abutments previously used for 3 months in oral cavity were assessed in this study. Abutments were submitted to cleaning, chemical disinfection, and autoclave sterilization according to clinical guidelines. The abutments were aseptically placed into glass tubes containing specific bacterial growth medium and then incubated for 10 days. From glass tubes with bacterial growth, 100 µl medium was transferred to Schaedler's agar for morphological identification and counting of strict anaerobes and to Columbia blood agar for presumptive identification of facultative anaerobes after incubation. Isolated strains were then identified at species level by enzymatic and biochemical tests within API microorganism detection platform. Also, polymerase chain reaction (PCR) was performed for identification of undefined strains. RESULTS: After the standard cleaning and sterilization procedures, fifty-six (approximately 30%) retrieved abutments showed the presence of remnant biofilm biomass. The bacteria identified into the remnant biofilms covering the abutments were representative of the commensal oral microbiota including Aggregatibacter actinomycetemcomitans, Prevotella intermedia, and Enterococcus faecalis. CONCLUSION: Although some healing abutments did not reveal the existence of bacteria, organic components from biofilm biomass are still strongly adhered on the retentive micro-regions and surfaces of abutments and therefore that would support the accumulation of biofilm including pathogenic species leading to patients' cross-infections. Further studies should be performed on the assessment of different materials, design, and connections of the healing abutments associated with clinical disinfection procedures in implant dentistry. ispartof: JOURNAL OF PERIODONTAL RESEARCH vol:56 issue:2 pages:415-422 ispartof: location:United States status: published

In the last years, several materials and design have been assessed in an attempt to improve the mechanical performance of temporomandibular joint total joint replacement (TMJ TJR) prostheses. However, the wear of the TMJ TJR condyle to the polymer-based fossa component during loading and sliding movements. That promotes the release of debris and risks of toxicity to the surrounding tissues. The purpose of this study was to perform a narrative literature review on the wear of TMJ TJR sliding contacts and potential toxicity of metallic debris to the patients. Previous studies reported a significant deterioration of the sliding contact surfaces of TMJ TJR prostheses. Material loss as a result of wear can cause a TMJ TJR condyle/fossa mismatch and the modification of the contact pressure and chewing loading. As a further consequence of wear, metal particles are released to the surrounding tissues with a high risk of local tissue and systemic toxicity through the bloodstream. The presence of particles induces the stimulation of inflammatory reactions depending on the concentration and size of debris. Thus, CoCr-based condyle release metallic ions and sub-micron particles that can be engulfed by macrophages or internalized by other tissue cells. The wear and material loss of TMJ TJR could be decreased by design optimization and novel materials with low friction and contact pressure. That consequently decrease the amount of metallic ions and particles to the surrounding tissues, preventing peri-prosthetic inflammatory reactions., This study was supported by FCT-Portugal (UID/EEA/04436/2013, NORTE-01-0145- FEDER-000018—HAMaBICo, POCI-01-0145-FEDER-031035_LaserMULTICER), SFRH/BPD/123769/ 2016 and CNPq-Brazil (CNPq/UNIVERSAL/421229/2018-7).

The main aim of this study was to perform an integrative review on the release of bisphenol A (BPA) from resin-matrix composites and potential toxic effects. A bibliographic search was performed on the PubMed platform using the following keywords: "Bisphenol A" OR "BPA" AND "resin composite" OR "composite resin" AND "toxicity" OR "cytotoxicity" OR "release". Inclusion criteria involved in vitro and in vivo studies on the release and toxicity of BPA. Results highlighted the release of BPA from resin-matrix composites due to insufficient polymerization and/or degradation of the polymeric matrix. BPA is part of the organic matrix of resin-matrix composites and may be hydrolysed in human saliva, although studies report that low doses might not be detected by traditional chemical analysis. Studies exposing zebrafish embryos to different concentrations of Bis-GMA, showed 55% mortality at 10 μM Bis-GMA while 30% mortality was recorded at 1 μM Bis-GMA. In patients, a BPA concentration of around 2.09 × 10-2 μg/ml was found in the saliva after placement of lingual orthodontic retainers with resin-matrix composites. Also, the BPA molecule can be swallowed and absorbed by the oral/gastrointestinal mucosa, which might result in systemic toxicity. The degradation of resin-matrix composites and release of BPA in oral environment are dependent on the organic matrix content and on the polymerization method. A increased release of BPA can lead to the absorption into oral and gastrointestinal mucosa with high risks of local and systemic toxicity.

Objective: The aim of the present study was to perform an integrative systematic review on the stress distribution assessed by finite element analysis on dental implants or abutments composed of carbon fiber-reinforced PEEK composites.Method: An electronic search was performed on PUBMED and ScienceDirect using a combination of the following search terms: PEEK, Polyetheretherketone, FEA, FEM, Finite element, Stress, Dental implant and Dental abutment.Results: The findings reported mechanical properties and the stress distribution through implant and abutment composed of PEEK and its fiber-reinforced composites. Unfilled PEEK revealed low values of elastic modulus and strength that negatively affected the stress distribution through the abutment and implant towards to the bone tisues. The incorporation of 30% carbon fibers increased the elastic modulus and strength of the PEEK-matrix composites although some studies reported no statistic differences in stress magnitude when compared to unfilled PEEK. However, an increase in short carbon fibers up to 60% revealed an enhancement on the stress distribution through abutment and implants towards to the bone tissues. PEEK veneering onto titanium core structures can also be a strategy to control the stress distribution at the implant-to-bone interface.Conclusions: The stiffness and strength of PEEK-matrix composites can be increased by the improvement of the carbon fibers' network. Thus, the content, shape, dimensions, and chemical composition of fibers are key factors to improve the stress distribution through abutment and implants composed of PEEK-matrix composites.

Objectives The aim of this work was to evaluate the biomechanical behavior of one-piece zirconia implants with a functionally graded bioglass (BG) layer as compared to monolithic zirconia and BG-coated implants, using the finite element method (FEM). Methods Zirconia disks were infiltrated with bioglass S53P4 and then morphologically inspected by scanning electron microscopy (SEM) followed by mechanical analyses on micro-indentation tests for further biomechanical validation using the finite element method (FEM). On modeling, zirconia dental implants anchored into mandibular bone were simulated on occlusal loading as recorded under mastication. Three types of implants were simulated: i) free of BG coating, ii) with 100 μm or 150 μm thick conventional BG coatings; and iii) with graded BG coatings involving 3 different chemical composition distributions. The stress state at both implant and bone were evaluated using the FEM. The mechanically-induced bone remodelling was analyzed through the bone strain results. Results Infiltration of BG into a zirconia structure resulted in a ∼100 μm thick layer with an exponential-like gradation of chemical composition and properties. Regarding the FEM calculations, the BG coating induced up to 30% decrease on stress in the implant body when compared to the monolithic zirconia implant. The gradient of chemical composition also improved the stresses’ distribution. The stresses distribution towards the BG-coatings were significantly high and could lead to failure. Stresses on the bone were recorded down to its strength threshold, with insignificant influence of the coating layer. The bone strain values on all models indicates further bone remodelling although BG-coated and BG-graded zirconia implants showed the highest strain magnitude that may enhance the mechanical stimulation for bone maintenance. Significance Graded BG-zirconia dental implants showed enhanced overall biomechanical behaviour as compared to the BG-coated or monolithic zirconia dental implants. Also, such biomechanical improvements noticed for the BG-graded system should be considered in combination with the well-known osseointegration benefits of bioactive glasses.

PURPOSE: The aim of this study was to evaluate the influence of different density and amplitude of electric current on the percentage of bone-implant contact (BIC) using the finite element method. MATERIALS AND METHODS: Numerical models were performed on commercially pure titanium grade IV implants connected to a 1.5 V battery with an electrical resistance (R) at 150 kΩ on 10 µA or at 75 kΩ on 20 µA. The percentage of simulated BIC was analysed by varying the electric current from 1 up to 60 µA. The variation of electric current application was simulated for coronal and apical peri-implant regions. RESULTS: The findings showed that a direct and constant electric current source below 10 μA does not provide a proper current density for osseointegration (BIC < 55%). Electric current sources ranging from 10 to 20 μA resulted in an increase in BIC above 60% while BIC reached 90% on 30 to 40 μA. Also, the application of the current source on 20 μA at the apical peri-implant region resulted in a high BIC percentage at around 86.1%. CONCLUSIONS: The location and intensity of the electrical current source can increase the resultant electrical current density at the implant-bone interface and enhance the bone healing process. Although the model is a simplified version of the biological process in the bone-implant interface, such findings can predict a magnitude of electrical current density required to stimulate osseointegration. ispartof: COMPUTER METHODS IN BIOMECHANICS AND BIOMEDICAL ENGINEERING vol:23 issue:14 pages:1041-1051 ispartof: location:England status: published

Bonding strategies within different brackets and dental materials are still a challenge concerning adhesion and dental surface damage. This study compared the shear and tensile bond strength of orthodontic ceramic and metallic brackets to enamel, acrylic, and ceramic surfaces after thermal cycling. Dental surfaces were divided into three groups: enamel, ceramic, and acrylic. Each group received stainless-steel and ceramic brackets. After thermal cycling, specimens were randomly divided into two subgroups considering tensile (TBS) or shear bond strength (SBS) test. After the mechanical testing, scanning electron and optical microscopy were performed, and the adhesive remnant index (ARI) was determined. The two-way ANOVA full factorial design was used to compare TBS, SBS, and ARI on the surface and bracket type (&alpha, = 0.05). There were significant differences in TBS, SBS, and ARI values per surface (p &lt, 0.001 and p = 0.009) and type of bracket (p = 0.025 and p = 0.001). The highest mean SBS values were recorded for a ceramic bracket bonded to an acrylic surface (8.4 &plusmn, 2.3 MPa). For TBS, a ceramic bracket bonded to acrylic showed the worst performance (5.2 &plusmn, 1.8 MPa) and the highest values were found on a metallic bracket bonded to enamel. The adhesion of metallic or ceramic brackets is enough for clinical practice although the damage of the enamel surface after debonding is irreversible and harmful for the aesthetic outcome of the teeth.

The main aim of this work was to perform a comprehensive review of findings reported by previous studies on the corrosion of titanium dental implants and consequent clinical detrimental effects to the patients. Most studies were performed by in vitro electrochemical tests and complemented with microscopic techniques to evaluate the corrosion behavior of the protective passive oxide film layer, namely TiO2. Results revealed that bacterial accumulation, dietary, inflammation, infection, and therapeutic solutions decrease the pH of the oral environment leading to the corrosion of titanium. Some therapeutic products used as mouthwash negatively affect the corrosion behavior of the titanium oxide film and promote changes on the implant surface. In addition, toothpaste and bleaching agents, can amplify the chemical reactivity of titanium since fluor ions interacting with the titanium oxide film. Furthermore, the number of in vivo studies is limited although corrosion signs have been found in retrieved implants. Histological evaluation revealed titanium macro- and micro-scale particles on the peri-implant tissues. As a consequence, progressive damage of the dental implants and the evolution of inflammatory reactions depend on the size, chemical composition, and concentration of submicron- and nanoparticles in the surrounding tissues and internalized by the cells. In fact, the damage of the implant surfaces results in the loss of material that compromises the implant surfaces, implant-abutment connections, and the interaction with soft tissues. The corrosion can be an initial trigger point for the development of biological or mechanical failures in dental implants., This study was supported by FCT-Portugal (UID/EEA/04436/2013, NORTE-01-0145-FEDER- 000018– HAMaBICo, POCI-01-0145-FEDER-031035_LaserMULTICER) and CNPq-Brazil (CNPq/UNIVERSAL/421229/2018-7)

The aim of this study was to characterize the mechanical properties of a bioactive-modified polyetheretherketone (PEEK) manufacturing approach for dental implants and to compare the in vitro biological behavior with titanium alloy (Ti6Al4V) as the reference. PEEK, PEEK with 5% hydroxyapatite (HA), PEEK with 5% beta-tricalcium phosphate (βTCP), and Ti6Al4V discs were produced using hot pressing technology to create a functionally graded material (FGM). Surface roughness values (Ra, Rz), water contact angle, shear bond strength, and Vickers hardness tests were performed. Human osteoblasts and gingival fibroblasts bioactivity was evaluated by a resazurin-based method, alkaline phosphatase activity (ALP), and confocal laser scanning microscopy (CLSM) images of fluorescent-stained fibroblasts. Morphology and cellular adhesion were confirmed using field emission gun-scanning electron microscopy (FEG-SEM). Group comparisons were tested using analysis of variance (Tukey post hoc test), α = .05. All groups presented similar roughness values (P > .05). Ti6Al4V group was found to have the highest contact angle (P < .05). Shear bond strength and Vickers hardness of different PEEK materials were similar (P > .05); however, the mean values in the Ti6Al4V group were significantly higher when compared with those of the other groups (P < .05). Cell viability and proliferation of osteoblast and fibroblast cells were higher in the PEEK group (P < .05). PEEK-βTCP showed the highest significant ALP activity over time (P < .05 at 14 days of culture). An enhanced bone and soft-tissue cell behavior on pure PEEK was obtained to the gold standard (Ti6Al4V) with equivalent roughness. The results substantiate the potential role of chemical composition rather than physical properties of materials in biological responses. The addition of 5% HA or βTCP by FGM did not enhance PEEK mechanical properties or periodontal cell behavior.

Statement of problem How processing by computer-aided design and computer-aided manufacturing (CAD-CAM) or traditional chairside fabrication techniques affects the presence of defects and the mechanical properties of interim dental prostheses is unclear. Purpose The purpose of this in vitro study was to compare the effects of CAD-CAM versus traditional chairside material processing on the fracture and biomechanical behavior of 4-unit interim prostheses with and without a cantilever. Material and methods Two types of 4-unit interim prostheses were fabricated with abutments on the first premolar and first mandibular molar, one from a prefabricated CAD-CAM block and one with a traditional chairside polymer-monomer autopolymerizing acrylic resin (n=10). Both groups were assessed by compressive strength testing and additionally with or without a cantilevered second molar by using a universal testing machine with a 5-kN load cell. A finite element model (FEM) was built by scanning both prosthesis designs. Finite element analysis (FEA) replicated the experimental conditions to evaluate the stress distribution through the prostheses. Results Interim fixed prostheses manufactured by CAD-CAM showed significantly higher mean fracture loading values (3126 N to 3136 N) than for conventionally made interim fixed prostheses (1287 N to 1390 N) (P=.001). The presence of a cantilever decreased the fracture loading mean values for CAD-CAM (1954 N to 2649 N), although the cantilever did not influence the traditional prostheses (1268 N to 1634 N). The highest von Mises stresses were recorded by FEA on the occlusal surface, with the cantilever design, and at the transition region (connector) between the prosthetic teeth. Conclusions Interim partial prostheses produced by CAD-CAM had a higher strength than those manufactured traditionally. The presence of a cantilever negatively affected the strength of the prostheses, although the structures manufactured by CAD-CAM still revealed high strength and homogenous stress distribution on occlusal loading.

Sulfonated PEEK (sPEEK) has been developed for drug delivery although there is still scarce evidence on its physicochemical and biological properties. The main aim of this study was to assess the cytotoxicity behavior of sPEEK processed for two different sulphonation times. PEEK was functionalized by sulphuric acid treatment for 1 or 1.5 h and then dissolved in dimethylsulfoxide (DMSO). The specimens were characterized by chemical, microstructural, thermophysical, hydrophobic, and roughness analysis. Cytotoxicity assays with fibroblasts followed ISO 10993-5. Thermophysical analyses by TGA and NMR revealed no statistical difference (p > 0,05) in the degree of sulphonation for both processing time points although chemical modifications were detected in the main polymer chain. PEEK surfaces were more hydrophilic than sPEEK surfaces and therefore biological assays revealed a higher cell proliferation on PEEK surfaces when compared to that recorded on sPEEK surfaces. Fibroblasts revealed a higher metabolic activity on PEEK than that on sPEEK specimens for 1 and 3 days of incubation. However, there was a significant increase in cell metabolic activity on sPEEK/DMSO of about 20% compared to that recorded on PEEK for 7 days of incubation. SPEEK specimens showed a limited cytocompatibility probably due to the release of sulfonic compounds to the surrounding medium. The sulphonation method should be adjusted considering different processing time and surface treatment to achieve a high biocompatibility performance of sPEEK for biomedical applications.

Objective The objective of this study was to evaluate the combined effect of the sulfuric acid etching and an acidic adhesive conditioning on the shear bond strength of PEEK to a resin-matrix composite. Materials and methods Forty PEEK specimens were assigned randomly to 4 groups for H2SO4 etching followed by universal adhesive (pH at 2.5) conditioning for 0, 1, 3, and 5 min. Thirty PEEK specimens were divided into 3 groups for only acidic adhesive conditioning for 0, 1, 3, and 5 min. After the light-curing of the adhesive, a nanohybrid resin composite was applied onto the surfaces and then light-cured following the manufacturer`s guidelines. All specimens were stored in distilled water at 37 °C for 24 h mechanical testing. Shear bond strength tests were performed using a universal testing machine. Surfaces were analyzed by SEM, light interferometry, FTIR, and liquid contact angle measurement. Statistical analysis was performed by one-way ANOVA and Tukey’s post hoc tests (p Results No adhesion was achieved between untreated PEEK a resin-matrix composite, regardless of the adhesive conditioning time points. Shear bond strength of H2SO4-etched PEEK to resin-matrix composite increased with time (0 mmin. 4.95 ± 2.86 MPa Significance The acidic adhesive was unable to modify the untreated PEEK surface to establish an effective adhesion although a synergistic effect was noticed when the universal (acidic) adhesive was applied over a H2SO4-etched PEEK surface, thus improving the PEEK to resin-matrix composite adhesion.

Conversely to natural teeth, where periodontal ligament (PDL) and pulp works as a damper reducing the effect of the stress on surrounding structures, when natural teeth is lost and replaced or restored the biting forces are directly transmitted to the bone or affect the integrity of the adjacent bottom layers. In this study, damping capacity and dynamic Young's modulus of CoCrMo-porcelain composites for dental restorations were evaluated. Dynamic Young's modulus and damping capacity of materials were assessed by dynamic mechanical analyzes (DMA) at 1 and 10 Hz frequencies, over a temperature ranging (18–60 °C). Results show that by reinforcing dental porcelain with metallic particles, producing ceramic matrix composites (CMCs) with 20 vol% and 40 vol% of metallic particles, the damping capacity and dynamic Young's modulus are improved. A decrease on both properties of the metal matrix composites (MMCs) with increasing ceramic particles content (from 20 vol% to 40 vol% of ceramic phase) was observed for all the studied frequencies and temperatures. While damping capacity is strongly dependent on frequency, no significant difference in dynamic Young's modulus was found. Results show that besides the yet reported advantages of the bio-inspired functionally graded restorations over traditional bilaminate ones, traduced by improved veneer to substrate adhesion and by the enhanced thermal and mechanical stress distribution, these restorations can also display improved behavior as regard to a damping capacity, which may have a positive impact in the long-term performance of implant – supported prosthesis.

Objective The aim of this study was to evaluate surface changes on dental implant systems and ions release after immersion in fluoride and hydrogen peroxide. Methods Ten implant-abutment assemblies were embedded in acrylic resin and cross-sectioned along the implant vertical axis. Samples were wet ground and polished. Delimited areas of groups of samples were immersed in 1.23% sodium fluoride gel (F) or in 35% hydrogen peroxide (HP) for 16 min. Gels (n = 3) were collected from the implant surfaces and analyzed by inductively coupled plasma mass spectrometry (ICP-MS), to detect the concentration of metallic ions released from the implant systems. Selected areas of the abutment and implant (n = 15) were analyzed by atomic force microscopy (AFM) and scanning electron microscopy (SEM). Results SEM images revealed surface topographic changes on implant-abutment joints after immersion in fluoride. Implants showed excessive oxidation within loss of material, while abutment surfaces revealed intergranular corrosion after immersion in fluoride. ICP-MS results revealed a high concentration of Ti, Al, V ions in fluoride after contact with the implant systems. Localized corrosion of implant systems could not be detected by SEM after immersion in hydrogen peroxide although the profilometry showed increase in roughness. ICP-MS showed the release of metallic ions in hydrogen peroxide medium after contact with dental implants. Conclusion Therapeutical substances such as fluorides and hydrogen peroxide can promote the degradation of titanium-based dental implant and abutments leading to the release of toxic ions.

The main aim of this study was to evaluate the physicochemical and biological behavior of (LZS) lithium-zirconium and (LZSA) lithium-zirconium-alumina silicate glass-ceramics. LZS and LZSA silicate glass-ceramics were produced from commercial raw materials by melting (1550 °C/2 h) followed by water-cooling casting. The obtained glass frits were milled by a two-step process (dry and wet milling) up to achieve 5–10 μm particles. The milled powder was uniaxially pressed (50 MPa) and later fired at 900 °C/2 h (LZS) and at 850 °C/2 h (LZSA). Specimens were characterized by physical, chemical, thermal, and cell culture assays. Crystalline phases such ZrSiO4 and residual quartz and lithium metasilicate (Li2SiO3) was found in the LZS group microstructure while LZSA showed a mixture of ZrSiO4 and β-spodumene (LiAlSi2O6). Materials showed different thermal behavior and mechanical properties. LZS silicate glass ceramics revealed higher fracture toughness and Young's modulus values than those recorded for LZSA silicate glass-ceramics. A higher percentage of osteoblast cell proliferation and mineralization was detected on LZS surfaces when compared to LZSA surfaces. The chemical composition, microstructure, thermal behavior, and mechanical strength of LZS and LZSA silicate glass-ceramic can be adjusted for manufacturing of prosthetic structures for oral rehabilitation. Also, the interaction of glass-ceramics with human cells and tissues can be enhanced by increasing the content of bioactive ceramic materials such as silica or by adding additional bioactive compounds such as beta-tricalcium phosphate.

Different zirconia porous layers were produced on zirconia dense zirconia substrates by slip casting using powder with different mean sizes: 40 μm (Z40), 70 μm (Z70), and 100 μm (Z100). The dynamic and static coefficients of friction against bovine femoral bone, mimicking the implantation process, were conducted using a ball-on-flat reciprocating sliding tribometer under 3 N of normal load. Additionally, the porous layers were assessed with regard to their low temperature degradation (aging). Results revealed that the porous layers were able to keep their integrity during the sliding testes against bone, with no zirconia particles being transferred to the bone. Results did not show significant differences (p > 0.05) in kinetic and static COF values for Z40, Z70, Z100, and GRAD specimens, ranging from 0.53 to 0.77 and 0.65 to 0.90, respectively. The aging tests revealed that all surfaces were prone to low temperature degradation (~49% of monoclinic content after 18 h). In conclusion, the cohesive integrity of the layers and relatively high COF observed reveled that zirconia porous layers may be considered for replacing the current implant surfaces, and are expected to improve their primary stability. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1113-1121, 2019.

The purpose of the present study was to evaluate the distribution and magnitude of stresses through the bone tissue surrounding Morse taper dental implants at different positioning relative to the bone crest.A mandibular bone model was obtained from a computed tomography scan. A three-dimensional (3D) model of Morse taper implant-abutment systems placed at the bone crest (equicrestal) and 2 mm bellow the bone crest (subcrestal) were assessed by finite element analysis (FEA). FEA was carried out on axial and oblique (45°) loading at 150 N relatively to the central axis of the implant. The von Mises stresses were analysed considering magnitude and volume of affected peri-implant bone.On vertical loading, maximum von Mises stresses were recorded at 6-7 MPa for trabecular bone while values ranging from 73 up to 118 MPa were recorded for cortical bone. On oblique loading at the equiquestral or subcrestal positioning, the maximum von Mises stresses ranged from 15 to 21 MPa for trabecular bone while values at 150 MPa were recorded for the cortical bone. On vertical loading,99.9vol.% cortical bone volume was subjected to a maximum of 2 MPa while von Mises stress values at 15 MPa were recorded for trabecular bone. On oblique loading,99.9vol.% trabecular bone volume was subjected to maximum stress values at 5 MPa, while von Mises stress values at 35 MPa were recorded for99.4vol.% cortical bone.Bone volume-based stress analysis revealed that most of the bone volume (99% by vol) was subjected to significantly lower stress values around Morse taper implants placed at equicrestal or subcrestal positioning. Such analysis is commentary to the ordinary biomechanical assessment of dental implants concerning the stress distribution through peri-implant sites.

The interest in zirconia as an excellent technical material is growing for a huge field of engineering and research applications, where some of them include rough and/or porous surfaces. Nevertheless, the wear resistance of yttria-stabilized zirconia coated with a porous layer is poorly documented. The aim of this work was to produce porous layers (powder with different average sizes – 40 μm, 70 μm, 100 μm) over a dense zirconia substrate and assess their tribological behaviour against an Al2O3 ball. The porous layers were removed from the substrate during the wear tests. No significant differences were found for the coefficient of friction and the wear rate of the different groups (p > 0.05).

Bioactive ceramic coatings have been proposed to improve the bioactivity of zirconia although the coating detachment can occur during implant placement. The main aim of this study was to enhance bioactivity and strength of the implant surface by using a gradated bioactive zirconia structure. Zirconia discs (8 × 3 mm) embedding gradual content of hydroxyapatite (YTZP-HA) or beta-tricalcium phosphate (YTZP-βTCP) were produced by hot-pressing technique. Specimens were initially studied regarding hardness, roughness, wettability, and shear bond strength of the gradated zone. Functionally gradated ceramic discs and zirconia (control group) were placed in contact with human osteoblast culture for 1, 3, 7, and 14 days. Field emission guns scanning electron microscopy (FEGSEM) was used to assess the morphology and adhesion of osteoblasts while cell viability was assessed by fluorometric method. The mineralization on the test and control discs was evaluated by Alkaline phosphatase (ALP) activity and fluorescent microscopy. Shear strength mean values of the outer layer bioactive ceramic and zirconia bulk were recorded at 150 MPa. Mechanical assays demonstrated that the novel design and manufacturing approach proposed for producing gradated zirconia embedding bioactive ceramics resulted in significantly higher mechanical strength as compared to monolithic zirconia. Also, cell viability and ALP levels increased on gradated zirconia containing HA or βTCP over time. Gradated zirconia containing hydroxyapatite revealed an increased viability, bioactivity, and mineralization of human osteoblasts when compared to conventional zirconia surface, without substantial loss of strength.

The aim of this study was to conduct a literature review on the potential benefits of custom-made root-analogue zirconia implants. A PubMed and ScienceDirect bibliographical search was carried out from 1969 to 2017. The increased interest in zirconia-based dental structures linked to aesthetic and biological outcomes have been reported in literature. Recent technological advances have focused on novel strategies for modification of zirconia-based surfaces to accelerate osseointegration. However, only a few studies revealed mechanical and biological benefits of custom-made root-analogue zirconia implants and therefore further studies should investigate the influence of different design and surface modification on the performance of such implants. Custom-made root-analogue zirconia implants have become a viable alternative to overcome limitations concerning stress distribution, aesthetics, and peri-implantitis induced by biofilms. However, further in vitro and in vivo studies on surface-bone interactions and mechanical behavior of zirconia should be evaluated to reduce clinical issues regarding mechanical failures and late peri-implant bone loss. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2888-2900, 2018.

The aim of this study was to perform a literature review on the use of finite element modeling (FEM) for the evaluation of the biomechanical behavior of temporomandibular joint replacement (TMJR) devices. An electronic search of online medical and scientific literature database was conducted using selected search terms. The search identified 307 studies, of which 19 were considered relevant to this study. Of the 19 selected studies, 10 (52.6%) investigated the influence of geometry and fixation methods, while two (10.5%) evaluated the behavior of artificial condyle-fossa structures. The TMJR devices assessed in these studies included TMJ Inc. (aka Christensen; 63.2%), Zimmer Biomet (15.7%), Stryker (10.5%), and a theoretical intramedullary condylar component (5.3%); 26.3% of the studies evaluated custom TMJR devices. Such studies provided important data on the distribution of strain and stress through TMJR structural components and surrounding bone by using different software systems and methods. The mean stress values were lower on a custom TMJR condyle-ramus component and the supporting bone than on the stock device. FEM proved to be an accurate and valuable biomechanical simulation tool for studying the current TMJR devices and should be considered a useful tool for the improvement and development of future joint replacement devices.

Zirconia structures with controlled surface porosity may be used in several biomedical and engineering applications. This work aimed at developing a processing route for the production of zirconia structures with porous surfaces, using the dip coating method and without pore forming additives. Zirconia powders (~ 40 µm diameter) were used in the dip coating suspensions in three different forms: agglomerates (as received), pre-sintered (1150 °C, 1 h) and sintered (1500 °C, 2 h). The addition of fine particles (

Objectives The aim of the present study was to evaluate the blood cell content, morphological aspects, gene expression of type I collagen, and release of growth factors on an injectable platelet rich fibrin (i-PRF). Materials and methods Blood samples were collected from 15 volunteers to prepare i-PRF samples. Peripheral blood was used as a control group. Blood clot and i-PRF samples were cultured for 10 days. The supernatant of the samples was collected for ELISA immunoassay quantification of PDGF and VEGF growth factors over periods of 1, 8, 24, 72, and 240 h. I-PRF and blood clot samples were biologically characterized using histological and immunohistochemistry analysis for IL-10, osteocalcin, and TGF-β. Scanning electron microscopy (SEM) was used to inspect the fibrin network and distribution of blood platelets and leukocytes. Reverse transcriptase polymerase chain reaction (RT-PCR) method was used to evaluate gene expression for type I collagen. Results A higher concentration of platelets and lymphocytes was recorded in i-PRF than in peripheral blood (p < 0.05). The release of VEGF was higher in blood clot samples (1933 ± 704) than that for i-PRF (852 ± 376; p < 0.001). Immunohistochemistry showed upregulation of TGF-B, IL-10, and osteocalcin in the i-PRF group. RT-PCR showed increased type I collagen gene expression in i-PRF (p < 0.05). SEM images revealed agglomeration of platelets in some regions, while a fibrin networking was noticeable in the entire i-PRF sample. Conclusions Injectable platelet rich fibrin becomes a good approach for soft and mineralized tissue healing considering the formation of a three-dimensional fibrin network embedding platelets, leukocytes, type I collagen, osteocalcin, and growth factors. Indeed, the injectable platelet rich fibrin can be indicated in several medical applications regarding bioactivity, simplied technique, and flowable mixing with other biomaterials. Clinical relevance Morphological, cell, and protein characterization of platelet rich fibrin provides a better understanding of the clinical effects and improvement of clinical guidelines for several medical applications. Once well physicochemical and biologically characterized, the use of an injectable platelet rich fibrin can be extended to other applications in the field of orthopedics, periodontics, and implant dentistry on the repairing process of both soft and mineralized tissues

The purpose of this study was to evaluate the mechanical properties of laser printed monolithic and laminated nano ceramic resins (NCR) for dental prosthetic applications. Three different types of discs were produced by laser printing: monolithic NCR discs and laminated NCR discs with 100 μm (laminate_100) and 500 μm (laminate_500) resin interlayers (n = 10). To assess the adhesion strength of the photosensitive resin used as interlayer to the NCR, cylindrical specimens were produced. The biaxial flexural strength and shear bond strength of the specimens were measured using a universal testing machine. Data was statistically analyzed by one-way ANOVA followed by Tukey HSD test (α = 0.05). The microstructure and fracture surfaces were analyzed by SEM/EDS. Results were rationalized with finite element analysis (FEA). Laminate_100 specimens showed significantly higher flexural strength (∼50%) than monolithic and Laminate_500 specimens (p

The aim of this study was to analyze the osteogenic cell behavior on the surface of novel functionally graded titanium-based composites containing bioactive ceramics. Titanium grade V discs (8 × 3 mm) embedding gradual content of hydroxyapatite (TiAlV-HA) or beta-tricalcium phosphate (TiAlV-βTCP) were produced by hot-pressing technique. Titanium-ceramic composite discs and Ti grade V (control group) were placed in contact with human osteoblast culture assays. The morphology and adhesion of osteoblasts were inspected by field emission guns scanning electron microscopy (FEGSEM) while cell viability was assessed by fluorometric method. Alkaline phosphatase (ALP) activity and fluorescent microscopic analyses were used to evaluate mineralization on the test and control discs. FEGSEM images showed cells adhered to Ti6Al4V-ceramic and Ti6Al4V surfaces over a period of 24 h, and therefore, an intense proliferation of osteoblasts and spreading cells was noticed for 7 days. Cell viability increased with time on all the surfaces although TiAlV-βTCP revealed significant higher percentage of cell viability than that recorded for TiAlV-HA (p < 0.01). TiAlV-βTCP also showed the highest hydrophilic character. ALP levels increased on the Ti6Al4V-ceramic surfaces when compared to the control group. Also, a qualitative analysis of mineralization evidenced an increase in mineral content on TiAlV-HA or TiAlV-βTCP groups. Novel functionally graded composites based on Ti grade V and hydroxyapatite or βTCP showed a higher bioactivity in presence of osteoblasts than that recorded on Ti grade V. Also, such functionally graded materials can prevent risks of failures by detachment of bioactive ceramic materials during implant placement. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 1923-1931, 2018.

The aim of this study was to evaluate the chemical reactivity of 58S mesoporous bioactive glass (MBG) particles in as-synthesized condition and after embedding propolis and cranberry antibiofilm compounds at different concentrations. MBG 58S was synthesized by alkali sol-gel method with the addition of the triblock pluronic copolymer P123 as surfactant. Samples were characterized by physicochemical properties measurement, N2 adsorption/desorption analysis, and field emission gun scanning electron microscopy (FEGSEM) observations. MBG powders were immersed into 5 and 10 µg/mL propolis or cranberry solutions for 24 h. The chemical reactivity of the specimens was evaluated by FEGSEM, EDX, FTIR, Ca/P ratio, XRD, and sample weight gain analysis after being immersed in simulated body fluid (SBF) for 8, 24, and 72 h. MBG particles exhibited the expected chemical composition with a particle size distribution ranging from 1.44 to 955 µm, and a mean particle size of 154 µm. MBG particles exhibited a pore volume of 0.8 cc/g, pore radius of ∼2 nm, and surface area of 350.2 m2 /g, according to BJH and BET analyses. A hydroxyl-carbonate apatite (HCAp) layer was formed on all samples after SBF immersion for 72 h. Pure MBG showed the highest chemical reactivity after 72 h, with the resulting apatite layer exhibiting a Ca/P ratio of ∼1.6 in accordance to stoichiometric biological apatite. MBG embedding propolis and cranberry can be considered for future microbiological analysis since the presence of propolis or cranberry did not interfere with MBG's ability to develop a HCAp layer, which is an essential feature for bone regeneration applications. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 1614-1625, 2018.

Objective: The purpose of this study was to investigate Morse taper implant-abutment joints by chemical, mechanical, and microscopic analysis.Materials and Methods: Surfaces of 10 Morse taper implants and the correlated abutments were inspected by field emission gun-scanning electron microscopy (FEG-SEM) before connection. The implant-abutment connections were tightened at 32 Ncm. For microgap evaluation by FEG-SEM, the systems were embedded in epoxy resin and cross-sectioned at a perpendicular plane of the implant-abutment joint. Furthermore, nanoindentation tests and chemical analysis were performed at the implant-abutment joints.Statistics: Results were statistically analyzed via one-way analysis of variance, with a significance level of P < 0.05.Results: Defects were noticed on different areas of the abutment surfaces. The minimum and maximum size of microgaps ranged from 0.5 μm up to 5.6 μm. Furthermore, defects were detected throughout the implant-abutment joint that can, ultimately, affect the microgap size after connection. Nanoindentation tests revealed a higher hardness (4.2 ± 0.4 GPa) for abutment composed of Ti6Al4V alloy when compared to implant composed of commercially pure Grade 4 titanium (3.2 ± 0.4 GPa).Conclusions: Surface defects produced during the machining of both implants and abutments can increase the size of microgaps and promote a misfit of implant-abutment joints. In addition, the mismatch in mechanical properties between abutment and implant can promote the wear of surfaces, affecting the size of microgaps and consequently the performance of the joints during mastication.

Sealing the occlusal pits and fissures of molars and premolars is considered an effective therapy for the prevention of dental caries. However, such sealants have limited wear resistance, resulting in surface damage and sealant volume loss. The purpose of this study was to perform an integrative review of the literature on wear pathways of current tooth occlusal fissure sealants. A scoping review of the literature was performed based on database search (Medline/PubMed) using the following combination of key terms: “occlusal fissure sealant” OR “fissure sealant” OR “pit sealant” AND “degradation” OR “wear” OR “erosion” OR “aging”. The inclusion criteria involved articles published in the English language within the last 20 years on the dominant degradation mechanisms of occlusal sealant fissures. The literature search identified a total of 228 articles and then 21 studies were selected considering the scope of this study. Studies revealed a detrimental effect of acidic conditions on the wear of tooth occlusal fissure sealants. The corrosion effect of such acidic medium was higher on glass-ionomer materials when compared to resin-matrix composite sealants. Additionally, the content, size, and type of fillers in the materials affected their wear resistance. Unfilled sealants showed a higher damage by wear than filled sealants. An increase in fillers' size induced an increased wear rate while a decrease in the fillers' content exposed the organic matrix of the fissure sealant to the acidic medium and occlusal loading. The wear of resin-matrix sealants depends on the size, shape, volume, type of filler particles, filler content, the organic matrix type, and distance between the particles exposing the organic matrix.

The aim of this study was to perform an integrative review of the literature on the clinically usual prosthesis-abutment misfit over implant-supported structures manufactured by conventional casting technique. The present integrative review used the PRISMA methodology. A bibliographical search was conducted on the following electronic databases: MEDLINE/PubMed (National Library of Medicine), Scopus (Elsevier), ScienceDirect (Elsevier), Web of Science (Thomson Reuters Scientific), Latin American and Caribbean Center on Health Sciences Information (BIREME), and Virtual Health Library (BVS). A total of 11 relevant studies were selected for qualitative analysis. The prosthetic-abutment vertical misfit considered clinically usual ranged from 50 to 160 μm. The vertical misfit depends on several steps during technical manufacturing techniques, which includes the materials and technical procedures. Lower values in misfit are recorded when precious metal or titanium alloys are utilized. Although a vertical misfit mean value of 100 μm has been considered clinically usual, most of the previous studies included in this revision showed lower mean values.

Objectives: After tooth loss, dimensional alterations on the alveolar bone ridge can occur that can negatively affect the placement of dental implants. The purpose of this study was to evaluate the synthesis, and mechanical properties of β-tricalcium phosphate (β-TCP) scaffolds coated with bioabsorbable polymers, namely, collagen and poly (D, L-lactic acid) (PDLLA). Materials and Methods: β-TCP powder was obtained by reactive milling and then characterized by X-ray diffraction and scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM/EDS). β-TCP scaffolds were obtained by replica method, in which polyurethane foams are immersed in β-TCP suspension and thereafter submitted to a thermal treatment to remove the polyurethane and sinter the ceramic. Type-I collagen or PDLLA were used to coat the β-TCP scaffolds by dip-coating method. Scaffolds were separated in four groups depending on the coating material: noncoated (Group A), double immersion in collagen (Group B), double immersion in PDLLA (Group C), and ten immersions in PDLLA (Group D). Samples were characterized by compressive tests and SEM/EDS. Data were statistically analyzed through two-way ANOVA (p = 0.05). Results: Chemical and microscopic analyses revealed proper morphology and chemical composition of powder particles and scaffolds with or without polymeric coatings. Scaffolds coated with PDLLA showed higher compressive strength (0.11 ± 0.054 MPa) than those of collagen (0.022 ± 0.012 MPa) or noncoated groups (0.024 ± 0.012 MPa). Conclusions: The coating method of β-TCP with PDLLA revealed a potential strategy to increase the mechanical strength of porous ceramic materials while collagen can enhance cell migration.