Biocompatibility of dental alloys used in dental fixed prosthodontics

Comparative analysis of cytotoxicity effects of two denture hard lining materials on human gingival fibroblasts: an in vitro study

Background

The objective of this study was to compare the cytotoxicity of TDV and Rebase II denture hard liners on human gingival fibroblasts, aiming to address issues associated with incomplete polymerization and free monomers that affect material properties.

Methods

Seventy-two specimens (24 each of TDV, Rebase II, and controls) were prepared under aseptic conditions according to factory instructions. Cytotoxicity was determined using the MTT test with methyl tetrazolium salt added to the cell culture medium. A two-way ANOVA and a post-hoc Tukey test was used to evaluate the results of incubation before mitochondrial activity was measured using Multiscan spectrophotometry (570 nm).

Results

There were significant differences in cell viability between the groups after 24 hours (P < 0.001), with TDV having higher viability than Rebase II. The difference between Rebase II and TDV, however, was not significant at 48 and 96 hours (P > 0.131). At 24 hours, Rebase II exhibited significantly lower viability than TDV liner, with a significant difference between the two groups (P = 0.001).

Conclusion

Due to the maximum monomer release in the early hours of incubation, the amount of cytotoxicity decreased with increasing incubation time.

Metal Ions Release from Welded Co-Cr Dental Alloys

Cobalt-chromium alloys (Co-Cr) are widely used in dentistry due to their excellent mechanical properties and corrosion resistance. Since prosthetic materials must be permanently stable in the oral cavity, it is very important to determine the release of ions from alloys in the oral cavity. In dentistry today, metals and alloys are mainly joined by laser and tungsten inert gas (TIG) welding. Therefore, in this work, the release of metal ions from six different Co-Cr alloys joined by these two welding methods was quantified to determine the effects of the welding method on an ion release. Static immersion tests, atomic absorption spectrometry and statistical analysis were performed for this purpose. The results showed that laser-welded alloys release a lower amount of metal ions compared to TIG-welded alloys.

Influence of TiO2 nanoparticles content as reinforce material to enhance the mechanical and corrosion resistance properties of Sn and Sn-Ag alloy for dental applications

This study evaluated the influence of the TiO₂ nanoparticles (NPs) on the mechanical and chemical performance of Sn and Sn-Ag alloys. The XRD (X-ray diffraction) and HR-TEM (high resolution-transmission electron microscopy) methods were used to characterize the NPs synthesized by the sol-gel microwave process. The chemical composition of the alloys was Sn, Sn+3TiO₂ NPs, Sn-5Ag+1.5TiO₂ NPs, Sn-10Ag, and Sn-10Ag+3TiO₂ NPs, obtained from an experimental factorial design (EFD). A statistical model was used to determine the mechanical and chemical properties, showing the Vickers hardness response surface, tensile strength, wear, and corrosion resistance. The wear and corrosion tests for the various alloy compositions were performed using human artificial saliva solution. The results indicated that the Sn-10Ag+3TiO₂ NPs exhibited the highest mechanical performance due to their increased hardness (380 HV), tensile strength (370 N), and wear resistance (0.34 × 10^-3 mm³ Nm^-1); in all the cases, the inclusion of TiO₂ NPs enhanced the corrosion resistance of the alloys. According to the American Dental Association (ADA), Sn-10Ag+3TiO₂ NPs alloy could be classified as a possible type IV restorative material.

Elemental analysis of contemporary dental materials regarding potential beryllium content

Exposure to beryllium (Be) can lead to lung pathologies, such as chronic beryllium disease (CBD). This occupational illness has been more prevalent among dental technicians compared to the non-exposed population. Although most manufacturers state that dental materials are Be-free, this prevalence raises the question of whether the materials are completely devoid of Be-traces. Thus, the objective of the present study was to analyze the elemental composition, with emphasis on Be, of a wide range of commercially available dental materials frequently used by dental laboratories. Samples of 32 different materials were collected and analyzed using inductively coupled plasma-optical emission spectrometry (ICP-OES) and X-ray fluorescence spectroscopy. The results showed that the Be content was below the limit of quantification in all included samples (< 0.00005 mass-%). Therefore, it can be concluded that possible traces of Be were below clinical relevance in dental materials. Exposure of dental technicians to alternative Be sources should be further evaluated.

Analytical Study Regarding the Behavior of Cr-Co and Ni-Cr in Saliva

Background and Objectives: The interaction between dental alloys and saliva affects both its own properties and those of metallic materials. Materials and Methods: Samples made of Cr-Co and Ni-Cr were studied. It was opted for corrosion under tension, scanning electron microscopy was used to characterize the surface morphology, and the chemical composition of the surface was assessed with the help of an Energy Dispersive Spectrometer. In vitro testing of the cytotoxic impact of the study eluates was carried out by flow cytometric analysis. Results: Pitting areas appear in the mass of the Ni-Cr alloy. Nickel, Manganese, and Cobalt dissolve and go into the solution. Corrosion is superficial in the case of the Cr-Co alloy, the corrosion points are shallow, and the amount of dissolved metal is relatively small. Mostly Nickel passes into the solution, unlike Chromium and Cobalt, which remain at this level. We noticed an increase in the viability of cell cultures in the case of Cr-Co alloy and a decrease in the number of living cells (87%) for Ni-Cr alloy. Conclusions: Common alloys (Ni-Cr and Cr-Co) are prone to corrosion, because they lack structural features that would shield the alloy from corrosion agents.

Cytotoxic assessment of 3D printed photoinitiated prosthodontic resins versus heat polymerized acrylic resin (In-Vitro Study).. [DOI: 10.21203/rs.3.rs-1948364/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Background: Although 3D printed photoinitiated resins are among the many materials utilized in prosthetic appliances today, biocompatibility for photocuring 3D printing materials for direct and long-term contacting with living body remain scarce. The purpose of this in vitro study was to evaluate the cell viability of human gingival fibroblasts after the exposure to two different 3D printed photoinitiated resins and compare it to the traditionally used heat polymerized acrylic resin for up to 7 days.Methods: This comparative in vitro study of sample size (n= 96), where the 3D printed resin disc samples (n= 64), were divided into two test groups, test group 1 (TG1) for NextDent Base resin (n= 32) and test group 2 (TG2) for Dental LT clear resin (n= 32), to be compared to Heat polymerized acrylic resin samples (Reference group (RG)) (n= 32). Human gingival fibroblasts were extracted from attached keratinized gingival tissues collected from healthy patient undergoing clinical crown lengthening procedure, cellular viability using MTT assay in response to TG1, TG2 and RG samples was assessed throughout four-time intervals (24, 48, 72 and 168 hours). The One-Way ANOVA test followed by Tukey’s post hoc test and Repeated Measures ANOVA test were used for statistical analyses, statistically significant different at P value ≤ 0.05Results: Throughout time intervals, there was a decrease in cell viability of all groups but with favorable cell viability which was more that 90% denoting non cytotoxicity. It was found to be significant among RG (P< 0.0001). The highest cell viability was found after 24 hours among all groups; however, the least viability was found after 48 hours among TG1 and RG, and among TG2 after 72 hours. After 168 hours, there was a non-statistical significant change in cell viability between groups (P= 0.526). there was significant increase in optical density for all groups throughout time intervals (P< 0.0001).Conclusion: Photoinitiated resins are comparable to traditionally used heat polymerized acrylic resin with equivalent cytotoxic effect for long term use. 3D printed photoinitiated resins are biocompatible and suggested for long term intraoral use.

Fracture strength of monolithic and glass-soldered ceramic sub-components of 5-unit fixed dental prosthesis

PURPOSE

Zirconium dioxide ceramic has been successfully introduced as a framework material for fixed dental prostheses. To reduce manufacturing constraints, joining of sub-components could be a promising approach to increase the mechanical performance of long-span fixed dental prostheses. In this experimental study, the biomechanical behavior of monolithic and soldered framework specimens for fixed dental prostheses made of Y-TZP was investigated.

MATERIALS AND METHODS

Framework specimens (n  =  80) of 5-unit fixed dental prostheses made of Y-TZP were prepared and divided into 10 equal groups. The specimens were monolithic or composed of sub-components, which were joined using a silicate-based glass solder. Thereby, three joint geometries (diagonal, vertical with an occlusal cap, and dental attachment-based) were investigated. Moreover, the groups differed based on the mechanical test (static vs. dynamic) and further processing (veneered vs. unveneered). The framework specimens were cemented on alumina-based jaw models, where the canine and second molar were acting as abutments, before a point-load was applied. In addition, μCT scans and microscopic fractography was used to evaluate the quality of soldered joints and to determine the causes of fracture.

RESULTS

The determined fracture loads of the different unveneered framework specimens in static testing did not vary significantly (p  =  1). Adding a veneering layer significantly increased the mechanical strength for monolithic framework specimens from 1,196.29 ±203.79 N to 1,606.85 ±128.49 N (p  =  0.008). In case of soldered specimens with a dental attachment-based geometry the mechanical strength increased from 1,159.42 ±85.65 N to 1,249.53 ±191.55 N (p  =  1). Within the dynamic testing, no differences were observed between monolithic and soldered framework specimens. μCT scans and fractography proved that the dental attachment-based joining geometry offers the highest quality.

CONCLUSION

Using glass soldering technology, sub-components of 5-unit framework specimens made of Y-TZP could be joined with mechanical properties comparable to those of monolithic frameworks. This article is protected by copyright. All rights reserved.

Assessment of Communication Quality through Work Authorization between Dentists and Dental Technicians in Fixed and Removable Prosthodontics

Fabrication of a clinically successful dental prosthesis requires clear and effective communication between dentists and dental technicians. Adequate completion of work authorization by dentists provides a means for increased professional quality assurance and satisfaction in dental prosthesis. The aim of this study was to evaluate the quality of communication between dentists and dental technicians via work authorization for fixed and removable dental prosthesis in Pakistan. This cross-sectional study was conducted for a period of 6 months to assess the quality of communication between dentists and dental technicians. A well-constructed questionnaire regarding work authorization of removable and fixed prostheses was used as a tool to collect data from 453 dentists. A linear regression analysis was performed to evaluate the relationship of the independent and dependent variables. A p value of ≤0.05 was considered statistically significant. It was observed that 92.1% of the dentists leave removable partial denture design to the dental technicians. About 56.5% of the dentists indicated information about base retention of partial dentures in work authorization. The majority of the dentists (56.5%) mentioned the material to be used for the construction of casting partial dentures. Nearly 66% of the dentists indicated the design of margins, and 44.6% of the dentists did not select the shade for fixed prostheses. Nearly 43% of the dentists did not draw the design of restoration, 21.9% chose to draw the design on paper, and 32.2% of the dentists drew the design on the cast. Meanwhile, 76.8% of the participants chose to directly communicate with their dental technicians personally. Nearly 41% of the dentists were satisfied with the restoration design, and 13.5% of the participants were not satisfied with the designs. Poor communication between dentists and technicians was observed, as the majority of the design decisions were left to the dental technicians. Therefore, communication between dentists and dental technicians should be improved by conducting combined workshops for the successful construction of dental prostheses.

Fixed Prosthetic Restorations and Periodontal Health: A Narrative Review

Periodontal health plays an important role in the longevity of prosthodontic restorations. The issues of comparative assessment of prosthetic constructions are complicated and not fully understood. The aim of this article is to review and present the current knowledge regarding the various technical, clinical, and molecular aspects of different prosthetic biomaterials and highlight the interactions between periodontal health and prosthetic restorations. Articles on periodontal health and fixed dental prostheses were searched using the keywords “zirconium”, “CAD/CAM”, “dental ceramics”, “metal–ceramics”, “margin fit”, “crown”, “fixed dental prostheses”, “periodontium”, and “margin gap” in PubMed/Medline, Scopus, Google Scholar, and Science Direct. Further search criteria included being published in English, and between January 1981 and September 2021. Then, relevant articles were selected, included, and critically analyzed in this review. The margin of discrepancy results in the enhanced accumulation of dental biofilm, microleakage, hypersensitivity, margin discoloration, increased gingival crevicular fluid flow (GCF), recurrent caries, pulp infection and, lastly, periodontal lesion and bone loss, which can lead to the failure of prosthetic treatment. Before starting prosthetic treatment, the condition of the periodontal tissues should be assessed for their oral hygiene status, and gingival and periodontal conditions. Zirconium-based restorations made from computer-aided design and computer-aided manufacturing (CAD/CAM) technology provide better results, in terms of marginal fit, inflammation reduction, maintenance, and the restoration of periodontal health and oral hygiene, compared to constructions made by conventional methods, and from other alloys. Compared to subgingival margins, supragingival margins offer better oral hygiene, which can be maintained and does not lead to secondary caries or periodontal disease.

Soft Tissue Interface with Various Kinds of Implant Abutment Materials

Various materials, such as titanium, zirconia and platinum-gold (Pt-Au) alloy, have been utilized for dental implant trans-mucosal parts. However, biological understanding of soft tissue reaction toward these materials is limited. The aim of this study was to compare the response of cell lines and soft tissue to titanium, zirconia and Pt-Au substrata. The surface hydroxyl groups and protein adsorption capacities of the substrata were measured. Next, gingival epithelial-like cells (Sa3) and fibroblastic cells (NIH3T3) were cultured on the materials, and initial cell attachment was measured. Immuno-fluorescent staining of cell adhesion molecules and cytoskeletal proteins was also performed. In the rat model, experimental implants constructed from various materials were inserted into the maxillary tooth extraction socket and the soft tissue was examined histologically and immunohistochemically. No significant differences among the materials were observed regarding the amount of surface hydroxyl groups and protein adsorption capacity. Significantly fewer cells of Sa3 and NIH3T3 adhered to the Pt-Au alloy compared to the other materials. The expression of cell adhesion molecules and a well-developed cytoskeleton was observed, both Sa3 and NIH3T3 on each material. In an animal model, soft tissue with supracrestal tissue attachment was observed around each material. Laminin-5 immuno-reactivity was seen in epithelia on both titanium and zirconia, but only in the bottom of epithelia on Pt-Au alloy. In conclusion, both titanium and zirconia, but not Pt-Au alloy, displayed excellent cell adhesion properties.

Recent update on potential cytotoxicity, biocompatibility and preventive measures of biomaterials used in dentistry

Dental treatment is provided for a wide variety of oral health problems like dental caries, periodontal diseases, periapical infections, replacement of missing teeth and orthodontic problems. Various biomaterials, like composite resins, amalgam, glass ionomer cement, acrylic resins, metal alloys, impression materials, bone grafts, membranes, local anaesthetics, etc., are used for dental applications. The physical and chemical characteristics of these materials influence the outcome of dental treatment. It also impacts on the biological, allergic and toxic potential of biomaterials. With innovations in science and their positive results, there is also a need for awareness about the biological risks of these biomaterials. The aim of dental treatment is to have effective, yet safe, and long-lasting results for the benefit of patients. For this, it is important to have a thorough understanding of biomaterials and their effects on local and systemic health. Materials used in dentistry undergo a series of analyses before their oral applications. To the best of our knowledge, this is the first and original review that discusses the reasons for and studies on the toxicity of commonly used biomaterials for applications in dentistry. It will help clinicians to formulate a methodical approach for the selection of dental biomaterials, thus providing an awareness for forecasting their risk of toxic reactions.

Effects of Copper Surface Oxidation and Reduction on Shear-Bond Strength Using Functional Monomers

This study was conducted to clarify the influence of the copper surface oxidation and reduction on the shear-bond strength with functional monomers. Unheated copper specimens (UH; n = 88) were wet-ground. Three-quarters of the UH were then heated (HT). Two-thirds of the HT was then immersed in a hydrochloric acid solution (AC). Half of the AC was then reheated (RH). Each group was further divided into two groups (n = 11), which were primed by either 6-methacryloyloxyhexyl 2-thiouracil-5-carboxylate (MTU-6) or 10-methacryloyloxydecyl dihydrogen phosphate (MDP). The shear-bond strength tests were used for bonding with an acrylic resin. The surface roughness values and chemical states of the four groups were analyzed using a confocal scanning laser microscope and X-ray photoelectron spectroscopy (XPS). The shear-bond strengths of HT and RH were the lowest in the MTU-6-primed groups. The result of AC was significantly lower than others in the MDP-primed groups. The XPS results showed that the surfaces of UH and AC consisted of Cu₂O and Cu. The surface changed to CuO upon heating. The presence or absence of copper-oxide films showed the opposite trends in the effectiveness of MTU-6 and MDP to improve bond strength. The results could elucidate the effects of functional monomers on copper-oxide films.

Characteristics of Periodontal Tissues in Prosthetic Treatment with Fixed Dental Prostheses

The objective of the present study was to investigate the effects of various types of fixed prostheses on periodontal tissues and explore the association of gingival biotype and gum recession in relation to prosthesis types. The study participants (N = 95) were divided into three groups based on the type of dental prosthesis: Group-I: cobalt-chrome (Co-Cr) ceramic prosthesis fabricated by the conventional method (n = 35); Group-II: consisted of patients with Co-Cr ceramic prostheses fabricated by a computer-aided design and computer aided manufacturing (CAD/CAM) technique (n = 30); and Group-III: zirconia-based prostheses fabricated by the CAD/CAM technique (n = 30). Following the use of prostheses, periodontal examinations were performed using the Community Periodontal Index (CPI) and Modified Approximal Plaque Index (MAPI). In addition, the gingival biotype was examined using a probe transparency method. The Statistical Package for the Social Sciences (SPSS), Version 20 (IBM Company, Chicago, IL, USA), was used to analyze the results, and the significance level was set at p = 0.05. It showed the MAPI results after the use of prosthetic rehabilitation for 12 months of periodontitis in 87.9% ± 15.4 of patients in Group-I, in 80.6% ± 17.97 in those in Group-II, and in 62.5% ± 21.4 in those in Group-III (p < 0.01). The CPI index results indicated a high prevalence of periodontal disease in all groups. The number of people with healthy periodontium constituted 17.1% of patients in Group-I, 24.2% in Group-II, and 37.1% in Group-III. Our study concluded that prosthetic treatment with periodontal diseases showed better outcomes while using dental prostheses fabricated by the CAD/CAM technique compared to the conventionally fabricated dental prostheses. The thin gingival biotype is more often associated with gingival recession than the thick biotype.

Characteristics of Periodontal Tissues in Prosthetic Treatment with Fixed Dental Prostheses

The objective of the present study was to investigate the effects of various types of fixed prostheses on periodontal tissues and explore the association of gingival biotype and gum recession in relation to prosthesis types. The study participants (N = 95) were divided into three groups based on the type of dental prosthesis: Group-I: cobalt-chrome (Co-Cr) ceramic prosthesis fabricated by the conventional method (n = 35); Group-II: consisted of patients with Co-Cr ceramic prostheses fabricated by a computer-aided design and computer aided manufacturing (CAD/CAM) technique (n = 30); and Group-III: zirconia-based prostheses fabricated by the CAD/CAM technique (n = 30). Following the use of prostheses, periodontal examinations were performed using the Community Periodontal Index (CPI) and Modified Approximal Plaque Index (MAPI). In addition, the gingival biotype was examined using a probe transparency method. The Statistical Package for the Social Sciences (SPSS), Version 20 (IBM Company, Chicago, IL, USA), was used to analyze the results, and the significance level was set at p = 0.05. It showed the MAPI results after the use of prosthetic rehabilitation for 12 months of periodontitis in 87.9% ± 15.4 of patients in Group-I, in 80.6% ± 17.97 in those in Group-II, and in 62.5% ± 21.4 in those in Group-III (p < 0.01). The CPI index results indicated a high prevalence of periodontal disease in all groups. The number of people with healthy periodontium constituted 17.1% of patients in Group-I, 24.2% in Group-II, and 37.1% in Group-III. Our study concluded that prosthetic treatment with periodontal diseases showed better outcomes while using dental prostheses fabricated by the CAD/CAM technique compared to the conventionally fabricated dental prostheses. The thin gingival biotype is more often associated with gingival recession than the thick biotype.

Ion Release from Dental Implants, Prosthetic Abutments and Crowns under Physiological and Acidic Conditions

Ion release from dental implants and prosthetic restoration can affect osteointegration and implant viability over a long period of time. Therefore, the aim of this study was to study the ion release from implants and crowns, with and without intermediate anodized abutments, in two different media, simulating clinical conditions. The implants, intermediate prosthetic abutments and Cr–Co crowns were divided into two groups depending on the media: Hanks’ solution and 1% lactic acid, simulating body fluids and microbiologically conditioned fluids, respectively. The study followed the ISO 10271:2011 and 10993-15:2000 standards modified to simulate the replacement of fluids in the oral environment. The ions’ release was measured by inductively coupled plasma mass spectroscopy (ICP-EOS), and only aluminum, chromium, cobalt, titanium and vanadium were identified. Ion concentration was higher in lactic acid than in Hanks’ solution at all time points (p < 0.05). Only vanadium showed a very low ion release in lactic acid, with no statistically significant differences from the ion release in Hanks’ solution (p = 0.524). Both anodized abutments and the immersion medium influenced the release of ions and affected the corrosion of these structures. The presence of an intermediate anodized abutment also affected ion release, as the level of ions was lower in groups with this component.

Bioadhesion in the oral cavity and approaches for biofilm management by surface modifications

BACKGROUND

All soft and solid surface structures in the oral cavity are covered by the acquired pellicle followed by bacterial colonization. This applies for natural structures as well as for restorative or prosthetic materials; the adherent bacterial biofilm is associated among others with the development of caries, periodontal diseases, peri-implantitis, or denture-associated stomatitis. Accordingly, there is a considerable demand for novel materials and coatings that limit and modulate bacterial attachment and/or propagation of microorganisms.

OBJECTIVES AND FINDINGS

The present paper depicts the current knowledge on the impact of different physicochemical surface characteristics on bioadsorption in the oral cavity. Furthermore, it was carved out which strategies were developed in dental research and general surface science to inhibit bacterial colonization and to delay biofilm formation by low-fouling or "easy-to-clean" surfaces. These include the modulation of physicochemical properties such as periodic topographies, roughness, surface free energy, or hardness. In recent years, a large emphasis was laid on micro- and nanostructured surfaces and on liquid repellent superhydrophic as well as superhydrophilic interfaces. Materials incorporating mobile or bound nanoparticles promoting bacteriostatic or bacteriotoxic properties were also used. Recently, chemically textured interfaces gained increasing interest and could represent promising solutions for innovative antibioadhesion interfaces. Due to the unique conditions in the oral cavity, mainly in vivo or in situ studies were considered in the review.

CONCLUSION

Despite many promising approaches for modulation of biofilm formation in the oral cavity, the ubiquitous phenomenon of bioadsorption and adhesion pellicle formation in the challenging oral milieu masks surface properties and therewith hampers low-fouling strategies.

CLINICAL RELEVANCE

Improved dental materials and surface coatings with easy-to-clean properties have the potential to improve oral health, but extensive and systematic research is required in this field to develop biocompatible and effective substances.

Cobalt-chromium alloys fabricated with four different techniques: Ion release, toxicity of released elements and surface roughness

OBJECTIVE

To investigate the metal ion release, surface roughness and cytoxicity for Co-Cr alloys produced by different manufacturing techniques before and after heat treatment. In addition, to evaluate if the combination of materials affects the ion release.

METHODS

Five Co-Cr alloys were included, based on four manufacturing techniques. Commercially pure titanium, CpTi grade 4 and a titanium alloy were included for comparison. The ion release tests involved both Inductive Coupled Plasma Optical Emission Spectrometry and Inductive Coupled Plasma Mass Spectrometry analyses. The surface analysis was conducted with optical interferometry. Cells were indirectly exposed to the materials and cell viability was evaluated with the MTT (3-(4.5-dimethylthiazol-2-yl)-2.5-diphenyltetrazolium bromide) method.

RESULTS

All alloys showed a decrease of the total ion release when CpTi grade 4 was present. The total ion release decreased over time for all specimens and the highest ion release was observed from the cast and milled Co-Cr alloy in acidic conditions. The cast and laser-melted Co-Cr alloy and the titanium alloy became rougher after heat treatment. All materials were within the limits of cell viability according to standards.

SIGNIFICANCE

The ion release from Co-Cr alloys is influenced by the combination of materials, pH and time. Surface roughness is influenced by heat treatment. Furthermore, both ion release and surface roughness are influenced by the manufacturing technique and the alloy type. The clinical implication needs to be further investigated.

Nanometals in Dentistry: Applications and Toxicological Implications-a Systematic Review

Nanotechnology is a vital part of health care system, including the dentistry. This branch of technology has been incorporated into various fields of dentistry ranging from diagnosis to prevention and treatment. The latter involves application of numerous biomaterials that help in restoration of esthetic and functional dentition. Over the past decade, these materials were modified through the incorporation of metal nanoparticles (NP) like silver (Ag), gold (Au), titanium (Ti), zinc (Zn), copper (Cu), and zirconia (Zr). They enhanced antimicrobial, mechanical, and regenerative properties of these materials. However, lately, the toxicological implications of these nanometal particles have been realized. They were associated with cytotoxicity, genotoxicity altered inflammatory processes, and reticuloendothelial system toxicity. As dental biomaterials containing metal NPs remain functional in oral cavity over prolonged periods, it is important to know their toxicological effects in humans. With this background, the present systematic review is aimed to gain an insight into the plausible applications and toxic implications of nano-metal particles as related to dentistry.

Biological responses to pediatric stainless steel crowns

A systematic review was conducted to identify the biological responses, allergic reaction, hypersensitivity, toxicity, and ion release profile associated with pediatric stainless steel crowns (SSCs) in the existing literature. A systematic search was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The inclusion criteria consisted of patients younger than 20 years of age with SSC placement on primary or permanent teeth and in vivo and in vitro exposure to SSCs. Outcomes measures included adverse oral/mucosal effects; removal/failure/replacement of the SSC; type of allergic reaction; nickel (Ni) or other ion levels in bodily fluids, cellular, genotoxic, cytotoxic, mutagenic or carcinogenic effects related to the SSC. After an initial search of 764 studies in the database, 17 articles were included in the analysis. Evidence of allergic reactions to SSCs in children is limited and obtained from mostly low-quality research. Some studies showed that the amount of Ni detected was less than the amount ingested in the daily diet. In contrast, other studies reported a significantly higher release of Ni occurred into the saliva in acidic environments. There is some concern about the leaching of metal ions such as Ni from SSCs in children at high risk for caries. Further long-term studies are required to investigate this phenomenon.

Ion release from three different dental alloys - effect of dynamic loading and toxicity of released elements

Objective

The aims of this in vitro study were to assess if dynamic loading increases the metal ion release of selected dental alloys and to evaluate the cytotoxicity of the released metal ions.

Materials and methods

One Pd–Ag alloy (Aurolite 2B) and two Co–Cr alloys (Wirobond 280 and d.Sign 30) were investigated. Two different corrosion immersion tests were used: a standardized static test (ISO 22674: 2016) and an experimental dynamic test. Both tests involved immersion of the specimens in a lactic acidic solution (pH = 2.3). Inductively coupled plasma mass spectrometry was used to identify and quantify released elements. A human monocyte cell-line (THP-1) was exposed to serially diluted solutions containing the selected metal ions. Cell viability was measured using the methyl-thiazolyl-tetrazolium assay.

Results

According to the threshold defined in ISO 22674, only low concentrations of released elements were observed for both corrosion tests. No increase in metal ion release from the dynamic test compared with the static test was observed. Of the released elements, only Zn(II) and Co(II) showed a cytotoxic effect on THP-1 cells at 250 µM and higher concentrations. No increased viability loss was observed when adding other released elements to the exposure mixture.

Conclusions

The tested alloys showed low levels of metal ion release from both static and dynamic corrosion testing. Dynamic loading did not increase the metal ion release compared to the static corrosion test. Concentrations of 250 µM and above of Zn(II) and Co(II) showed a cytotoxic effect on THP-1 cells.

Detection of DNA adduct 8-hydroxy-2'-deoxyguanosine (8-OHdG) as a toxicity bioindicator to the effects of nickel on Ni-Cr alloy prosthesis users

Previous studies have suggested that exposure to Ni from Ni-Cr alloys can affect the human body through oxidative stress. The present study discusses the effect of nickel from Ni-Cr alloy prostheses on the formation of DNA Adduct 8-Hydroxy-2′-Deoxyguanosine (8-OHdG), evaluated based on creatinine and 8-OHdG concentrations in urine, determined with LC-MS/MS, for a Ni-Cr alloy user group and a never-user control group. The mean creatinine and 8-OHdG concentrations were not significantly different between the test groups, although highest levels were observed for the in the Ni-Cr user group. It is suggested that samples with relatively high creatinine and/or 8-OHdG levels are further studied in more detail for stability of concentrations and for the effect of contributing factors.

An innovative method for in-situ composition analysis of fixed metallic dental restorations

Dental restorations made from alloys corrode during their service time. In cases of suspected toxic or allergic reactions to the corrosion products, the composition of the intraoral dental restorations has to be determined. The sample materials can be obtained intra-orally in a non-destructive manner using the chipping test. Metallic shavings are extracted with the aid of a dental stone and graphite carrier platelet, which is then transferred to an electron microscope for electro dispersive X-ray (EDX) analysis. The chipping test suffers from a rather complicated and error-prone procedure of obtaining and transferring the samples.

OBJECTIVE

The objective of the present study was the validation of a simplified method for non-destructive in-situ extraction of dental alloy samples, using a newly developed dental bur made from carbon fiber reinforced polyether ether ketone (PEEK), which at the same time serves as an electrically conductive sample carrier for EDX analysis.

METHODS

Fifteen burs for dental hand pieces were manufactured from carbon fiber reinforced PEEK, using two formulations. The burs were passed over precious and non-precious dental alloys with different rotation speeds. The alloy samples embedded in the burs were analyzed using EDX and compared to a control.

RESULTS

The burs manufactured from PEEK containing 30% short carbon fibers proved sufficiently robust for sample extraction even from the harder non-precious metals. The results of EDX analysis were in accordance with the control,no statistical significant differences, free of contamination, and were not affected by rotation speed,higher as 20%.

SIGNIFICANCE

The proposed method is valid, practical and constitutes an improvement over the traditional chipping test.

Effect of preconditioning cobalt and nickel based dental alloys with Bacillus sp. extract on their surface physicochemical properties and theoretical prediction of Candida albicans adhesion

Biofilm formation on dental biomaterials is implicated in various oral health problems. Thus the challenge is to prevent the formation of this consortium of microorganisms using a safe approach such as antimicrobial and anti-adhesive natural products. Indeed, in the present study, the effects of an antifungal extract of Bacillus sp., isolated from plant rhizosphere, on the surface physicochemical properties of cobalt and nickel based dental alloys were studied using the contact angle measurements. Furthermore, in order to predict the adhesion of Candida albicans to the treated and untreated dental alloys, the total free energy of adhesion was calculated based on the extended Derjaguin-Landau-Verwey-Overbeek approach. Results showed hydrophobic and weak electron-donor and electron-acceptor characteristics of both untreated dental alloys. After treatment with the antifungal extract, the surface free energy of both dental alloys was influenced significantly, mostly for cobalt based alloy. In fact, treated cobalt based alloy became hydrophilic and predominantly electron donating. Those effects were time-dependent. Consequently, the total free energy of adhesion of C. albicans to this alloy became unfavorable after treatment with the investigated microbial extract. A linear relationship between the electron-donor property and the total free energy of adhesion has been found for both dental alloys. Also, a linear relationship has been found between this latter and the hydrophobicity for the cobalt based alloy. However, the exposure of nickel based alloy to the antifungal extract failed to produce the same effect.

Cell death affected by dental alloys: Modes and mechanisms

Previous reports have demonstrated that ions released from dental alloys might cause cytotoxicity. However, how dental alloys influence the organism has not been extensively studied. In order to make it clear, the cytotoxic effect of four dental alloys on L929 cells was evaluated by flow cytometry (FCM) and Real-time quantitative PCR assay (Real-time qPCR) to identify the cell death mode and its biological mechanism. The cells were treated with the leach liquors of cobalt-chromium (Co-Cr), commercially pure titanium (CP-Ti), palladium-based (Pd-based) and gold-platinum (Au-Pt) alloys for 48 and 72 h. FCM results indicated, apart from Au-Pt alloy, the major cell death of dental alloys was time-dependent early apoptosis rather than necrosis/late apoptosis. Caspase 3 and Caspase 9 mRNA expression were determined by Real-time qPCR, and shared the same trend in each group over time. Hence, except for Au-Pt alloy, dental alloys might cause time-dependent early apoptosis via the intrinsic pathway.

Electrochemical comparison and biological performance of a new CoCrNbMoZr alloy with commercial CoCrMo alloy

A new CoCrNbMoZr alloy, with Nb and Zr content is characterized from the point of view of surface features, corrosion resistance and biological performance in order to be proposed as dental restorative material. Its properties are discussed in comparison with commercial Heraenium CE alloy based on Co, Cr and Mo as well. The microstructure of both alloys was revealed by scanning electron microscopy (SEM). The composition and thickness of the alloy native passive films were identified by X-ray photoelectron spectroscopy (XPS). The surface characteristics were analyzed by atomic force microscopy (AFM) and contact angle techniques. The quantity of ions released from alloys in artificial saliva was evaluated with inductively coupled plasma-mass spectroscopy (ICP-MS) measurements. The electrochemical stability was studied in artificial Carter-Brugirard saliva, performing open circuit potentials, polarization resistances and corrosion currents and rates. The biological performance of the new alloy was tested in vitro in terms of human adipose stem cells (hASCs) morphology, viability and proliferation status. The new alloy is very resistant to the attack of the aggressive ions from the artificial saliva. The surface properties, the roughness and wettabiliy sustain the cell behavior. The comparison of the new alloy behavior with that of existing commercial CoCrMo alloy showed the superior properties of the new metallic biomaterial.