Dental materials: 1997 literature review

Molecular mechanism of nanomaterials induced liver injury: A review

The unique physicochemical properties inherent to nanoscale materials have unveiled numerous potential applications, spanning beyond the pharmaceutical and medical sectors into various consumer industries like food and cosmetics. Consequently, humans encounter nanomaterials through diverse exposure routes, giving rise to potential health considerations. Noteworthy among these materials are silica and specific metallic nanoparticles, extensively utilized in consumer products, which have garnered substantial attention due to their propensity to accumulate and induce adverse effects in the liver. This review paper aims to provide an exhaustive examination of the molecular mechanisms underpinning nanomaterial-induced hepatotoxicity, drawing insights from both in vitro and in vivo studies. Primarily, the most frequently observed manifestations of toxicity following the exposure of cells or animal models to various nanomaterials involve the initiation of oxidative stress and inflammation. Additionally, we delve into the existing in vitro models employed for evaluating the hepatotoxic effects of nanomaterials, emphasizing the persistent endeavors to advance and bolster the reliability of these models for nanotoxicology research.

The applications of polysaccharides in dentistry

Polysaccharides are natural polymers widely present in animals, plants, and several microorganisms. Polysaccharides have remarkable properties, including easy extractions, degradability, and renewability, and have no apparent toxicity, making them ideal for biomedical applications. Moreover, polysaccharides are suitable for repairing oral tissue defects and treating oral diseases due to their excellent biocompatibility, biosafety, anti-inflammatory, and antibacterial properties. The oral cavity is a relatively complex environment vulnerable to numerous conditions, including soft tissue diseases, hard tissue disorders, and as well as soft and hard tissue diseases, all of which are complex to treat. In this article, we reviewed different structures of natural polysaccharides with high commercial values and their applications in treating various oral disease, such as drug delivery, tissue regeneration, material modification, and tissue repair.

Effect of Disinfectants on Mechanical Properties of Orthodontic Acrylics

Objective

Infection control protocols in dentistry dictate that orthodontic acrylics have to be disinfected. No specific products for orthodontic acrylics are available. The objective of this study was to investigate the influence of chemical disinfectants on mechanical properties of orthodontic acrylics.

Materials and Methods

260 test specimens of two cold-curing orthodontic acrylics were manufactured. Three chemical disinfecting agents were tested: Impresept, D050 Instru-Gen, and Stammopur DR. Test specimens were stored in distilled water and divided into test groups. E-Modulus, flexural strength, macro hardness, micro hardness, average roughness, and colour change were measured.

Results

Disinfection agents showed no significant influence on E-modulus. Values ranged from 1783.80 ± 163.80 MPa (Forestacryl colourless) to 2474.00 ± 135.00 MPa (Orthocryl green) after storage in distilled water. Disinfection agents performed no significant influence on flexural strength. Values ranged from 18.64±1.59 N/mm² (Forestacryl colourless) to 25.64 ± 1.43 N/mm² (Orthocryl green) after storage in distilled water. Orthocryl colourless showed a reduction of the macro hardness after disinfection (Stammopur DR (p≤0.001), D050 Instru-Gen (p≤0.037)). Disinfection of Orthocryl green with D050 Instru-Gen (p<0.001) and Forestacryl colourless with Impresept (p≤0.001) led to a reduction of macro hardness. Micro hardness of Orthocryl colourless altered significantly after disinfection with D050 Instru-Gen (p≤0.001). Micro hardness of Forestacryl colourless increased (Impresept (p≤0.039)) and decreased (Stammopur DR (p≤0.006) Instru-Gen (p≤0.001)) after disinfection. Average roughness did not change significantly (Orthocryl colourless). Forestacryl colourless performed a significant change after disinfection with Stammopur DR (p≤0.05). This is also true for the disinfection of Orthocryl green and Forestacryl pink with Instru-Gen (p≤0.05). Disinfection performed no significant influence on colour change. ΔE-values were in a range of 1 to 2.

Conclusions

Some orthodontic acrylics disinfection caused significant changes of determined parameters. Changes were specific for the applied disinfectant and tested orthodontic acrylic. Further studies should verify the impact of long-term disinfection intervals. Thus, from manufacturers of orthodontic acrylics recommendations for appropriate disinfectants would be desirable.

The effect of metal ions released from different dental implant-abutment couples on osteoblast function and secretion of bone resorbing mediators

OBJECTIVES

The etiology of the reduced marginal bone loss observed around platform-switched implant-abutment connections is not clear but could be related to the release of variable amounts of corrosion products. The present study evaluated the effect of different concentrations of metal ions released from different implant abutment couples on osteoblastic cell viability, apoptosis and expression of genes related to bone resorption.

METHODS

Osteoblastic cells were exposed to five conditions of culture media prepared containing metal ions (titanium, aluminum, vanadium, cobalt, chromium and molybdenum) in different concentrations representing the amounts released from platform-matched and platform-switched implant-abutment couples as a result of an earlier accelerated corrosion experiment. Cell viability was evaluated over 21days using the Alamar Blue assay. Induction of apoptosis was measured after 24h of exposure using flow cytometry. Expression of interleukin-6, interleukin-8, cyclooxygenase-2, caspase-8, osteoprotegerin and receptor activator of nuclear factor kappa-B ligand (RANKL) by osteoblastic cells were analysed after exposure for 1, 3 and 21days using real-time quantitative polymerase chain reaction assay RESULTS: Metal ions in concentrations representing the platform-matched groups led to a reduction in cell viability (P<0.01) up to 7days of exposure. Stimulated cells showed higher rates of early apoptosis (P<0.01) compared to non-treated cells. Metal ions up-regulated the expression of interleukin-6, interleukin-8, cyclooxygenase-2 and RANKL in a dose dependent manner after 1day of exposure (P<0.05). The up-regulation was more pronounced in the groups containing the corrosion products of platform-matched implant-abutment couples.

CONCLUSION

Osteoblastic cell viability, apoptosis, and regulation of bone resorbing mediators were significantly altered in the presence of metal ions. The change in cytokine levels expressed was directly proportional to the metal ion concentration.

CLINICAL SIGNIFICANCE

The observed biological responses to decreased amounts of metal ions released from platform-switched implant-abutment couples compared to platform-matched couples may partly explain the positive radiographic findings in respect to crestal bone level when utilising the "platform-switching" concept, which highlights the possible role of corrosion products in the mediation of crestal bone loss around dental implants.

Long-term biological performance of injectable and degradable calcium phosphate cement

Enhancing degradation of poorly degrading injectable calcium phosphate (CaP) cements (CPCs) can be achieved by adding poly(lactic-co-glycolic acid) (PLGA) microparticles, generating porosity after polymer degradation. CPC-PLGA has proven to be biodegradable, although its long-term biological performance is still unknown. Optimization of injectability could be achieved via addition of carboxymethyl cellulose (CMC). Here, we evaluated the long-term in vivo performance of CPC-PLGA with or without the lubricant CMC in comparison to the devitalized bovine bone mineral (DBBM) predicate device Bio-Oss^®. Rabbit femoral bone defects were injected with a CPC-formulation or filled with Bio-Oss^® granules. Samples were retrieved at 6 and 26 weeks. Material degradation for Bio-Oss^® was marginal, starting with 57% material remnants at implantation, 49% at 6 weeks, and 35% at 26 weeks, respectively. In contrast, CPC-PLGA and CPC-PLGA-CMC showed significant material degradation, starting with 100% material remnants at implantation, 56 and 78% at 6 weeks, and 8 and 21% at 26 weeks. Bone formation showed to be rapid for Bio-Oss^®, with 24% at 6 weeks, and a similar value (27%) at 26 weeks. Both CPC-PLGA and CPC-PLGA-CMC showed a continuous temporal increase in bone formation, with 13 and 6% at 6 weeks, and 44 and 32% at 26 weeks. This study showed that CPC-PLGA induces favorable bone responses with  >90% degradation and  >40% new bone formation after an implantation period of 26 weeks.

Micro/Nano Multilayered Scaffolds of PLGA and Collagen by Alternately Electrospinning for Bone Tissue Engineering

The dual extrusion electrospinning technique was used to fabricate multilayered 3D scaffolds by stacking microfibrous meshes of poly(lactic acid-co-glycolic acid) (PLGA) in alternate fashion to micro/nano mixed fibrous meshes of PLGA and collagen. To fabricate the multilayered scaffold, 35 wt% solution of PLGA in THF-DMF binary solvent (3:1) and 5 wt% solution of collagen in hexafluoroisopropanol (HFIP) with and without hydroxyapatite nanorods (nHA) were used. The dual and individual electrospinning of PLGA and collagen were carried out at flow rates of 1.0 and 0.5 mL/h, respectively, at an applied voltage of 20 kV. The density of collagen fibers in multilayered scaffolds has controlled the adhesion, proliferation, and osteogenic differentiation of MC3T3-E1 cells. The homogeneous dispersion of glutamic acid-modified hydroxyapatite nanorods (nHA-GA) in collagen solution has improved the osteogenic properties of fabricated multilayered scaffolds. The fabricated multilayered scaffolds were characterized using FT-IR, X-ray photoelectron spectroscopy, and transmission electron microscopy (TEM). The scanning electron microscopy (FE-SEM) was used to evaluate the adhesion and spreads of MC3T3-E1 cells on multilayered scaffolds. The activity of MC3T3-E1 cells on the multilayered scaffolds was evaluated by applying MTT, alkaline phosphatase, Alizarin Red, von Kossa, and cytoskeleton F-actin assaying protocols. The micro/nano fibrous PLGA-Col-HA scaffolds were found to be highly bioactive in comparison to pristine microfibrous PLGA and micro/nano mixed fibrous PLGA and Col scaffolds.

The effect of platform switching on the levels of metal ion release from different implant-abutment couples

The improved peri-implant bone response demonstrated by platform switching may be the result of reduced amounts of metal ions released to the surrounding tissues. The aim of this study was to compare the levels of metal ions released from platform-matched and platform-switched implant–abutment couples as a result of accelerated corrosion. Thirty-six titanium alloy (Ti-6Al-4V) and cobalt–chrome alloy abutments were coupled with titanium cylinders forming either platform-switched or platform-matched groups (n=6). In addition, 18 unconnected samples served as controls. The specimens were subjected to accelerated corrosion by static immersion in 1% lactic acid for 1 week. The amount of metal ions ion of each test tube was measured using inductively coupled plasma mass spectrometry. Scanning electron microscope (SEM) images and energy dispersive spectroscopy X-ray analyses were performed pre- and post-immersion to assess corrosion at the interface. The platform-matched groups demonstrated higher ion release for vanadium, aluminium, cobalt, chrome, and molybdenum compared with the platform-switched groups (P<0.05). Titanium was the highest element to be released regardless of abutment size or connection (P<0.05). SEM images showed pitting corrosion prominent on the outer borders of the implant and abutment platform surfaces. In conclusion, implant–abutment couples underwent an active corrosion process resulting in metal ions release into the surrounding environment. The highest amount of metal ions released was recorded for the platform-matched groups, suggesting that platform-switching concept has a positive effect in reducing the levels of metal ion release from the implant–abutment couples.

Ceramic nanoparticles: Recompense, cellular uptake and toxicity concerns

Over the past few years, nanoparticles and their role in drug delivery have been the centre of attraction as new drug delivery systems. Various forms of nanosystems have been designed, such as nanoclays, scaffolds and nanotubes, having numerous applications in areas such as drug loading, target cell uptake, bioassay and imaging. The present study discusses various types of nanoparticles, with special emphasis on ceramic nanocarriers. Ceramic materials have high mechanical strength, good body response and low or non-existing biodegradability. In this article, the various aspects concerning ceramic nanoparticles, such as their advantages over other systems, their cellular uptake and toxicity concerns are discussed in detail.

Biotribocorrosion (tribo-electrochemical) characterization of anodized titanium biomaterial containing calcium and phosphorus before and after osteoblastic cell culture

The purpose of this study was to investigate the relationship between the osteoblastic cells behavior and biotribocorrosion phenomena on bioactive titanium (Ti). Ti substrates submitted to bioactive anodic oxidation and etching treatments were cultured up to 28 days with MG63 osteoblast-like cells. Important parameters of in vitro bone-like tissue formation were assessed. Although no major differences were observed between the surfaces topography (both rough) and wettability (both hydrophobic), a significant increase in cell attachment and differentiation was detected on the anodized substrates as product of favorable surface morphology and chemical composition. Alkaline phosphatase production has increased (≈20 nmol/min/mg of protein) on the anodized materials, while phosphate concentration has reached the double of the etched material and calcium production increased (over 20 µg/mL). The mechanical and biological stability of the anodic surfaces were also put to test through biotribocorrosion sliding solicitations, putting in evidence the resistance of the anodic layer and the cells capacity of regeneration after implant degradation. The Ti osteointegration abilities were also confirmed by the development of strong cell-biomaterial bonds at the interface, on both substrates. By combining the biological and mechanical results, the anodized Ti can be considered a viable option for dentistry.

Effects of processing parameters in thermally induced phase separation technique on porous architecture of scaffolds for bone tissue engineering

Tissue engineering makes use of 3D scaffolds to sustain three-dimensional growth of cells and guide new tissue formation. To meet the multiple requirements for regeneration of biological tissues and organs, a wide range of scaffold fabrication techniques have been developed, aiming to produce porous constructs with the desired pore size range and pore morphology. Among different scaffold fabrication techniques, thermally induced phase separation (TIPS) method has been widely used in recent years because of its potential to produce highly porous scaffolds with interconnected pore morphology. The scaffold architecture can be closely controlled by adjusting the process parameters, including polymer type and concentration, solvent composition, quenching temperature and time, coarsening process, and incorporation of inorganic particles. The objective of this review is to provide information pertaining to the effect of these parameters on the architecture and properties of the scaffolds fabricated by the TIPS technique.

Porcine gelatin microsphere/calcium phosphate cement composites: an in vitro degradation study

Scaffolds for bone tissue engineering preferably should be mechanically stable, osteoconductive, biodegradable and porous. To comply with these characteristics, calcium phosphate cements (CPCs) with porcine (type A) gelatin microspheres were formulated. In this experiment, in vitro degradation of 10 wt % gelatin type A microsphere CPCs (GELA CPCs) was followed for 12 weeks in proteolytic medium. Results showed a gradual decrease in mass, compression strength and E-modulus. Morphology investigation showed that degradation of the spheres started at the surface of the composite and gradually proceeded to the inner part. Overall, porcine gelatin microspheres can be used to generate in situ macroporosity into an injectable CPC.

Ceramic composites as matrices and scaffolds for drug delivery in tissue engineering

Ceramic composites and scaffolds are popular implant materials in the field of dentistry, orthopedics and plastic surgery. For bone tissue engineering especially CaP-ceramics or cements and bioactive glass are suitable implant materials due to their osteoconductive properties. In this review the applicability of these ceramics but also of ceramic/polymer composites for bone tissue engineering is discussed, and in particular their use as drug delivery systems. Overall, the high density and slow biodegradability of ceramics is not beneficial for tissue engineering purposes. To address these issues, macroporosity can be introduced often in combination with osteoinductive growth factors and cells. Ceramics are good carriers for drugs, in which release patterns are strongly dependent on the chemical consistency of the ceramic, type of drug and drug loading. Biodegradable polymers like polylactic acid, gelatin or chitosan are used as matrices for ceramic particles or as adjuvant to calcium phosphate cements. The use of these polymers can introduce a tailored biodegradation/drug release to the ceramic material.

Anisotropic fracture in bovine root and coronal dentin

OBJECTIVES

This purpose of this study was to address the fundamental question of how the fracture properties of dentin are related to its composite structure.

METHODS

Strain concentration tests and impression-induced damage tests were designed to compare bovine root dentin with coronal dentin, and to understand the role of individual structural elements in the fracture of dentin.

RESULTS

Absent in peritubular dentin, root dentin is insensitive to cracks and exhibits higher fracture resistance than coronal dentin that has a typical brittle fracture behavior along the peritubular dentin. Fracture analysis and impression damage experiments found that root dentin is highly anisotropic in fracture behavior. Cracking is predominantly controlled by the organization of collagen fibrils, with the incremental lines being the weakest planes. In coronal dentin, highly mineralized peritubular dentin that intersects with the incremental lines creates additional weak orientations that compete with the incremental lines and thus greatly decrease the degree of fracture anisotropy.

SIGNIFICANCE

This study demonstrated that dentin is by no means homogeneous in terms of fracture properties. Location and orientation (especially in terms of incremental lines) should be taken into account when examining tooth failure both in laboratory and in clinical studies.

Curing efficiency and heat generation of various resin composites cured with high-intensity halogen lights

The objective of this study was to assess the curing efficiency and heat generation of two high-intensity halogen lamps, the Astralis 10 HIP (1100 mW cm(-2)), and Optilux 501 Boost (1000 mW cm(-2)) in curing three resin composites (InTen-S, Tetric Ceram, and Filtek Z250). It was expected that the two lamps, having similar irradiance would give rise to the same curing efficiency and heat generation. The curing efficiency was evaluated by Vickers hardness and depth of cure measurements. Heat generation in the resin composites was studied in standardized restorations using a thermocouple. No significant differences were observed in curing efficiency between the two lamps for the three resin composites. The temperature rise in the composites during curing was between 11.2 degrees C and 16.2 degrees C. At subsequent irradiation, after the composites had been cured, the temperature rise was between 8.2 degrees C and 12.1 degrees C. The Optilux 501 generated, in all cases, less heat than the Astralis 10. This was not expected based on the irradiance, but could be accounted for by the differing spectra.

Separation of ethoxylated bisphenol A dimethacrylates in dental composite after derivatisation to ionisable amines by capillary zone electrophoresis

Bisphenol A ethoxylate dimethacrylates (Bis-EMA) are transformed into ionisable amines by derivatisation in order to make the analytes applicable to capillary electrophoresis. For this goal, piperidine was added onto the C=C double bond of the alpha,beta-unsaturated ester group forming a tertiary amine with pKa values between 9 and 10. Formation of the derivatives was confirmed by electrospray ionisation MS. Commercial Bis-EMA is a mixture of homologues with different number of ethoxy groups; it is characterised by the average number of the ethoxy groups in the chains. These homologues were resolved by capillary zone electrophoresis at pH 4. It is shown for the product with an average of four ethoxy groups per Bis-EMA molecule that about seven homologues can be baseline separated when differing by only one ethoxy group. For Bis-EMA with 30 ethoxy groups in average, about 23 homologues could be differentiated. The high resolution power of capillary zone electrophoresis enables characterisation of commercial dental composite material concerning the Bis-EMA constituents.

Repositioning of the gingival margin by extrusion

In this case report, orthodontic intervention was used to move the gingival margin of a maxillary canine incisally by almost 9 mm to mimic a lateral incisor. Increasing the thickness of the labial plate of bone of the canine and subsequently increasing the thickness of the attached gingiva before extrusion prevented gingival recession at a later stage. In many situations, orthodontic treatment can achieve results that could not be attained by restorations and other means of cosmetic dentistry, especially when dealing with gingival margins and gingival height. A step-by-step approach to achieving these treatment objectives is described.

Provision of Atraumatic Restorative Treatment (ART) restorations to Chinese pre-school children--a 30-month evaluation

OBJECTIVES

The objectives of this study were: to provide restorations using the ART approach to pre-school children in Southern China in a kindergarten environment, using a high-strength glass-ionomer restorative material; to assess the acceptability of this approach and to evaluate on a longitudinal basis the restorations placed.

SAMPLE AND METHODS

A total of 170 ART restorations were placed in 95 children, aged 5.1 +/- 0.7 years, by seven final-year dental students using standard ART procedures and hand instruments. The restorations were evaluated every six months thereafter by two calibrated independent examiners using explorers and mouth-mirrors.

RESULTS

93% of the children reported that they did not feel pain during treatment and 86% were willing to receive ART restorations again. The cumulative 12- and 30-month survival rates of Class I restorations were 91% and 79%, respectively. The corresponding figures for Class V restorations were 79% and 70%, while those for Class II restorations were 75% and 51%. The failure rates of Class III and IV restorations were high with more than half of them scored as missing within the first year.

CONCLUSIONS

The ART approach was shown to be acceptable to Chinese pre-school children for providing restorative dental care outside the traditional clinical setting. The success rates were high for Class I and V restorations in primary teeth, modest for Class II, and low for Class III and IV restorations.