Prolonged UV-C Irradiation is a Double-Edged Sword on the Zirconia Surface

The mechanical, wear, antibacterial properties and biocompatibility of injectable restorative materials under wet challenge

OBJECTIVES

To evaluate the mechanical, wear, antibacterial properties, and biocompatibility of injectable composite materials.

METHODS

Two injectable composite resins (GU and BI), one flowable composite resin (FS), and one flowable compomer (DF), in A2 shade, were tested. Mechanical properties were tested via three-point bending test immediately after preparation and after 1-day, 7-day, 14-day, and 30-day water storage. Under water-PMMA slurry immersion, specimens were subjected to a 3-body wear test (10,000 cycles) against stainless steel balls, while the roughness, wear depth, and volume loss were recorded. After 1-day and 3-day MC3T3-E1 cell culture, cell viability was evaluated with CCK-8 test kits, while the cell morphology was observed under CLSM and SEM. Antibacterial properties on S. mutans were assessed via CFU counting, CLSM, and SEM observation. SPSS 26.0 was used for statistical analysis (α = 0.05).

RESULTS

The mechanical properties were material-dependent and sensitive to water storage. Flexural strength ranked GU > FS > BI > DF at all testing levels. Three nanocomposites had better wear properties than DF. No significant difference on 1-day cell viability was found, but DF showed significantly lower cell proliferation than nanocomposites on 3-day assessment. GU and FS had more favourable cell adhesion and morphology. CFU counting revealed no significant difference, while FS presented a slightly thicker biofilm and BI showed relatively lower bacteria density.

CONCLUSIONS

Injectable nanocomposites outperformed the compomer regarding mechanical properties, wear resistance, and biocompatibility. The tested materials presented comparable antibacterial behaviours. Flowable resin-based composites' performances are affected by multiple factors, and their compositions can be attributed.

CLINICAL SIGNIFICANCE

A profound understanding of the mechanical, wear, and biological properties of the restorative material is imperative for the clinical success of dental restorations. The current study demonstrated superior properties of highly filled injectable composite resins, which imply their wider indications and better long-term clinical performances.

The integration of peri-implant soft tissues around zirconia abutments: Challenges and strategies

Stable soft tissue integration around the implant abutment attenuates pathogen penetration, protects underlying bone tissue, prevents peri-implantitis and is essential in maintaining long-term implant stability. The desire for "metal free" and "aesthetic restoration" has favored zirconia over titanium abutments, especially for implant restorations in the anterior region and for patients with thin gingival biotype. Soft tissue attachment to the zirconia abutment surface remains a challenge. A comprehensive review of advances in zirconia surface treatment (micro-design) and structural design (macro-design) affecting soft tissue attachment is presented and strategies and research directions are discussed. Soft tissue models for abutment research are described. Guidelines for development of zirconia abutment surfaces that promote soft tissue integration and evidence-based references to inform clinical choice of abutment structure and postoperative maintenance are presented.

A biomimetic approach to evaluate mineralization of bioactive glass-loaded resin composites

PURPOSE

This study explores novel solutions other than standard SBF for biomimetic evaluations of mineralization particularly for resin composites containing bioactive glass (BAG).

METHODS

Experimental UDMA/TEGDMA resin composites with 0.0, 1.9, 3.8 or 7.7 vol% of 45S5 BAG fillers were prepared. Besides simulated body fluid (SBF) as control, the specimens were immersed in three other solutions either with bicarbonate which are Hank's balanced salt solution (HBSS) and cell culture medium (MEM), or without bicarbonate which is a novel Simple HEPES-containing Artificial Remineralization Promotion (SHARP) solution, for 3, 7 and 14 days. These solutions were then analyzed by ICP-OES and pH, and the surfaces of the BAG composites were analyzed by SEM, XRD and FTIR.

RESULTS

ICP-OES revealed Ca and P concentration continuously decrease, while Si concentration increases with time in the solutions other than SBF, which showed almost unchanged elemental concentration. Only SHARP solution is able to maintain a constant pH over the immersion time. SEM, together with XRD and FTIR, showed nano-sized octacalcium phosphate (OCP) nanospheres formation on 3.8 and 7.7 vol% BAG composites after 14 days immersion in HBSS (500-600 nm) and MEM (300-400 nm). SHARP solution enabled OCP formation after 3 days and then self-assembled into urchin-like carbonated hydroxyapatite (CHA) microspheres encompassed with nanorods of 100 nm width and 8 µm length after 14 days of immersion for 7.7 vol% BAG composites.

CONCLUSION

This study suggests SHARP solution can evaluate mineralization biomimetically whereas CHA microspheres can be formed on BAG-containing resin composites.

A simple solution to recycle and reuse dental CAD/CAM zirconia block from its waste residuals

Purpose To seek a simple solution that can recycle and regenerate dental CAD/CAM zirconia green blanks from its waste residuals.Methods Waste residuals (3M® Lava™ Plus HT) were pulverized after dry milling and cutting, and subsequently sieved before pickling in a 0.5 M nitric acid. These powders were then dry-pressed and pre-sintered into blocks at seven different temperatures in the range 800-1100 °C. New zirconia blocks flagged with the same batch numbers were used as control. These blocks were cut into bars before subjected them to manufacturer-recommended sintering at 1450 °C. Crystalline phases (by XRD), elemental compositions (by EDX), surface morphologies (by SEM), machinability, linear shrinkage rate, relative density, and Knoop microhardness were evaluated before and after sintering, and four-point flexural strengths were also evaluated for the sintered zirconia bars.Results Only tetragonal phases were found in both pre- and fully-sintered recycled zirconia blocks. SEM results showed that pre-sintered samples at 950 °C had smooth and flat surfaces with evenly distributed particles. Recycled and control zirconia blocks had similar elemental compositions. Results from machined surface, linear shrinkage rate, relative density, and Knoop microhardness established that 950 °C and 1000 °C were suitable pre-sintering temperatures for recycling zirconia. Pre-sintered recycled zirconia had no significant differences in flexural strengths, however, samples pre-sintered at 1000 °C exhibited the closest value (897 MPa) compared to that of the control (904 MPa).Conclusions Dental CAD/CAM zirconia can be recycled and reused from its waste residuals by adopting a simple method that requires a pre-sintering at 950 or 1000 °C.

An introduction of biological performance of zirconia with different surface characteristics: A review

Zirconia (ZrO₂) ceramic is widely used in dentistry as a clinical dental biomaterial. In this review, we are focusing on and summarizing the biological performance of zirconia under different surface characteristics. We have included an initial tissue cell attachment study on zirconia and bacterial adhesion on zirconia. Our results suggest that surface modifications applied on zirconia may change the interfacial surface characteristics e.g. surface roughness, surface free energy, and chemistry of zirconia. The modifications also result in advanced biological performance of zirconia, including enhanced tissue cell attachment and reduction of bacterial adhesion. The recent laboratory research has provided many interesting modification methods and showed clinically interesting and promising outcomes. A few of the outcomes are validated and have been applied in clinical dentistry.