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Liu W, Zhao Q, Tang C, Cai Z, Jin Y, Ahn DU, Huang X. Promoting effect of phosvitin in the mineralization of eggshell inner membrane with the application in osteogenic induction scaffold. Colloids Surf B Biointerfaces 2024; 237:113842. [PMID: 38513299 DOI: 10.1016/j.colsurfb.2024.113842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/05/2024] [Accepted: 03/10/2024] [Indexed: 03/23/2024]
Abstract
Exploring affordable and easily prepared inorganic-organic hybrid membrane materials has attracted a great interest in the bone repair field. This study is based on biomimetic mineralization technique to study the role of phosvitin (PV) in the mineralized process of eggshell inner membrane. Results showed that PV promoted the formation of hydroxyapatite on the eggshell inner membrane surface, and the phosvitin content in the simulated body fluid was decreased during the mineralization process. Besides, in vitro preosteoblast experiments indicated that mineralized membrane with PV exhibited more conducive to cell proliferation and differentiation than that mineralized membrane without PV. Interestingly, with the increase of mineralization time, the stimulating ability of mineralized membranes with PV on adhesion, proliferation, alkaline phosphatase activity and collagen type I content gradually improved. In summary, the eggshell inner membrane composites mineralized with PV obtained by biomimetic mineralization might be potential scaffold materials for bone repair.
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Affiliation(s)
- Wei Liu
- National Research and Development Center for Egg Processing, College of Food Science and Technology, Huazhong Agricultural University, Wuhan, Hubei 430070, PR China
| | - Qiancheng Zhao
- National Research and Development Center for Egg Processing, College of Food Science and Technology, Huazhong Agricultural University, Wuhan, Hubei 430070, PR China
| | - Cuie Tang
- National Research and Development Center for Egg Processing, College of Food Science and Technology, Huazhong Agricultural University, Wuhan, Hubei 430070, PR China
| | - Zhaoxia Cai
- National Research and Development Center for Egg Processing, College of Food Science and Technology, Huazhong Agricultural University, Wuhan, Hubei 430070, PR China
| | - Yongguo Jin
- National Research and Development Center for Egg Processing, College of Food Science and Technology, Huazhong Agricultural University, Wuhan, Hubei 430070, PR China
| | - Dong Uk Ahn
- Animal Science Department, Iowa State University, Ames, USA.
| | - Xi Huang
- National Research and Development Center for Egg Processing, College of Food Science and Technology, Huazhong Agricultural University, Wuhan, Hubei 430070, PR China.
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Wuersching SN, Högg C, Kohl L, Reichl FX, Hickel R, Kollmuss M. Leaching components and initial biocompatibility of novel bioactive restorative materials. Dent Mater 2023; 39:293-304. [PMID: 36754734 DOI: 10.1016/j.dental.2023.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/24/2023] [Accepted: 01/31/2023] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Bioactive restorative materials were developed on the premise that direct restorations should not only serve the purpose of reconstructing dental hard tissue defects but also exhibit biological features that prevent secondary caries development, without having adverse effects on the host cells. This study focuses on assessing the in vitro biocompatibility of two novel bioactive restorative materials. METHODS Specimens of the bioactive restorative materials, Cention Forte (CF) and ACTIVA BioACTIVE RESTORATIVE (AB), a glass ionomer cement/glass hybrid (EQUIA Forte HT, EF) and an established nanohybrid composite (Venus Diamond, VD) were produced and finished. The specimens were eluted in water and methanol and the resulting eluates were analyzed via gas chromatography-mass spectrometry. hGF-1 cells were exposed to eluates prepared in cell culture medium. Cellular ATP levels, oxidized glutathione concentration, caspase-3/7 activity and the inflammatory response (IL-6 and PGE2 levels) were determined. Microscopic images were taken to examine the cell morphology. RESULTS Methyl methacrylate and 2-Hydroxyethyl methacrylate were the main monomers detected in CF and AB eluates. All materials inhibited cell proliferation and led to significantly reduced ATP-levels. The cells exhibited a healthy morphology in the presence of CF and AB. Cells exposed to VD showed increased oxidized glutathione levels. Only EF led to enhanced caspase-3/7 activity. CF and AB caused IL-6 levels to increase, while EF and AB led to enhanced PGE2 levels. SIGNIFICANCE CF and AB are promising materials from a biological point of view and seem to have improved bioactive properties compared to glass ionomer cements.
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Affiliation(s)
- Sabina Noreen Wuersching
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany. .-muenchen.de
| | - Christof Högg
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany; Walther Straub Institute of Pharmacology and Toxicology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Lisa Kohl
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany
| | - Franz-Xaver Reichl
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany; Walther Straub Institute of Pharmacology and Toxicology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany
| | - Maximilian Kollmuss
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany
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Bioactive Restorative Materials. Int Dent J 2023; 73:9-10. [PMID: 36653076 PMCID: PMC9875277 DOI: 10.1016/j.identj.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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Franca CM, Balbinot GDS, Cunha D, Saboia VDPA, Ferracane J, Bertassoni LE. In-vitro models of biocompatibility testing for restorative dental materials: From 2D cultures to organs on-a-chip. Acta Biomater 2022; 150:58-66. [PMID: 35933103 PMCID: PMC9814917 DOI: 10.1016/j.actbio.2022.07.060] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/13/2022] [Accepted: 07/28/2022] [Indexed: 02/08/2023]
Abstract
Dental caries is a biofilm-mediated, diet-modulated, multifactorial and dynamic disease that affects more than 90% of adults in Western countries. The current treatment for decayed tissue is based on using materials to replace the lost enamel or dentin. More than 500 million dental restorations are placed annually worldwide, and materials used for these purposes either directly or indirectly interact with dentin and pulp tissues. The development and understanding of the effects of restorative dental materials are based on different in-vitro and in-vivo tests, which have been evolving with time. In this review, we first discuss the characteristics of the tooth and the dentin-pulp interface that are unique for materials testing. Subsequently, we discuss frequently used in-vitro tests to evaluate the biocompatibility of dental materials commonly used for restorative procedures. Finally, we present our perspective on the future directions for biological research on dental materials using tissue engineering and organs on-a-chip approaches. STATEMENT OF SIGNIFICANCE: Dental caries is still the most prevalent infectious disease globally, requiring more than 500 million restorations to be placed every year. Regrettably, the failure rates of such restorations are still high. Those rates are partially based on the fact that current platforms to test dental materials are somewhat inaccurate in reproducing critical components of the complex oral microenvironment. Thus, there is a collective effort to develop new materials while evolving the platforms to test them. In this context, the present review critically discusses in-vitro models used to evaluate the biocompatibility of restorative dental materials and brings a perspective on future directions for tissue-engineered and organs-on-a-chip platforms for testing new dental materials.
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Affiliation(s)
- Cristiane Miranda Franca
- Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, United States
| | - Gabriela de Souza Balbinot
- Dental Materials Laboratory, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Diana Cunha
- Post-Graduation Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | | - Jack Ferracane
- Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, United States
| | - Luiz E Bertassoni
- Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, United States; Center for Regenerative Medicine, School of Medicine, Oregon Health & Science University, Portland, OR, United States; Department of Biomedical Engineering, School of Medicine, Oregon Health & Science University, Portland, OR, United States; Cancer Early Detection Advanced Research Center (CEDAR), Knight Cancer Institute, Portland, OR, United States.
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Neto CCL, das Neves AM, Arantes DC, Sa TCM, Yamauti M, de Magalhães CS, Abreu LG, Moreira AN. Evaluation of the clinical performance of GIOMERs and comparison with other conventional restorative materials in permanent teeth: a systematic review and meta-analysis. Evid Based Dent 2022:10.1038/s41432-022-0281-8. [PMID: 35915167 DOI: 10.1038/s41432-022-0281-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/25/2021] [Indexed: 11/08/2022]
Abstract
Aim The aim of this systematic review and meta-analysis was to analyse the clinical performance of GIOMER restorative composites and compare them with other conventional restorative materials in permanent teeth.Methods Searches in PubMed, Web of Science, Scopus, Ovid and Cochrane Library were conducted. Grey literature search was also performed. Clinical trials that evaluated the clinical performance of restorations with GIOMER restorative composites in permanent teeth compared to those using composite resin, glass ionomer cement, resin-modified glass ionomer cement (RMGIC) and other GIOMERs were included. Meta-analyses comparing GIOMER restorative composites with RMGIC at 6- and 12-month follow-ups and comparing two types of GIOMER were feasible.Results Ten studies fulfilled the inclusion criteria. In these studies, GIOMER was compared to different types of dental restoration materials. Dental restorations were evaluated by United States Public Health Service criteria in all included studies. Four studies were suitable for meta-analysis, which showed significant differences between GIOMER and RMGIC surface roughness at 6-month (odds ratio [OR] = 6.56; 95% confidence interval [CI] = 2.38-18.13) and 12-month (OR = 8.76; CI = 3.19-24.07) follow-ups. No significant differences between GIOMER restorative composites and RMGIC for marginal adaptation were found at 6- and 12-month follow-ups. When comparing two GIOMERs, significant differences were seen between Beautifil II and Beautifil Flowable Plus F00 for marginal staining (OR = 2.58; CI = 1.42-23.27; I2 = 0%) and surface roughness (OR = 4.59; CI = 1.11-18.97; I2 = 0%) at the 36-month follow-up. No significant differences between Beautifil II and Beautifil Flowable Plus F00 were seen for marginal adaptation and anatomic form at 6-, 18- and 36-month follow-ups.Conclusions GIOMER restorative composites presented similar performance concerning marginal adaptation and better surface roughness when compared to RMGIC. GIOMER Beautifil II presented similar performance to GIOMER Beautifil Flow Plus F00 concerning marginal adaptation and anatomic form and worse marginal staining and surface roughness when compared to Beautifil Flowable Plus F00.
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Affiliation(s)
- Clóvis Ciryllo Limonge Neto
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais, Avenida Antônio Carlos, 6627, Campus Pampulha, CEP 31270-091, Belo Horizonte, Minas Gerais, Brazil
| | - André Martins das Neves
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais, Avenida Antônio Carlos, 6627, Campus Pampulha, CEP 31270-091, Belo Horizonte, Minas Gerais, Brazil
| | - Diandra Costa Arantes
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais, Avenida Antônio Carlos, 6627, Campus Pampulha, CEP 31270-091, Belo Horizonte, Minas Gerais, Brazil
| | - Tassiana Cançado Melo Sa
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais, Avenida Antônio Carlos, 6627, Campus Pampulha, CEP 31270-091, Belo Horizonte, Minas Gerais, Brazil
| | - Monica Yamauti
- Associate Professor, Department of Restorative Dentistry, Faculty of Dental Medicine, Hokkaido University, 17 Chome Minami 1 Jonishi, Chuo Ward, Sapporo, Hokkaido 060-8556, Japan
| | - Cláudia Silami de Magalhães
- Full Professor, Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais, Avenida Antônio Carlos, 6627, Campus Pampulha, CEP 31270-091, Belo Horizonte, Minas Gerais, Brazil
| | - Lucas Guimarães Abreu
- Adjunct Professor, Department of Paediatric Dentistry, School of Dentistry, Federal University of Minas Gerais, Avenida Antônio Carlos, 6627, Campus Pampulha, CEP 31270-091, Belo Horizonte, Minas Gerais, Brazil.
| | - Allyson Nogueira Moreira
- Full Professor, Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais, Avenida Antônio Carlos, 6627, Campus Pampulha, CEP 31270-091, Belo Horizonte, Minas Gerais, Brazil
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Filemban H, Bhadila G, Wang X, Melo MAS, Oates TW, Hack GD, Lynch CD, Weir MD, Sun J, Xu HHK. Effects of thermal cycling on mechanical and antibacterial durability of bioactive low-shrinkage-stress nanocomposite. J Dent 2022; 124:104218. [PMID: 35817225 DOI: 10.1016/j.jdent.2022.104218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/10/2022] [Accepted: 05/18/2022] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVES Recent studies developed low-shrinkage-stress composite with remineralizing and antibacterial properties to combat secondary caries and increase restoration longevity. However, their long-term durability in thermal cycling is unclear. The objectives of this study were to develop an antibacterial, remineralizing and low-shrinkage-stress composite, and to investigate its durability in thermal cycling for 20,000 cycles, equivalent to two years of clinical life. METHODS The resin consisted of urethane dimethacrylate (UDMA) and triethylene glycol divinylbenzyl ether (TEG-DVBE). Composites were made with 5% dimethylaminohexadecyl methacrylate (DMAHDM) and 20% of nanoparticles of amorphous calcium phosphate (NACP). Composites were thermal cycled at 5°C and 55°C for 20,000 cycles. A human salivary biofilm model was used to evaluate antibiofilm activity before and after thermal cycling. RESULTS After 20,000 cycles, the flexural strength of bioactive low-shrinkage-stress composite matched commercial control with no antibacterial activity (p > 0.05). Surface roughness was clinically acceptable at less than 0.2 μm. UV+NACP+DMAHDM composite reduced the total microorganisms, total streptococci, and mutans streptococci by 2-5 logs, compared to commercial composite. Biofilm lactic acid production was reduced by 11 folds. The antibacterial performance was maintained after thermal cycling, with no decrease after 20,000 cycles. CONCLUSIONS Bioactive low-shrinkage-stress composite possessed good mechanical properties that matched commercial composite both before and after thermal cycling. The new composite had potent antibacterial activity, which was maintained and did not decrease after thermal cycling. CLINICAL SIGNIFICANCE The new bioactive low-shrinkage-stress composite could reduce polymerization shrinkage stress and release calcium and phosphate ions, with good mechanical properties and strong antibacterial function that were durable after thermal cycling. These properties indicate great potential for inhibiting recurrent caries and increasing the restoration longevity.
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Affiliation(s)
- Hanan Filemban
- Ph.D. Program in Dental Biomedical Sciences, Biomaterials and Tissue Engineering Division, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; Department of Operative Dentistry, Faculty of Dentistry, King AbdulAziz University, Jeddah 21589, Saudi Arabia
| | - Ghalia Bhadila
- Department of Pediatric Dentistry, Faculty of Dentistry, King AbdulAziz University, Jeddah 21589, Saudi Arabia
| | - Xiaohong Wang
- American Dental Association Science and Research Institute, Gaithersburg, MD 20899, USA
| | - Mary Ann S Melo
- Division of Operative Dentistry, Department of General Dentistry, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Thomas W Oates
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Gary D Hack
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Christopher D Lynch
- Restorative Dentistry, University Dental School and Hospital, University College Cork, Wilton, Cork, Ireland
| | - Michael D Weir
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA.
| | - Jirun Sun
- The Forsyth Institute, Cambridge, USA.
| | - Hockin H K Xu
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; Center for Stem Cell Biology & Regenerative Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
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Darvell BW, Smith AJ. Inert to bioactive - A multidimensional spectrum. Dent Mater 2021; 38:2-6. [PMID: 34893350 DOI: 10.1016/j.dental.2021.11.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/14/2021] [Accepted: 11/17/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To clarify the terminology and its application in the context of materials placed in contact with tissues in living systems. METHODS Review the nature of both the biological and chemical reactions occurring in such contexts with a view to a classification of types of behaviour and thus types of material. RESULTS A range of types of behaviour was identified with clear diagnostic characteristics. Materials could thus be classified accordingly, with the possibility of more than one type of behaviour being exhibited. 'Bioactivity' was concluded to depend solely on the modulation of a natural biological process, but excluding pharmaceutical action. SIGNIFICANCE Clarity in the characterisation and labelling of materials and their behaviours in biological systems will benefit the interpretation of the literature, the design of experiments, and future research directions.
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Affiliation(s)
- Brian W Darvell
- Dental Materials Science, School of Dentistry, University of Birmingham, UK.
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Cardoso OS, Meier MM, Carvalho EM, Ferreira PVC, Gavini G, Zago PMW, Grazziotin-Soares R, Menezes ASD, Carvalho CN, Bauer J. Synthesis and characterization of experimental endodontic sealers containing bioactive glasses particles of NbG or 45S5. J Mech Behav Biomed Mater 2021; 125:104971. [PMID: 34798534 DOI: 10.1016/j.jmbbm.2021.104971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/03/2021] [Accepted: 11/08/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study evaluated the influence of adding bioactive glasses particles [Niobophosphate (NbG) or bioglass (45S5)] into endodontic cements in relation to physical, chemical and biological properties. METHODS The following commercial cements were used as comparison: AH Plus (Dentsply), Endofill (Dentsply), MTA Fillapex (Angelus) and EndoSequence (BC Sealer, Brasseler). Setting time, radiopacity, flow rate, weight loss/variation, alkaline capacity (pH) at different time-intervals (24h/48h/7d/14d/28d), bioactivity (assessed under SEM/EDS, FTIR/ATR and XDR) and cell viability were measured. Data were analyzed by One-way ANOVA/Holm-Sidak post-test (α = 5%) (normal distribution) and Kruskal-Wallis/Students-Newman-Keuls post-test (α = 5%) (non-normal distribution). RESULTS Bioactive endodontic experimental cements (containing NbG or 45S5) had high alkalinization capacity. The experimental cements presented high weight loss/variation (p < 0.001). 45S5 experimental cement did not present radiopacity (p < 0.001). AH Plus had the lowest cell cytotoxicity when compared to the other tested cements (p < 0.001). Regarding bioactivity, SEM/EDS analyses showed precipitates with high concentrations of Ca/P for 45S5 and NbG, as well as for MTA Fillapex and BC Sealer. AH plus and Endofill did not present bioactive precipitates. FTIR/ATR and XDR analyses found hydroxyapatite precursors for NbG, 45S5, MTA Fillapex and BC Sealer. SIGNIFICANCE The incorporation of bioactive particles (NbG or 45S5) into endodontic cements had potential to neutralize acidic environments and induced formation of hydroxyapatite precursors. Clinically, these would produce a cement that is bactericidal and have the potential to improve tissue healing. The improved radiopacity and flowability would facilitate the visualization of the material in the radiograph and the filling of anatomical complexities during root canal obturation. As drawbacks, the excessive weight loss and post-setting cytotoxicity could result in clinical degradation of the cement and adjacent tissue irritation for the patient.
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Affiliation(s)
- Olinto Santos Cardoso
- Discipline of Dental Materials, School of Dentistry, Federal University of Maranhão (UFMA), Av. dos Portugueses, 1966, Zip Code 65080-805, São Luis, Maranhão, Brazil
| | - Marcia Margarete Meier
- Department of Chemistry, State University of Santa Catarina (UDESC), Rua Paulo Malschitzki, 200, Zip Code: 89219-710, Joinville, Santa Catarina, Brazil
| | - Edilausson Moreno Carvalho
- University Ceuma (UNICEUMA), School of Dentistry, Rua Josué Montello, 1, Renascença II, Zip Code 65075-120, São Luis, Maranhão, MA, Brazil
| | - Paulo Vitor Campos Ferreira
- Department of Restorative Dentistry, School of Dentistry, Universidade de São Paulo (FOUSP), Av. Prof Lineu Prestes, 2227, Zip Code: 05508-000, São Paulo, Brazil
| | - Giulio Gavini
- Department of Restorative Dentistry, Dental Materials Division, School of Dentistry, University of Campinas (UNICAMP), Av. Limeira, 901, Zip Code 13414-903, Piracicaba, São Paulo, Brazil
| | - Patrícia Maria Wiziack Zago
- São Leopoldo Mandic Dental School and Research Center, Av. Dona Renata, 71, Zip Code: 13606-134, Araras, São Paulo, Brazil
| | - Renata Grazziotin-Soares
- College of Dentistry, University of Saskatchewan, 105 Wiggins Road, Saskatoon, Saskatchewan, S7N 5E4, Canada
| | - Alan Silva de Menezes
- Department of Physics, Federal University of Maranhão (UFMA), Av. dos Portugueses, 1966, Zip Code 65080-805, São Luis, Maranhão, Brazil
| | - Ceci Nunes Carvalho
- University Ceuma (UNICEUMA), School of Dentistry, Rua Josué Montello, 1, Renascença II, Zip Code 65075-120, São Luis, Maranhão, MA, Brazil
| | - Jose Bauer
- Discipline of Dental Materials, School of Dentistry, Federal University of Maranhão (UFMA), Av. dos Portugueses, 1966, Zip Code 65080-805, São Luis, Maranhão, Brazil.
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