Modifications in Glass Ionomer Cements: Nano-Sized Fillers and Bioactive Nanoceramics

In vitro degradation, swelling, and bioactivity performances of in situ forming injectable chitosan-matrixed hydrogels for bone regeneration and drug delivery

Injectable, tissue mimetic, bioactive, and biodegradable hydrogels offer less invasive regeneration and repair of tissues. The monitoring swelling and in vitro degradation capacities of hydrogels are highly important for drug delivery and tissue regeneration processes. Bioactivity of bone tissue engineered constructs in terms of mineralized apatite formation capacity is also pivotal. We have previously reported in situ forming chitosan-based injectable hydrogels integrated with hydroxyapatite and heparin for bone regeneration, promoting angiogenesis. These hydrogels were functionalized by glycerol and pH to improve their mechano-structural properties. In the present study, functionalized hybrid hydrogels were investigated for their swelling, in vitro degradation, and bioactivity performances. Hydrogels have degraded gradually in phosphate-buffered saline (PBS) with and without lysozyme enzyme. The percentage weight loss of hydrogels and their morphological and chemical properties, and pH of media were analyzed. The swelling ratio of hydrogels (55%-68%(wt), 6 h of equilibrium) indicated a high degree of cross-linking, can be suitable for controlled drug release. Hydrogels have gradually degraded reaching to 60%-70% (wt%) in 42 days in the presence and absence of lysozyme, respectively. Simulated body fluid (SBF)-treated hydrogels containing hydroxyapatite-induced needle-like carbonated-apatite mineralization was further enhanced by heparin content significantly.

Improving the Mechanical Properties of Glass Ionomer Cement With Nanocrystalline Cellulose From Rice Husk

This study aimed to evaluate the effect of incorporating nanocrystalline cellulose (NCC) sourced from rice husk on the mechanical properties of a commercial glass ionomer cement (GIC). NCC was isolated through acid hydrolysis, and its crystallinity, chemical structure, and morphology were characterized through x-ray diffractometry, Fourier-transform infrared spectroscopy, and transmission electron microscopy, respectively. Various concentrations of NCC (0%, 0.5%, 1%, and 1.5%) were added to reinforce the GIC matrix. Mechanical tests including compressive strength, flexural strength, hardness, and shear bond strength were conducted on the modified GIC samples. The addition of NCC resulted in increased hardness and shear bond strength values, with 1% NCC showing the highest values compared to other concentrations. However, there was no significant improvement observed in the compressive and flexural strength of the modified GIC. Failure mode test revealed a reduction in adhesive failure with the addition of NCC. Incorporating small amounts of NCC (0.5%-1%) suggests a promising and affordable modification of GIC restorative material using biomass residue, resulting in improved mechanical properties.

Titanium dioxide nanotubes applied to conventional glass ionomer cement influence the expression of immunoinflammatory markers: An in vitro study

Objectives

To assess the impact of different concentrations TiO2-nt incorporated into a glass ionomer cement on the proliferation, mitochondrial metabolism, morphology, and pro- and anti-inflammatory cytokine production of cultured fibroblasts (NIH/3T3), whether or not stimulated by lipopolysaccharides (LPS-2 μg/mL, 24 h).

Methods

TiO2-nt was added to KM (Ketac Molar EasyMix™, 3 %, 5 %, 7 % in weight); unblended KM was used as the control. The analyses included: Cell proliferation assay (n = 6; 24/48/72h); Mitochondrial metabolism assay (n = 6; 24/48/72h); Confocal laser microscopy (n = 3; 24/48/72h); Determination of biomarkers (IL-1β/IL-6/IL-10/VEGF/TNF) by using both multiplex technology (n = 6; 12/18 h) and the quantitative real-time PCR assay (q-PCR) (n = 3, 24/72/120 h). The data underwent analysis using both the Shapiro-Wilk and Levene tests, and by generalized linear models (α = 0.05).

Results

It demonstrated that cell proliferation increased over time, regardless of the presence of TiO2-nt or LPS, and displayed a significant increase at 72 h; mitochondrial metabolism increased (p < 0.05), irrespective of exposure to LPS (p = 0.937); no cell morphology changes were observed; TiO2-nt reverted the impact of KM on the secreted levels of the evaluated proteins and the gene expressions in the presence of LPS (p < 0.0001).

Conclusions

TiO2-nt did not adversely affect the biological behavior of fibroblastic cells cultured on GIC discs.

Microhardness, Surface Roughness, and Wear Resistance Enhancement of Reinforced Conventional Glass Ionomer Cement Using Fluorinated Graphene Oxide Nanosheets

OBJECTIVES

 Conventional glass ionomer cements (GICs) have been considered the most prevalent restorative material however; the reduced mechanical qualities and decreased wear resistance have been the main challenges facing their wide clinical application. This study was designed to assess the mechanical properties of fluorinated graphene (FG) oxide-modified conventional GIC.

MATERIALS AND METHODS

 Composites of FG/GIC samples were prepared using (Medifil from PROMEDICA, Germany, shade A3) at different concentrations (0wt%) control group and (1wt%, 2wt% and 3wt% FG) groups using cylindrical molds (3mm × 6mm). FG was prepared using hydrothermal technique and characterized using XPERT-PRO Powder Diffractometer system for X-ray diffraction analysis and JEOL JEM-2100 high resolution transmission electron microscope. Vickers' hardness and wear resistance of GI samples were measured. Mechanical abrasion was performed via three-body tooth brushing wear test using ROBOTA chewing simulator coupled with a thermocycling protocol (Model ACH-09075DC-T, AD-Tech Technology Co., Ltd., Leinfelden-Echterdingen, Germany).

STATISTICAL ANALYSIS

 Comparisons between groups with respect to normally distributed numeric variables were performed using one-way analysis of variance test followed by posthoc test. While paired t-test was utilized for comparing data within the same group.

RESULTS

The surface roughness values of GICs (1wt% FG) and (2wt% FG) composites were significantly lower than those of the control and 3wt%FG groups. Vickers' hardness numbers were significantly higher in FG/GICs composites than in the control group (p≤0.05).

CONCLUSION

 GIC/FG combinations have sufficient strength to resist the occlusion stresses with improved hardness as compared with conventional GIC. GIC/FG appeared to be a promising restorative material.

Effect of various surface coating methods on surface roughness, micromorphological analysis and fluoride release from contemporary glass ionomer restorations

OBJECTIVE

To evaluate the effect of various surface coating methods on surface roughness, micromorphological analysis and fluoride release from contemporary resin-modified and conventional glass ionomer restorations.

MATERIALS & METHODS

A total of 72 permanent human molars were used in this study. The teeth were randomly assigned into 2 groups according to type of restorative materials used; resin modified glass ionomer cement and conventional glass ionomer (SDI Limited. Bayswater Victoria, Australia). Each group was subdivided into 3 subgroups according to the application of coat material; Sub-group1: without application of coat; Sub-group2: manufacturer recommended coat was applied and sub-group3: customized (vaseline) coat was applied. Each group was then subdivided into two divisions according to the time of testing; immediate (after 24 h) and delayed (after 6 months of storage). Three specimens from each sub-group were selected for surface roughness test (AFM) and another 3 specimens for the micromorphological analysis using scanning electron microscope (SEM). For the fluoride release test, a total of 60 cylindrical discs were used (n = 60). The discs were randomly split into 2 groups according to type of restorative materials used (n = 30); resin modified glass ionomer cement and conventional glass ionomer. Each group was subdivided into 3 subgroups (n = 10) according to the application of the coat material; Sub-group1: without application of coat; Sub-group2: with the manufacturer recommended coat and sub-group3: with application of customized (vaseline) coat. Data for each test was then collected, tabulated, were collected, tabulated, and tested for the normality with Shapiro-Wilk test. Based on the outcome of normality test, the significant effects of variables were assessed using appropriate statistical analysis testing methods.

RESULTS

Regarding the data obtained from surface roughness test, Shapiro-Wilk test showed normal distribution pattern of all values (p > 0.05). Accordingly, Two-way ANOVA outcome showed that the 'type of restoration' or 'test time' had statistically significant effect on the AFM test (p < 0.05). Regarding Fluoride specific ion electrode test 2-way ANOVA followed by Least Significant Difference (LSD) Post-hoc test revealed significant difference among the groups (p < 0.05). It showed that SDI GIC group after 14 days of measurement had the highest mean of fluoride release (36.38 ± 3.16 PPM) and SDI RMGIC after 30 days of measurement had the second highest mean of fluoride release (43.28 ± 1.89 PPM). Finally, regarding the micromorphological analysis using SEM, a slight difference was observed between the studied groups.

CONCLUSIONS

Based on the results of this study, various coatings enhance surface roughness in the initial 24 h of restoration insertion. Different coat types seems that have no influence on fluoride release and the micromorphological features of the restoration/dentin interface.

Acemannan-containing bioactive resin modified glass ionomer demonstrates satisfactory physical and biological properties

Background/purpose

Resin-modified glass ionomers (RMGIs) have been recommended as liner and cement to provide the teeth with mechanical support, a chemical barrier, and thermal insulation. Acemannan, the main polysaccharide extracted from Aloe vera, is a promising inductive material in vitro and in vivo. This study aimed to develop acemannan-containing bioactive resin-modified glass ionomers (RMGIs).

Materials and methods

Acemannan (3%, 5%, and 10%) was added to the three types of RMGIs (RU-HBM1/Fuji II LC/Vitrebond) to generate 3%, 5%, and 10% aceRMGIs (aceRU/aceFuji/aceVB). The materials were evaluated for depth of cure/flexural strength/cumulative fluoride ion release. Cell viability and vascular endothelial growth factor (VEGF) and bone morphogenetic protein-2 (BMP-2) secretion were determined using MTT/apoptosis/necrosis assays, and ELISA kits, respectively. RMGI without acemannan were used as controls.

Results

The aceRMGIs met the ISO requirements for depth of cure and flexural strength. Adding 10% acemannan increased the cumulative fluoride release in the RU and FJ groups, but slightly decreased it in the VB group (P < 0.05). The MTT assay revealed 10% aceRU and all aceFJ groups significantly increased cell viability compared with each control group (P < 0.05). Apoptosis/necrosis assay showed the biocompatibility of all aceRMGIs. Adding acemannan to RMGIs significantly induced VEGF expression in a dose dependent manner while 5% and 10% aceRU significantly induced BMP-2 expression compared with RU group (P < 0.05).

Conclusion

We conclude that 5-10% acemannan in RMGI is the optimal concentration based on its physical properties and ability to induce pulp cell proliferation and growth factor secretion.

Green Synthesis, Characterization, and Evaluation of the Antimicrobial Properties and Compressive Strength of Hydroxyapatite Nanoparticle-Incorporated Glass Ionomer Cement

Background Glass ionomer cement (GIC) plays a vital role in dental restorative procedures, serving purposes such as filling, luting, and adhesion. However, its inadequate mechanical properties pose challenges, especially in areas experiencing significant stress. To overcome this limitation, nanohydroxyapatite (nHA), known for its bioactive phosphate content, is added to the GIC at specific concentrations to improve its properties. Aim  We aim to evaluate the antimicrobial property and compressive strength of green-mediated nHA-incorporated GIC. Material and methods Green synthesis of hydroxyapatite nanoparticles was prepared using Moringa oleifera extract in a solvent form and eggshell waste served as the calcium source. These nHA powders were then integrated into the GIC at varying concentrations (3%, 5%, and 10%) designated as Group I, Group II, and Group III, respectively, while Group IV (control) consisted of conventional GIC. Specimens were fabricated and subjected to chemical structure analysis through Fourier transform infrared spectroscopy (FTIR), energy dispersive X-ray (EDX), and scanning electron microscopy (SEM). The antimicrobial activity and compressive strength of all groups were investigated. The antimicrobial activity against Streptococcus mutans and Lactobacillus was evaluated through the minimum inhibitory concentration (MIC) test, while compressive strength was evaluated by measuring the maximum force endured by the specimen before fracturing. Data analysis utilized IBM SPSS Statistics software, employing repeated measures ANOVA to determine mean MIC values and compressive strength, with Tukey's posthoc test for pairwise comparisons. Results The results of the study showed that the antimicrobial efficacy of nHA GIC improved with increasing weight percent (% wt) of the additive, exhibiting significantly enhanced activity against Streptococcus mutans and Lactobacillus compared to the control group (Group IV) with statistical significance (p < 0.05). Moreover, the compressive strength exhibited notable enhancements in the modified groups, including Group I (172.55 ± 0.76), Group II (178.16 ± 0.760), and Group III (182.45 ± 0.950), when compared to the control (162.46 ± 1.606), with statistically significant differences (p < 0.05). Conclusion The study demonstrates that the incorporation of green-mediated nHA-containing GIC results in superior antimicrobial efficacy and compressive strength compared to the control group (Group IV). In particular, the highest concentration of nHA-modified GIC (10%) exhibited the most favorable antimicrobial properties along with increased strength. Therefore, utilizing green-mediated nHA in the GIC shows promise as an effective restorative material. Future investigations should delve into the molecular chemistry and bonding mechanisms to further explore its potential.

New generation of orthodontic devices and materials with bioactive capacities to improve enamel demineralization

OBJECTIVE

The article reviewed novel orthodontic devices and materials with bioactive capacities in recent years and elaborated on their properties, aiming to provide guidance and reference for future scientific research and clinical applications.

DATA, SOURCES AND STUDY SELECTION

Researches on remineralization, protein repellent, antimicrobial activity and multifunctional novel bioactive orthodontic devices and materials were included. The search of articles was carried out in Web of Science, PubMed, Medline and Scopus.

CONCLUSIONS

The new generation of orthodontic devices and materials with bioactive capacities has broad application prospects. However, most of the current studies are limited to in vitro studies and cannot explore the true effects of various bioactive devices and materials applied in oral environments. More research, especially in vivo researches, is needed to assist in clinical application.

CLINICAL SIGNIFICANCE

Enamel demineralization (ED) is a common complication in orthodontic treatments. Prolonged ED can lead to dental caries, impacting both the aesthetics and health of teeth. It is of great significance to develop antibacterial orthodontic devices and materials that can inhibit bacterial accumulation and prevent ED. However, materials with only preventive effect may fall short of addressing actual needs. Hence, the development of novel bioactive orthodontic materials with remineralizing abilities is imperative. The article reviewed the recent advancements in bioactive orthodontic devices and materials, offering guidance and serving as a reference for future scientific research and clinical applications.

Evaluation of mechanical, optical, and fluoride-releasing properties of a translucent bulk fill glass hybrid restorative dental material

OBJECTIVE

Measure and compare the mechanical properties, translucency, and fluoride-releasing capabilities of EQUIA Forte HT against Fuji IX GP and ChemFil Rock.

MATERIALS AND METHODS

Ten specimens of each material were fabricated for compressive strength (CS), flexural strength (FS), and surface hardness analysis at 24 h and 7 days. The L*a*b* values were measured against a black-and-white background using a spectrophotometer to analyze the translucency parameter (TP). Fluoride release was recorded after 2 months of immersion in distilled water. The mean data was analyzed by 1- and 2-way ANOVA (α = 0.5).

RESULTS

EQUIA Forte HT showed higher CS, surface hardness, and FS values (p < 0.05) compared with Fuji IX GIC, while no significant difference was found in FS values between EQUIA Forte HT and Chemfil Rock (p > 0.05). The EQUIA Forte HT exhibited significantly higher translucency in comparison to both ChemFil Rock (p < 0.001) and Fuji IX GICs (p < 0.05). An increase (p > 0.05) of fluoride release was observed for EQUIA Forte HT.

CONCLUSION

The EQUIA Forte HT Glass-ionomer cements (GIC) offers enhanced translucency, improved strength, and enhanced fluoride-releasing properties compared to the traditionally used Fuji IX GIC and ChemFil Rock GICs. This material might have a wide range of clinical applications due to its improved strength and optical properties.

CLINICAL SIGNIFICANCE

Glass-ionomer dental restorative materials possess unique advantageous characteristics. However, its poor mechanical and optical properties have typically limited its clinical applications. Efforts to improve these properties have resulted in enhanced GICs. EQUIA Forte HT GIC offers enhanced mechanical and optical properties with potential applications in posterior and anterior restorative procedures.

Effect of protective coating agents on microleakage and flexural strength of glass ionomer cement and zirconomer. an in vitro study

PURPOSE

The objective of this study was to assess the microleakage and flexural strength of glass ionomer cement (GIC) and modified GIC (Zirconomer) when coated with protective coating agents such as COAT-IT and G-COAT plus.

METHODS

Sixty tooth specimens were grouped into two groups based on the type of restorations (GIC (n = 30) and Zirconomer (n = 30)). The samples were further divided into three subgroups (n = 10) based on the protective coating agent (Petroleum jelly, G-COAT Plus, or COAT IT) applied. This study evaluated the microleakage at the occlusal and cervical margins of class V restoration after being subjected to dye penetration and sectioning. Each specimen was viewed under a 40 × microscope and was given scores based on the depth of dye penetration. They were statistically analyzed using the Kruskal-Wallis test and compared within the groups using the Mann- Whitney Test. In addition, flexural strength was assessed using standardized cuboid (25 × 2 × 2 mm) specimens of restorative materials with and without protective coating agents. The mean flexural strength data of all the subgroups were statistically evaluated using a one-way analysis of variance (ANOVA) and compared within the subgroups using the student t test.

RESULTS

A statistically significant difference was found when occlusal margin microleakage scores were evaluated with G-COAT Plus demonstrating the lowest occlusal margin microleakage when applied over GIC restoration. The increasing order of occlusal margin microleakage scores is as follows: GIC with G-COAT Plus, Zirconomer with COAT-IT, GIC with COAT-IT, GIC, Zirconomer with G-COAT Plus, and Zirconomer. However, the cervical margin microleakage scores revealed no significant difference. While flexural strength was found to be highest for the GIC group coated with G-COAT Plus, it was observed that there was a significant improvement in the flexural strength of both GIC and Zirconomer when coated with either of the protective coating agents.

CONCLUSION

Within the limitations of this in vitro study, it was observed that the application of protective coating agents can significantly reduce the potential microleakage and improve the flexural strength of the restorative material especially when zirconia-reinforced GIC is the restorative material.

Current antibacterial agents in dental bonding systems: a comprehensive overview

Dental caries is mainly caused by oral biofilm acid, and the most common dental restoration treatment is composite dental restorations. The main cause of failure is secondary caries adjacent to the restoration. Long-term survival of dental materials is improved by the presence of antibacterial agents, which selectively inhibit bacterial growth or survival. Chemical, natural and biomaterials have been studied for their antimicrobial activities and antibacterial bonding agents have been improved. Their usage has been increased to inhibit the growth of invading and residual bacteria in the oral cavity, as biofilm accumulation increases the risk of treatment failure. In this article, the success and applications of antibacterial agents are discussed in dental bonding systems.

Comparative Evaluation of Flexural Strength of Conventional and Modified with Chitosan, Titanium Dioxide Nanopowder and Nanohydroxyapatite: An In Vitro Study

Aim

To evaluate the effect of different add-ons on the flexural strength (FS) of glass ionomer cement (GIC).

Materials and methods

Around 72 samples were fabricated and divided among the following six different groups: group I-control (conventional GIC-nonmodified), group II-GIC powder modified with 3% titanium dioxide (TiO2) and liquid is unmodified, group III-powder modified with 10% nanohydroxyapatite (nHA) and liquid is unmodified, group IV-powder is unmodified and Liquid is modified with 10% chitosan (CH), group V-powder is modified with 3% TiO2 and liquid is modified with 10% CH, and group VI-powder is modified with 10% nHA and liquid is modified with 10% CH. The samples were then subjected to a three-point bending test on a universal testing machine for the evaluation of FS. The results obtained were analyzed statistically using the analysis of variance (ANOVA) test.

Result

The mean FS value of group V depicts significantly high FS among all groups (29.42 ± 3.35). A significant difference was present in FS amongst all the groups that is groups V>II>IV>VI>III>I.

Conclusion

Glass ionomer cement (GIC) powder can be modified with nHA, nanotitanium, and GIC liquid can be modified with CH to improve its FS.

Clinical significance

Glass ionomer cement (GIC) supplemented with additives like nanoparticles (NPs) and CH can be used as an enhanced filling material due to its potential antibacterial properties and in areas with a high masticatory load.

How to cite this article

Showkat I, Chaudhary S, Sinha AA, et al. Comparative Evaluation of Flexural Strength of Conventional Glass Ionomer Cement and Glass Ionomer Cement Modified with Chitosan, Titanium Dioxide Nanopowder and Nanohydroxyapatite: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(S-1):S72-S76.

Adhesion and Surface Roughness of Apatite-Containing Carbomer and Improved Ionically Bioactive Resin Compared to Glass Ionomers

The surface roughness of different glass-ionomer-based materials and their shear bond strength with a resin composite with and without thermal cycling were evaluated. Ketac Molar (KM, 3M ESPE, St. Paul, MN, USA), Glass Carbomer (GC, GCP Dental, Leiden, The Netherlands), Bioactive (BA, PULPDENT, Corporation, Watertown, MA, USA) and Fuji II LC (FJ, GC, Tokyo, Japan) were used to prepare the specimens and they were kept in distilled water at 37 °C for 24 h. The surface roughness of the specimens was measured with a profilometer (n = 6). A universal adhesive resin was applied on glass-ionomer materials and cylindrical universal composites were applied and polymerized, respectively (n = 16). The specimens were divided into two subgroups. The first subgroup was subjected to thermal cycling. Shear bond strength was investigated for both subgroups (n = 8). Stereomicroscopy and SEM examinations were performed. The roughest surface was obtained in the GC group (p < 0.05). The shear bond strength of the specimens without thermal cycling was higher than that of those with thermal cycling (p < 0.05). The lowest shear bond was measured in the GC group (p < 0.05). Although FJ, KM and BA have been observed to be suitable materials for clinical use, BA, in particular, is evidenced to become the best option among the materials we tested. GC cement's long-term performance needs to be improved.

Recent advances on nanomaterials for antibacterial treatment of oral diseases

An imbalance of bacteria in oral environment can lead to a variety of oral diseases, such as periodontal disease, dental caries, and peri-implant inflammation. In the long term, in view of the increasing bacterial resistance, finding suitable alternatives to traditional antibacterial methods is an important research today. With the development of nanotechnology, antibacterial agents based on nanomaterials have attracted much attention in dental field due to their low cost, stable structures, excellent antibacterial properties and broad antibacterial spectrum. Multifunctional nanomaterials can break through the limitations of single therapy and have the functions of remineralization and osteogenesis on the basis of antibacterial, which has made significant progress in the long-term prevention and treatment of oral diseases. In this review, we have summarized the applications of metal and their oxides, organic and composite nanomaterials in oral field in recent five years. These nanomaterials can not only inactivate oral bacteria, but also achieve more efficient treatment and prevention of oral diseases by improving the properties of the materials themselves, enhancing the precision of targeted delivery of drugs and imparting richer functions. Finally, future challenges and untapped potential are elaborated to demonstrate the future prospects of antibacterial nanomaterials in oral field.

Silver Nanoparticles in Dental Applications: A Descriptive Review

Silver nanoparticles have been a recent focus of many researchers in dentistry, and their potential uses and benefits have drawn attention in dentistry and medicine. The fabrication and utilization of nanoscale substances and structures are at the core of the rapidly developing areas of nanotechnology. They are often used in the dental industry because they prevent bacteria from making nanoparticles, oxides, and biofilms. They also stop the metabolism of bacteria. Silver nanoparticles (AgNPs) are a type of zero-dimensional material with different shapes. Dentistry has to keep up with changing patient needs and new technology. Silver nanoparticles (AgNPs) can be used in dentistry for disinfection and preventing infections in the oral cavity. One of the most interesting metallic nanoparticles used in biomedical applications is silver nanoparticles (AgNPs). The dental field has found promising uses for silver nanoparticles (AgNPs) in the elimination of plaque and tartar, as well as the elimination of bacterial and fungal infections in the mouth. The incorporation of AgNPs into dental materials has been shown to significantly enhance patients' oral health, leading to their widespread use. This review focuses on AgNP synthesis, chemical properties, biocompatibility, uses in various dental fields, and biomaterials used in dentistry. With an emphasis on aspects related to the inclusion of silver nanoparticles, this descriptive review paper also intends to address the recent developments of AgNPs in dentistry.

Engineering Polypropylene-Calcium Sulfate (Anhydrite II) Composites: The Key Role of Zinc Ionomers via Reactive Extrusion

Polypropylene (PP) is one of the most versatile polymers widely used in packaging, textiles, automotive, and electrical applications. Melt blending of PP with micro- and/or nano-fillers is a common approach for obtaining specific end-use characteristics and major enhancements of properties. The study aims to develop high-performance composites by filling PP with CaSO₄ β-anhydrite II (AII) issued from natural gypsum. The effects of the addition of up to 40 wt.% AII into PP matrix have been deeply evaluated in terms of morphology, mechanical and thermal properties. The PP-AII composites (without any modifier) as produced with internal mixers showed enhanced thermal stability and stiffness. At high filler loadings (40% AII), there was a significant decrease in tensile strength and impact resistance; therefore, custom formulations with special reactive modifiers/compatibilizers (PP functionalized/grafted with maleic anhydride (PP-g-MA) and zinc diacrylate (ZnDA)) were developed. The study revealed that the addition of only 2% ZnDA (able to induce ionomeric character) leads to PP-AII composites characterized by improved kinetics of crystallization, remarkable thermal stability, and enhanced mechanical properties, i.e., high tensile strength, rigidity, and even rise in impact resistance. The formation of Zn ionomers and dynamic ionic crosslinks, finer dispersion of AII microparticles, and better compatibility within the polyolefinic matrix allow us to explain the recorded increase in properties. Interestingly, the PP-AII composites also exhibited significant improvements in the elastic behavior under dynamic mechanical stress and of the heat deflection temperature (HDT), thus paving the way for engineering applications. Larger experimental trials have been conducted to produce the most promising composite materials by reactive extrusion (REx) on twin-screw extruders, while evaluating their performances through various methods of analysis and processing.

Advanced materials and technologies for oral diseases

Oral disease, as a class of diseases with very high morbidity, brings great physical and mental damage to people worldwide. The increasing burden and strain on individuals and society make oral diseases an urgent global health problem. Since the treatment of almost all oral diseases relies on materials, the rapid development of advanced materials and technologies has also promoted innovations in the treatment methods and strategies of oral diseases. In this review, we systematically summarized the application strategies in advanced materials and technologies for oral diseases according to the etiology of the diseases and the comparison of new and old materials. Finally, the challenges and directions of future development for advanced materials and technologies in the treatment of oral diseases were refined. This review will guide the fundamental research and clinical translation of oral diseases for practitioners of oral medicine.

Glutathione and selenium nanoparticles have a synergistic protective effect during cryopreservation of bull semen

Introduction

In the present study, the synergistic protective effect of co-supplementation of glutathione (GSH) with selenium nanoparticles (SeNPs) on the cryopreservation efficiency of bull semen was analyzed.

Methods

After collection, the ejaculates of Holstein bulls were subsequently diluted with a Tris extender buffer supplemented with different concentrations of SeNPs (0, 1, 2, and 4 μg/ml), followed by semen equilibration at 4°C and assessment of sperm viability and motility. Subsequently, the ejaculates of Holstein bulls were pooled, split into four equal groups, and diluted with a Tris extender buffer supplemented with basic extender (negative control group, NC group), 2 μg/ml SeNPs (SeNPs group), 4 mM GSH (GSH group), and 4 mM GSH plus 2 μg/ml SeNPs (GSH + SeNPs group). After cryopreservation, motility, viability, mitochondrial activity, plasma membrane integrity, acrosome integrity, concentration of malondialdehyde (MDA), superoxide dismutase (SOD), and catalase (CAT), and ability of frozen-thawed sperm cells to support in vitro embryonic development were evaluated.

Results and discussion

No side effect of SeNPs concentrations applied in the current study on the motility and viability of equilibrated bull spermatozoa was found. Meanwhile, supplementation of SeNPs significantly promoted the motility and viability of equilibrated bull spermatozoa. Furthermore, the co-supplementation of GSH with SeNPs effectively protected bull spermatozoa from cryoinjury as expressed by promoting semen motility, viability, mitochondrial activity, plasma membrane integrity, and acrosome integrity. Finally, the enhanced antioxidant capacity and embryonic development potential in the frozen-thawed bull spermatozoa cryopreserved by co-supplementation of GSH with SeNPs further confirmed the synergistic protective effect of co-supplementation of GSH with SeNPs on the cryopreservation of bull semen.

Secondary caries and marginal adaptation of ion-releasing versus resin composite restorations: a systematic review and meta-analysis of randomized clinical trials

This systematic review was aimed to evaluate occurrence of secondary caries and marginal adaptation in ion-releasing materials versus resin composite. Electronic search of PubMed, Scopus, and Open Grey databases with no date or language restrictions until May 21st, 2021, was conducted. Randomized clinical trials that compared ion-releasing restorations versus resin composite were included. For quantitative analysis, a random-effects meta-analysis with risk difference as an effect measure and a 95% confidence interval was used. Quality of evidence was assessed using The Grading of Recommendations, Assessment, Development, and Evaluation criteria. The risk of bias was evaluated using the Cochran Collaboration Risk of Bias tool. The inclusion criteria were met by 22 studies, and 10 studies were included in the meta-analysis. Three follow-up periods (1 year, 18 months-2 years, and 3 years) were evaluated. The overall quality of evidence for secondary caries and marginal adaptation outcomes was low. The results of the meta-analysis showed no significant difference (p > 0.05) in both outcomes between ion-releasing materials and resin composite. The occurrence of secondary caries was not dependent on the nature of the restorative material. It is more likely a complex process that involves the same risk factors as primary carious lesions.

Mechanical Properties of Orthodontic Cements and Their Behavior in Acidic Environments

The present research is focused on three different classes of orthodontic cements: resin composites (e.g., BracePaste); resin-modified glass ionomer RMGIC (e.g., Fuji Ortho) and resin cement (e.g., Transbond). Their mechanical properties such as compressive strength, diametral tensile strength and flexural strength were correlated with the samples' microstructures, liquid absorption, and solubility in liquid. The results show that the best compressive (100 MPa) and flexural strength (75 Mpa) was obtained by BracePaste and the best diametral tensile strength was obtained by Transbond (230 MPa). The lowestvalues were obtained by Fuji Ortho RMGIC. The elastic modulus is relatively high around 14 GPa for BracePaste, and Fuji Ortho and Transbond have only 7 GPa. The samples were also subjected to artificial saliva and tested in different acidic environments such as Coca-Cola and Red Bull. Their absorption and solubility were investigated at different times ranging from 1 day to 21 days. Fuji Ortho presents the highest liquid absorption followed by Transbond, the artificial saliva has the best absorption and Red Bull has the lowest absorption. The best resistance to the liquids was obtained by BracePaste in all environments. Coca-Cola presents values four times greater than the ones observed for artificial saliva. Solubility tests show that BracePaste is more soluble in artificial saliva, and Fuji Ortho and Transbond are more soluble in Red Bull and Coca-Cola. Scanning electron microscopy (SEM) images evidenced a compact structure for BracePaste in all environments sustaining the lower liquid absorption values. Fuji Ortho and Transbond present a fissure network allowing the liquid to carry out in-depth penetration of materials. SEM observations are in good agreement with the atomic force microscopy (AFM) results. The surface roughness decreases with the acidity increasing for BracePaste meanwhile it increases with the acidity for Fuji Ortho and Transbond. In conclusion: BracePaste is recommended for long-term orthodontic treatment for patients who regularly consume acidic beverages, Fuji Ortho is recommended for short-term orthodontic treatment for patients who regularly consume acidic beverages and Transbond is recommended for orthodontic treatment over an average time period for patients who do not regularly consume acidic beverages.

Update on Dental Luting Materials

A dental luting material aids in the retention and stability of indirect restorations on the prepared tooth structure. In dentistry, clinicians are using a wide range of luting materials for the cementation of indirect restorations. Zinc oxide eugenol and non-eugenol cements, zinc phosphate cement, zinc polycarboxylate cement, glass ionomer cement and resin cements are common dental cements used in dentistry. Each luting material or cement possesses unique properties and clinical implications. An ideal luting cement should be biocompatible, insoluble, resistant to thermal and chemical assaults, antibacterial, aesthetic, simple and easy to use. It should have high strength properties under tension, shear and compression to resist stress at the restoration-tooth interface, as well as adequate working and setting times. So far, no luting material possesses all of these properties of an ideal cement. Scientists have been modifying the conventional luting cements to improve the material's clinical performance and developing novel materials for clinical use. To achieve the best clinical outcome, clinicians should update their knowledge and gain a good understanding of the luting materials so that they can make a wise clinical decision on the material selection and obtain an insight into the development of luting cements. Therefore, the objective of this study is to provide a discussion on the physical, chemical, adhesive and aesthetic properties of common luting materials. The clinical indications of these luting materials are suggested based on their properties. In addition, overviews of the modification of the conventional luting materials and the newly developed luting materials are provided.

Medical and Dental Applications of Titania Nanoparticles: An Overview

Currently, titanium oxide (TiO₂) nanoparticles are successfully employed in human food, drugs, cosmetics, advanced medicine, and dentistry because of their non-cytotoxic, non-allergic, and bio-compatible nature when used in direct close contact with the human body. These NPs are the most versatile oxides as a result of their acceptable chemical stability, lower cost, strong oxidation properties, high refractive index, and enhanced aesthetics. These NPs are fabricated by conventional (physical and chemical) methods and the latest biological methods (biological, green, and biological derivatives), with their advantages and disadvantages in this epoch. The significance of TiO₂ NPs as a medical material includes drug delivery release, cancer therapy, orthopedic implants, biosensors, instruments, and devices, whereas their significance as a dental biomaterial involves dentifrices, oral antibacterial disinfectants, whitening agents, and adhesives. In addition, TiO₂ NPs play an important role in orthodontics (wires and brackets), endodontics (sealers and obturating materials), maxillofacial surgeries (implants and bone plates), prosthodontics (veneers, crowns, bridges, and acrylic resin dentures), and restorative dentistry (GIC and composites).

Effect of Currently Available Nanoparticle Synthesis Routes on Their Biocompatibility with Fibroblast Cell Lines

Nanotechnology has acquired significance in dental applications, but its safety regarding human health is still questionable due to the chemicals utilized during various synthesis procedures. Titanium nanoparticles were produced by three novel routes, including Bacillus subtilis, Cassia fistula and hydrothermal heating, and then characterized for shape, phase state, size, surface roughness, elemental composition, texture and morphology by SEM, TEM, XRD, AFM, DRS, DLS and FTIR. These novel titanium nanoparticles were tested for cytotoxicity through the MTT assay. L929 mouse fibroblast cells were used to test the cytotoxicity of the prepared titanium nanoparticles. Cell suspension of 10% DMEM with 1 × 104 cells was seeded in a 96-well plate and incubated. Titanium nanoparticles were used in a 1 mg/mL concentration. Control (water) and titanium nanoparticles stock solutions were prepared with 28 microliters of MTT dye and poured into each well, incubated at 37 °C for 2 h. Readings were recorded on day 1, day 15, day 31, day 41 and day 51. The results concluded that titanium nanoparticles produced by Bacillus subtilis remained non-cytotoxic because cell viability was >90%. Titanium nanoparticles produced by Cassia fistula revealed mild cytotoxicity on day 1, day 15 and day 31 because cell viability was 60−90%, while moderate cytotoxicity was found at day 41 and day 51, as cell viability was 30−60%. Titanium nanoparticles produced by hydrothermal heating depicted mild cytotoxicity on day 1 and day 15; moderate cytotoxicity on day 31; and severe cytotoxicity on day 41 and day 51 because cell viability was less than 30% (p < 0.001). The current study concluded that novel titanium nanoparticles prepared by Bacillus subtilis were the safest, more sustainable and most biocompatible for future restorative nano-dentistry purposes.

Precisely Tuning the Pore-Wall Surface Composition of Bioceramic Scaffolds Facilitates Angiogenesis and Orbital Bone Defect Repair

Orbital bone damage (OBD) may result in severe post-traumatic enophthalmos, craniomaxillofacial deformities, vision loss, and intracranial infections. However, it is still a challenge to fabricate advanced biomaterials that can match the individual anatomical structure and enhance OBD repair in situ. Herein, we aimed to develop a selective surface modification strategy on bioceramic scaffolds and evaluated the effects of inorganic or organic functional coating on angiogenesis and osteogenesis, ectopically and orthotopically in OBD models. It was shown that the low thermal bioactive glass (BG) modification or layer-by-layer assembly of a biomimetic hydrogel (Biogel) could readily integrate into the pore wall of the bioceramic scaffolds. The BG and Biogel modification showed appreciable enhancement in the initial compressive strength (∼30-75%) or structural stability in vivo, respectively. BG modification could enhance by nearly 2-fold the vessel ingrowth, and the osteogenic capacity was also accelerated, accompanied with a mild scaffold biodegradation after 3 months. Meanwhile, the Biogel-modified scaffolds showed enhanced osteogenic differentiation and mineralization through calcium and phosphorus retention. The potential mechanism of the enhanced bone repair was elucidated via vascular and osteogenic cell responses in vitro, and the cell tests indicated that the Biogel and BG functional layers were both beneficial for in vitro osteoblastic differentiation and mineralization on bioceramics. Totally, these findings demonstrated that the bioactive ions or biomolecules could significantly improve the angiogenic and osteogenic capabilities of conventional bioceramics, and the integration of inorganic or organic functional coating in the pore wall is a highly flexible material toolbox that can be tailored directly to improve orbital bone defect repair.

Salivary orosomucoid 1 as a biomarker of hepatitis B associated hepatocellular carcinoma

Saliva is rich in proteins, DNA, RNA and microorganisms, and can be regarded as a biomarker library. In order to explore a noninvasive and simple means of early screening for liver cancer, proteomics was used to screen salivary markers of hepatitis B associated liver cancer. We used mass spectrometry coupled isobaric tags for relative and absolute quantitation (iTRAQ)-technology to identify differentially expressed proteins (DEPs). Western blot, immunohistochemistry and enzyme linked immunosorbent assay were used to detect marker expression of in tissues and saliva. Statistical analysis was used to analyze the diagnostic efficacy of the markers was analyzed through statistical analyses. By comparing the hepatocellular carcinoma (HCC) group with non-HCC groups, we screened out 152 salivary DEPs. We found orosomucoid 1(ORM1) had significantly higher expression in saliva of HCC patients compared with non-HCC groups (p < 0.001) and the expression of ORM1 in liver cancer tissues was significantly higher than that in adjacent normal tissues (p < 0.001). The combination of salivary ORM1 and alpha-fetoprotein (AFP) showed reasonable specificities and sensitivities for detecting HCC. In a word, salivary ORM1 as a new biomarker of hepatitis B associated hepatocellular carcinoma, combination of salivary ORM1 and AFP as an improved diagnostic tool for hepatocellular carcinoma.

Biological Activities of Glass Ionomer Cement Supplemented with Fortilin on Human Dental Pulp Stem Cells

This study aimed to determine the most suitable recombinant fortilin and evaluate the biological activities of glass ionomer cement (GIC) incorporated with fortilin on human dental pulp stem cells (hDPSCs). Full-length and three fragments of Penaeus merguiensis fortilin were cloned and examined for their proliferative and cytoprotective effects on hDPSCs by MTT (3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide) assay. Human DPSCs were cultured with GIC supplemented with fortilin, tricalcium phosphate, or a combination of tricalcium phosphate and fortilin, designated as GIC + FL, GIC + TCP, and GIC + TCP + FL, respectively (n = 4 for each group). At given time points, hDPSCs were harvested and analyzed by MTT, quantitative reverse transcription polymerase chain reaction, alkaline phosphatase activity, and Alizarin Red assays. The full-length fortilin promoted cell proliferation and significantly increased cell survival. This protein was subsequently added into the GIC along with tricalcium phosphate to investigate the biological activities. All experimental groups showed reduced cell viability after treatment with modified GICs on days 1 and 3. The GIC + TCP + FL group significantly promoted odontoblastic differentiation at particular time points. In addition, alkaline phosphatase activity and calcium phosphate deposit were markedly increased in the GIC + TCP + FL group. Among all experimental groups, the GIC incorporated with fortilin and tricalcium phosphate demonstrated the best results on odontogenic differentiation and mineral deposition in hDPSCs.

Evaluation of the Mechanical Properties of Three Resin-Modified Glass-Ionomer Materials

This study is aimed at evaluating the flexural strength (FS), fracture toughness (FT), and diametral tensile strength (DTS) of three resin-modified glass-ionomer cements (RMGICs): Ketac Nano, Riva Light Cure, and Fuji II LC. One hundred twenty specimens were prepared from the RMGIC materials ( $n=10$ ). The cements were mixed and inserted into different mould sizes according to the test performed: FS: rectangular Teflon mould ( $32\text{mm}\times 3.15\text{mm}\times 2\text{mm}$ ); FT: notchless triangular prism (NTP) Teflon mould ( $6\text{mm}\times 6\text{mm}\times 6\text{mm}\times 12\text{mm}$ ); and DTS: ring road stainless steel mould ( $6\text{mm}\times 3\text{mm}$ ). Specimens were light cured for 20 seconds on each surface and stored in distilled water at ${37}^{°}\text{C}\pm 2^{°}\text{C}$ for seven days prior to tests. To evaluate the influence of storage in the mechanical properties of the RMGIs, specimens tested for DTS were stored in distilled water at ${37}^{°}\text{C}\pm 2^{°}\text{C}$ for 32 days prior to test. Data were analyzed by ANOVA and Tukey’s test ( $\alpha =0.05$ ). Fuji II LC presented significantly higher values for all tests employed when compared to Ketac Nano and Riva LC RMGIs. There was no significant difference on DTS before and after the 32-day storage for each material. Fuji II LC presented superior mechanical properties when compared to Ketac Nano, and Riva LC storage showed no influence on the mechanical properties of the RMGI materials tested.

Inhibitory activity of S-PRG filler on collagen-bound MMPs and dentin matrix degradation

OBJECTIVES

To evaluate the inhibitory activity of an ion-releasing filler (S-PRG) eluate on dentin collagen-bound metalloproteinases (MMPs) and dentin matrix degradation.

METHODS

Dentin beams (5 × 2 × 0.5 mm) from human molars were completely demineralized to produce dentin matrix specimens. The dry mass was measured, and a colorimetric assay (Sensolyte) determined the initial total MMP activity to allocate the beams into four treatment groups (n = 10/group): 1) water for 1 min (negative control); 2) 2% chlorhexidine digluconate (CHX - inhibitor control) for 1 min; 3) S-PRG eluate for 1 min; 4) S-PRG eluate for 30 min. After the treatments, the total MMP activity was reassessed. The specimens were stored in simulated body fluid (SBF) at 37 °C for up to 21 days. The dry mass was reassessed weekly. On day 7, the dentin matrix degradation was analyzed for the presence of collagen fragments (CF; Sirius Red) and hydroxyproline (Hyp) in the SBF. Statistical analyses were performed with ANOVA/Tukey, paired t-tests, and RM-ANOVA/Sidak (α = 5%).

RESULTS

S-PRG eluate exposure for 1 and 30 min reduced (p < 0.0001) MMP activity. S-PRG exposure for 30 min presented MMP activity inhibition equivalent to CHX (p = 0.061). S-PRG and CHX decreased CF (p ≤ 0.007) and Hyp (p < 0.046) release. After 21 days of storage, S-PRG-treated beams, regardless of exposure time, presented a reduced (p ≤ 0.017) mass loss, intermediate between CHX and control.

CONCLUSION

Treating demineralized dentin with S-PRG eluate for 1 or 30 min reduced matrix-bound MMP activity and dentin matrix degradation for up to 21 days.

CLINICAL SIGNIFICANCE

S-PRG filler may hinder the progression of dentin carious/erosive lesions and enhance the stabilization of dentin bonding interfaces.

Synthesis and Characterization of Titanium Oxide Nanoparticles with a Novel Biogenic Process for Dental Application

The prevalence of dental caries has been largely consonant over time despite the enhancement in dental technologies. This study aims to produce novel GIC restorative material by incorporating TiO2 nanoparticles synthesized by Bacillus subtilis for the treatment of dental caries. The TiO2 nanoparticles were prepared by inoculating a fresh culture of Bacillus subtilis into a nutrient broth for 24 h, which was then characterized by XRD, DRS, FTIR, AFM, SEM, TEM and EDX. These TiO2 nanoparticles were incorporated in GIC restorative material at different concentrations (0-10% TiO2 -GIC) and were tested for their mechanical properties in a universal testing machine. The XRD analysis revealed synthesis of anatase and rutile-phased TiO2 nanoparticles with a particle size of 70.17 nm that was further confirmed by SEM and TEM analysis. The EDX spectrum indicated prominent peaks of titanium and oxygen with no impurities in the prepared material. Treatment with 5% TiO2 -GIC proved to be most effective for the treatment of dental caries with no observable cytotoxic effect. An increase in the compressive strength of TiO2 nanoparticle-reinforced GIC was observed as the concentration of the TiO2 nanoparticles was increased up to 5%; subsequently, the compressive strength was lowered. An increase in the flexural strength was observed in GIC containing 0%, 3% and 5% TiO2 nanoparticles sequentially. Based on the results, it can be concluded that Bacillus subtilis-derived TiO2 nanoparticles have excellent potential for developing next generation of restorative materials for dental issues.

Effect of immersion in NaCl solution on the electrical conductivity and the reduction of the shear bond strength of resin-modified glass-ionomer-cements after current application

Advancements in dental cements have considerably improved their bond strengths. However, high bond strength often makes the removal of restorations difficult. Thus, smart dental cements that show controllable bond strength are required. A conventional resin-modified glass-ionomer-cement demonstrated a significant reduction in the bond strength after current application. However, for this system, the ions in the cement are released into the oral cavity, resulting in a reduction of the electrical conductivity and in losses of the expected on-demand debonding property. Herein, the effects of immersion in 0.9 and 15% NaCl solutions on the electrical conductivity and debonding properties were investigated. The cement immersed in 0.9% NaCl solution from 1 to 28 days maintained similar bond strength reductions after current application, whereas that in 15% NaCl solution initially showed no bond strength reduction after 1 day but exhibited an increase in the bond strength reduction after immersion for 28 days.

Emergence of Nano-Dentistry as a Reality of Contemporary Dentistry

(1) Background. Nanotechnology offers significant alternative ways to solve scientific, medical, and human health issues. Dental biomaterials were improved by nanotechnology. It manufactures better materials or improves the existing ones and forms the basis of novel methods for disease diagnosis and prevention. Modern nanotechnology makes oral health care services more acceptable for patients. Nanotechnology is now important area of research, covering a broad range of applications in dentistry. (2) Methods. Relevant literature from Scopus published in English was selected using the keywords “nanoparticle” and “dentistry”. To the selected articles we applied the inclusion and exclusion criteria to choose the relevant ones. (3) Results. Based on the relevant articles, a literature review was prepared. This review provides an insight into the applications of nanotechnology in various branches of dentistry. We applied several regression models to fit number of papers versus time and chose the best one. We used it to construct the forecast and its 95%-confidence interval for the number of publications in 2022–2026. (4) Conclusions. It shows that a significant rise in papers is expected. This review familiarizes dentists with properties and benefits of nanomaterials and nanotechnology. Additionally, it can help scientists to consider the direction of their research and to plan prospective research projects.

Long-Term Water Balance Evaluation in Glass Ionomer Restorative Materials

The complex role of water in glass ionomer cement (polyalkenoate) dental restorative materials has been studied, but much of the present understanding concerning water balance within these materials is based on very early studies and short-term experiments. This study evaluated the nature of the water species of six conventional and four resin modified glass ionomer restorative materials over 3 years using thermogravimetric analysis techniques. Materials were prepared, placed in crucibles, and stored in physiologic phosphate buffered saline and evaluated at 24 h, 1 week, and then at 1, 3, 6, 9, 12, 18, 24, 30 and 36 months. All materials demonstrated a significant increase in unbound water percentage content but except for the resin modified materials, the enthalpy required to remove the unbound water species did not significantly change over 36 months. Also, bound water content percentage and removal enthalpy was established at 24 h, as no significant increase was noted in both bound water content and removal enthalpy over the course of this evaluation. This study suggests that unbound water species may increase with time and is loosely held except for the resin modified materials. Protective coatings placement and re-evaluation are prudent to prevent unbound water loss.

Evaluation of the Surface Hardness and Roughness of a Resin-Modified Glass Ionomer Cement Containing Bacterial Cellulose Nanocrystals

The purpose of this study was to evaluate the performance of a resin-modified glass ionomer cement (RMGIC) to which bacterial cellulose nanocrystals (BCNs) were added. BCNs were incorporated into the RMGIC powder in ratios of 0.3%, 0.5%, and 1% (w/w). One control and three experimental groups were enrolled in the study: unmodified RMGIC (control), 0.3% (w/w) BCN-modified RMGIC, 0.5% (w/w) BCN-modified RMGIC, and 1% (w/w) BCN-modified RMGIC. The surface hardness and surface roughness were the parameters assessed. The materials were characterized by scanning electron microscopy (SEM). The data were analyzed using the one-way ANOVA and Kruskal–Wallis tests for surface hardness and roughness, respectively. The addition of BCN resulted in the improvement of surface roughness in all the specimens compared with the control material. The RMGIC modified by 1% (w/w) BCN showed the lowest surface roughness (decreased by 52%) among all tested groups. However, BCN had a negative effect on the surface hardness of RMGIC. The group with 0.3% (w/w) BCN had the least decrease in microhardness (13%). According to the results, the RMGIC group modified by 1% (w/w) BCN had a smoother surface than the other groups. The surface microhardness of the RMGIC decreased after BCNs were added to it.

Application of Selected Biomaterials and Stem Cells in the Regeneration of Hard Dental Tissue in Paediatric Dentistry-Based on the Current Literature

Currently, the development of the use of biomaterials and their application in medicine is causing rapid changes in the fields of regenerative dentistry. Each year, new research studies allow for the discovery of additional possibilities of dental tissue restoration. The structure and functions of teeth are complex. They consist of several diverse tissues that need to act together to ensure the tooth’s function and durability. The integrity of a tooth’s enamel, dentin, cementum, and pulp tissue allows for successful mastication. Biomaterials that are needed in dentistry must withstand excessive loading forces, be biocompatible with the hosts’ tissues, and stable in the oral cavity environment. Moreover, each tooth’s tissue, as well as aesthetic qualities in most cases, should closely resemble the natural dental tissues. This is why tissue regeneration in dentistry is such a challenge. This scientific research focuses on paediatric dentistry, its classification of caries, and the use of biomaterials in rebuilding hard dental tissues. There are several methods described in the study, including classical conservative methods such as caries infiltration or stainless-steel crowns. Several clinical cases are present, allowing a reader to better understand the described methods. Although the biomaterials mentioned in this work are artificial, there is currently ongoing research regarding clinical stem cell applications, which have a high potential for becoming one of the most common techniques of lost dental-tissue regeneration in the near future. The current state of stem cell development is mentioned, as well as the various methods of its possible application in dentistry.

Structural, Physical, and Mechanical Analysis of ZnO and TiO2 Nanoparticle-Reinforced Self-Adhesive Coating Restorative Material

This study aimed to modify an EQUIA coat (EC; GC, Japan) by incorporating 1 and 2 wt.% of zinc oxide (ZnO; EC-Z1 and EC-Z2) and titanium dioxide (TiO₂; EC-T1 and EC-T2) nanoparticles, whereby structural and phase analyses were assessed using Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD), respectively. Thermogravimetric analysis/differential scanning calorimetry, micro-hardness, and water absorption analyses were conducted, and the microstructure was studied by scanning electron microscopy/energy-dispersive spectroscopy. FTIR spectra showed a reduction in peak heights of amide (1521 cm^-1) and carbonyl (1716 cm^-1) groups. XRD showed peaks of ZnO (2θ ~ 31.3°, 34.0°, 35.8°, 47.1°, 56.2°, 62.5°, 67.6°, and 68.7°) and TiO₂ (2θ ~ 25.3°, 37.8°, 47.9, 54.5°, 62.8°, 69.5°, and 75.1°) corresponding to a hexagonal phase with a wurtzite structure and an anatase phase, respectively. Thermal stability was improved in newly modified materials in comparison to the control group. The sequence of obtained glass transitions was EC-T2 (111 °C), EC-T1 (102 °C), EC-Z2 (98 °C), EC-Z1 (92 °C), and EC-C (90 °C). EC-T2 and EC-T1 showed the highest (43.76 ± 2.78) and lowest (29.58 ± 3.2) micro-hardness values. EC showed the maximum water absorption (1.6%) at day 7 followed by EC-T1 (0.82%) and EC-Z1 (0.61%). These results suggest that EC with ZnO and TiO₂ nanoparticles has the potential to be used clinically as a coating material.

Effect of Nanostructures on the Properties of Glass Ionomer Dental Restoratives/Cements: A Comprehensive Narrative Review

Overall perspective of nanotechnology and reinforcement of dental biomaterials by nanoparticles has been reported in the literature. However, the literature regarding the reinforcement of dental biomaterials after incorporating various nanostructures is sparse. The present review addresses current developments of glass ionomer cements (GICs) after incorporating various metallic, polymeric, inorganic and carbon-based nanostructures. In addition, types, applications, and implications of various nanostructures incorporated in GICs are discussed. Most of the attempts by researchers are based on the laboratory-based studies; hence, it warrants long-term clinical trials to aid the development of suitable materials for the load bearing posterior dentition. Nevertheless, a few meaningful conclusions are drawn from this substantial piece of work; they are as follows: (1) most of the nanostructures are likely to enhance the mechanical strength of GICs; (2) certain nanostructures improve the antibacterial activity of GICs against the cariogenic bacteria; (3) clinical translation of these promising outcomes are completely missing, and (4) the nanostructured modified GICs could perform better than their conventional counterparts in the load bearing posterior dentition.

Compressive Strength of Conventional Glass Ionomer Cement Modified with TiO2 Nano-Powder and Marine-Derived HAp Micro-Powder

The aim of this research was to investigate the compressive strength (CS), breaking strength (BS), and compressive modulus (CM) of conventional glass ionomer cement (GIC) modified with TiO₂ nano particles, marine-derived hydroxyapatite (md-HAp) microparticles (<45 µm), and a combination of TiO₂ NP and md-HAp particles. The materials used in the study were conventional GIC Fuji IX GP Extra (GC Corporation, Tokyo, Japan), TiO₂ powder P25 (Degussa, Essen, Germany), and HAp synthesized from cuttlefish bone and ground in a mortar to obtain md-HAp powder. md-HAp was characterized using FTIR and SEM analysis. There were four groups of GIC samples: (i) Fuji IX control group, (ii) powder modified with 3 wt% TiO2, (iii) powder modified with 3 wt% HAp, and (iv) powder modified with 1.5 wt% TiO2 + 1.5 wt% HAp. Measurements were performed in a universal testing machine, and CS, BS, and CM were calculated. Statistical analysis was performed using ANOVA and Tukey’s tests. CS, BS, and CM differed significantly between the Fuji IX control group and all experimental groups while differences between the experimental groups were not statistically significant. The addition of TiO₂ NP, md-HAp micro-sized particles, and a combination of TiO₂ and md-HAp reduced the CS, BS, and CM of conventional GICs when mixed at the powder/liquid (p/l) ratio recommended by the manufacturer.

A Repeated State of Acidification Enhances the Anticariogenic Biofilm Activity of Glass Ionomer Cement Containing Fluoro-Zinc-Silicate Fillers

This study aimed to evaluate the anticariogenic biofilm activity of a novel zinc-containing glass ionomer cement, Caredyne Restore (CR), using a flow-cell system that reproduces Stephan responses. Streptococcus mutans biofilms were cultured on either CR or hydroxyapatite (HA) discs mounted on a modified Robbins device. The media were allowed to flow at a speed of 2 mL/min for 24 h while exposed to an acidic buffer twice for 30 min to mimic dietary uptake. Acid exposure enhanced biofilm inhibition in the CR group, which showed 2.6 log CFU/mm² in viable cells and a 2 log copies/mL reduction in total cells compared to the untreated group after 24 h of incubation, suggesting enhanced anticariogenic activity due to the release of fluoride and zinc ions. However, there was no difference in the number of viable and total cells between the two experimental groups after 24 h of incubation in the absence of an acidic environment. The anticariogenic biofilm activity of CR occurs in acidic oral environments, for example in the transient pH drop following dietary uptake. CR restorations are recommended in patients at high risk of caries due to hyposalivation, difficulty brushing, and frequent sugar intake.

The Comparison of Biofilm Formation, Mechanical and Chemical Properties between Glass Ionomer Cement and Giomer

Aims:

The aim of this study was to compare compressive strength and its correlation with the surface morphology and chemical elements of GIC and Giomer, as well as to determine the fluoride amount effect on the bacterial biofilm formation of GIC and Giomer.

Background:

The liability of Glass Ionomer Cement (GIC) mechanical properties is overcome with better antibacterial properties among restorative materials. Another fluoride-releasing restorative material, such as Giomer, has been discovered and is expected to overcome the issues with GIC’s mechanical properties; however, no research has been conducted related to antibacterial properties in Giomer.

Objective:

To compare compressive strength and its correlation with the surface morphology and chemical elements, then determine the fluoride amount effect on the bacterial biofilm formation of GIC and Giomer.

Methods:

Sixteen specimens of GIC and Giomer were prepared for a compressive strength measurement with the Universal Testing Machine. Sixteen specimens of GIC and Giomer were incubated for three days with the Streptococcus mutans culture at 37°C. The bacterial colonization was calculated using the Colony Forming Unit (CFU) and bacterial adhesion was calculated using a Scanning Electron Microscope (SEM). The mechanical properties’ compressive strength measurement, surface morphology, and chemical elements analyses were performed using SEM-EDX.

Results:

The compressive strength of Giomer was higher than GIC (P=0.001). The higher compressive strength of Giomer was reflected by a predominant regular surface, fewer voids, smaller and denser particles, and a higher content of silica and carbon. The bacterial biofilm on the surface of Giomer was higher than GIC, although there was no significant difference. GIC and Giomer have identical chemical elements: C, O, F, Na, Al, Si, P, and Ca.

Conclusion:

The compressive strength of Giomer is better than GIC; however, the biofilm formation of Giomer is higher than GIC, whereas GIC has a higher fluoride content but inferior in surfaces morphology characteristic

Effects of ionizing radiation on surface properties of current restorative dental materials

To investigate the impact of radiotherapy on surface properties of restorative dental materials. A conventional resin composite-CRC (Aura Enamel), a bulk-fill resin composite-BFRC (Aura Bulk-fill), a conventional glass ionomer cement-CGIC (Riva self cure), and a resin-modified glass ionomer cement-RMGIC (Riva light cure) were tested. Forty disc-shaped samples from each material (8 mm diameter × 2 mm thickness) (n = 10) were produced according to manufacturer directions and then stored in water distilled for 24 h. Surface wettability (water contact angle), Vickers microhardness, and micromorphology through scanning electron microscopy (SEM) before and after exposition to ionizing radiation (60 Gy) were obtained. The data were statistically evaluated using the two-way ANOVA and Tukey posthoc test (p < 0.05). Baseline and post-radiation values of contact angles were statistically similar for CRC, BFRC, and RMGIC, whilst post-radiation values of contact angles were statistically lower than baseline ones for CGIC. Exposition to ionizing radiation statistically increased the microhardness of CRC, and statistically decreased the microhardness of CGIC. The surface micromorphology of all materials was changed post-radiation. Exposure to ionizing radiation negatively affected the conventional glass ionomer tested, while did not alter or improved surface properties testing of the resin composites and the resin-modified glass ionomer cement tested.

Periodontal treatment of furcation involvement at the mandibular first molar with a follow-up of 27 years

Due to the complicated anatomical structures in the furcation area of multirooted mandibular first molars, dental hygiene is greatly compromised once the furcation is involved in the periodontitis, leading to the unfavorable prognosis of teeth with furcation involvement. A patient came to a dental office with the chief complaint of "mobile mandibular posterior tooth" 27 years ago. The periapical film showed alveolar bone resorption at the root furcation of the right mandibular first molar. Flap surgery and fine supportive therapy were conducted. The patient was diagnosed with "furcation involvement Class Ⅲ" during a revisit three years ago. Satisfactory and healthy periodontal statuses were observed 2, 9, 24, and 33 months after the periodontal flap surgery plus tunneling procedures. A follow-up of 27 years in the present case demonstrated that a favorable prognosis of furcation involvement can be achieved after adequate periodontal treatment.

The TiO2-μ implant residual is more toxic than the Al2O3-n implant residual via blocking LAP and inducing macrophage polarization

Medical device residuals cause harmful effects and diseases in the human body, such as Particle Disease (PD), but the biological interaction of different types of particles is unclear. In this study, after a biological interaction screen between different particles, we aimed to explore the mechanism of the biological interaction between different types of particles, and the effect of a proteasome inhibitor on PD. Our studies showed that the titanium oxide microscale particle (Ti-μ) was more toxic than the aluminum oxide nanoscale particle (Al-n). Al-n activated LAP, attenuated the macrophage M1 polarization, inhibited the activator of the NF-κB pathway, and blocked the secretion of inflammatory factors and apoptosis in vitro, and also prevented the inflammation tissue disorder and aseptic loosening in vivo induced by Ti-μ. What is more, Bortezomib blocked apoptosis, secretion of inflammatory factors and the activation of the NF-κB pathway induced by TiO2 micro particles. Al-n-induced autophagy could play the function in the efficient clearance of dying cells by phagocytosis, and serves in dampening M1 polarization-related pro-inflammatory responses. While the Ti alloy medical implant and devices are applied worldwide, the toxicity of Ti-μ and its interaction with Al-n could be considered in the implant design, and Bortezomib was a potential therapeutic for PD.

Promoting reactive oxygen species generation: a key strategy in nanosensitizer-mediated radiotherapy

The radiotherapy enhancement effect of numerous nanosensitizers is based on the excessive production of reactive oxygen species (ROS), and only a few systematic reviews have focused on the key strategy in nanosensitizer-mediated radiotherapy. To clarify the mechanism underlying this effect, it is necessary to understand the role of ROS in radiosensitization before clinical application. Thus, the source of ROS and their principle of tumor inhibition are first introduced. Then, nanomaterial-mediated ROS generation in radiotherapy is reviewed. The double-edged sword effect of ROS and the potential dangers they may pose to cancer patients are subsequently addressed. Finally, future perspectives regarding ROS-regulated nanosensitizer applications and development are discussed.

Effect of Nano-Filled Protective Coating and Different pH Enviroment on Wear Resistance of New Glass Hybrid Restorative Material

The purpose of the study was to determine the wear rate of Equia Forte HT Fil with Equia Forte Coat or without coating and compare it with Fuji IX GP high-viscosity glass ionomer cement (GIC) in conditions with acid load or at neutral pH. The samples were stored for 7 days: (1) in artificial saliva, (2) in artificial saliva and cyclically exposed to low pH, and (3) in distilled water and cyclically exposed to low pH. Wear was determined by measuring the difference in mass before and after brushing in an abrasion testing device. The wear of Fuji IX GP was significantly higher than that of Equia Forte HT Fil with or without coating (p = 0.000). The difference between Equia Forte HT Fil with and without Coat was not statistically significant (p < 0.803). The differences in wear resistance between samples stored in saliva and in distilled water were not significant (p = 0.588). Periodic exposure to the low pH solution significantly affected the wear resistance of all materials (p = 0.000). Equia Forte HT Fil was more resistant to wear than Fuji IX GP in all storage conditions. A resinous coat did not significantly increase wear resistance.

Emerging nanomaterials for dental treatments

The emergence of nanomaterials for dental treatments is encouraged by the nanotopography of the tooth structure, together with the promising benefits of nanomedicine. The use of nanoparticles in dentistry, also termed as 'nanodentistry', has manifested in applications for remineralisation, antimicrobial activity, local anaesthesia, anti-inflammation, osteoconductivity and stem cell differentiation. Besides the applications on dental tissues, nanoparticles have been used to enhance the mechanical properties of dental composites, improving their bonding and anchorage and reducing friction. The small particle size allows for enhanced permeation into deeper lesions, and reduction in porosities of dental composites for higher mechanical strength. The large surface area to volume ratio allows for enhanced bioactivity such as bonding and integration, and more intense action towards microorganisms. Controlled release of encapsulated bioactive molecules such as drugs and growth factors enables them to be delivered more precisely, with site-targeted delivery for localised treatments. These properties have benefitted across multiple fields within dentistry, including periodontology and endodontics and reengineering of dental prosthetics and braces. This review summarises the current literature on the emerging field of nanomaterials for dental treatments.

Minimally invasive judgement calls: managing compromised first permanent molars in children

This paper aims to update the reader on how minimally invasive (MI) techniques may be used to improve the longevity of carious or defective/compromised first permanent molars (cFPMs) in young children. Clinical and radiographic diagnosis and the prognostic factors will be discussed in view of recent studies showing that these teeth can be kept in function and have an improved prognosis as the child gets older. Clinical protocols for their care, based on the latest evidence and techniques for MI restorations, together with longevity information of possible restorative options, are described. This paper also explores the rationale behind enforced extractions and related morbidity, in order to help oral healthcare practitioners to determine the optimal management of these key elements in the dentition for the benefit of the patients.