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Alsharbaty MHM, Naji GA, Ghani BA, Schagerl M, Khalil MA, Ali SS. Cytotoxicity and antibacterial susceptibility assessment of a newly developed pectin-chitosan polyelectrolyte composite for dental implants. Sci Rep 2024; 14:16968. [PMID: 39043806 PMCID: PMC11266696 DOI: 10.1038/s41598-024-68020-7] [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: 03/10/2024] [Accepted: 07/18/2024] [Indexed: 07/25/2024] Open
Abstract
Biopolymers such as chitosan and pectin are currently attracting significant attention because of their unique properties, which are valuable in the food industry and pharmaceutical applications. These properties include non-toxicity, compatibility with biological systems, natural decomposition ability, and structural adaptability. The objective of this study was to assess the performance of two different ratios of pectin-chitosan polyelectrolyte composite (PCPC) after applying them as a coating to commercially pure titanium (CpTi) substrates using electrospraying. The PCPC was studied in ratios of 1:2 and 1:3, while the control group consisted of CpTi substrates without any coating. The pull-off adhesion strength, cytotoxicity, and antibacterial susceptibility tests were utilized to evaluate the PCPC coatings. In order to determine whether the composite coating was the result of physical blending or chemical bonding, the topographic surface parameters were studied using Fourier transform infrared spectroscopy (FTIR) and atomic force microscopy (AFM). PCPC (1:3) had the highest average cell viability of 93.42, 89.88, and 86.85% after 24, 48, and 72 h, respectively, as determined by the cytotoxicity assay, when compared to the other groups. According to the Kirby-Bauer disk diffusion method for testing antibacterial susceptibility, PCPC (1:3) showed the highest average diameter of the zone of inhibition, measuring 14.88, 14.43, and 11.03 mm after 24, 48, and 72 h of incubation, respectively. This difference was highly significant compared to Group 3 at all three time periods. PCPC (1:3) exhibited a significantly higher mean pull-off adhesion strength (521.6 psi) compared to PCPC (1:2), which revealed 419.5 psi. PCPC (1:3) coated substrates exhibited better surface roughness parameters compared to other groups based on the findings of the AFM. The FTIR measurement indicated that both PCPC groups exhibited a purely physical blending in the composite coating. Based on the extent of these successful in vitro experiments, PCPC (1:3) demonstrates its potential as an effective coating layer. Therefore, the findings of this study pave the way for using newly developed PCPC after electrospraying coating on CpTi for dental implants.
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Affiliation(s)
| | - Ghassan A Naji
- College of Dentistry, AL-Iraqia University, Baghdad, Iraq
| | - Ban A Ghani
- Department of Oral Diagnostic Sciences, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Michael Schagerl
- Department of Functional and Evolutionary Ecology, University of Vienna, Djerassiplatz 1, 1030, Vienna, Austria.
| | - Maha A Khalil
- Biology Department, College of Science, Taif University, 21944, Taif, Saudi Arabia
| | - Sameh S Ali
- Botany Department, Faculty of Science, Tanta University, Tanta, 31527, Egypt.
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2
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Goenka S, Lee HM. Effect of Commercial Children's Mouthrinses and Toothpastes on the Viability of Neonatal Human Melanocytes: An In Vitro Study. Dent J (Basel) 2023; 11:287. [PMID: 38132425 PMCID: PMC10742640 DOI: 10.3390/dj11120287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/06/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023] Open
Abstract
In this study, we examined the cytotoxic effects of six commercial children's mouthrinses (designated as #1, #2, #3, #4, #5, and #6) and four commercial children's toothpastes (designated as #1, #2, #3, and #4) on primary human neonatal melanocytes that were used as a representative model for oral melanocytes. Mouthrinses diluted directly with culture medium (1:2, 1:5, 1:10, 1:100, and 1:1000) were added to monolayers of melanocytes for 2 min, followed by 24 h recovery, after which MTS cytotoxicity assay was conducted. The extracts of each toothpaste were prepared (50% w/v), diluted in culture medium (1:2, 1:5, 1:10, 1:50, 1:100, and 1:1000), and added to cell monolayers for 2 min (standard brushing time), followed by an analysis of cell viability after 24 h. Results showed that all mouthrinses except mouthrinse #4 showed significantly greater loss of cell viability, ascribed to cetylpyridinium chloride (CPC) that induced significant cytotoxicity to melanocytes (IC50 = 54.33 µM). In the case of toothpastes, the examination of cellular morphology showed that a 2 min exposure to all toothpaste extracts induced a concentration-dependent decline in cell viability, pronounced in toothpaste containing sodium lauryl sulfate (SLS) detergent. Further results suggested SLS to be the critical driver of cytotoxicity (IC50 = 317.73 µM). It is noteworthy that toothpaste #1 exhibited much lower levels of cytotoxicity compared to the other three toothpastes containing SLS. Taken together, these findings suggest that the melanocytotoxicity of children's mouthrinse (#4) and toothpaste (#1) is comparatively low. To the best of our knowledge, this is the first study to examine the impact of children's toothpastes and mouthrinses on neonatal primary human melanocytes. Future studies to investigate these findings in a realistic scenario replicating oral cavity conditions of the presence of microbiota, pellicle layer and saliva, and other cell types are warranted.
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Affiliation(s)
- Shilpi Goenka
- Department of Biochemistry and Cell Biology, Stony Brook University, Stony Brook, NY 11794, USA
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, USA
| | - Hsi-Ming Lee
- Department of Oral Biology and Pathology, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794, USA;
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Al-Noaman A, Rawlinson SCF. Polyether ether ketone coated with nanohydroxyapatite/graphene oxide composite promotes bioactivity and antibacterial activity at the surface of the material. Eur J Oral Sci 2023; 131:e12946. [PMID: 37528738 DOI: 10.1111/eos.12946] [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: 03/31/2023] [Accepted: 07/15/2023] [Indexed: 08/03/2023]
Abstract
Polyether ether ketone (PEEK) is considered an alternative material for manufacturing dental implants. However, PEEK lacks bioactivity and antibacterial action. In a series of experiments designed to enhance the surface properties of PEEK, we present a nanohydroxyapatite (nHA) and graphene oxide (GO) composite as a coating for PEEK-based dental implants to improve biological properties and antibacterial action. PEEK discs were polished, cleaned, and coated with the composite consisting of nHA particles doped with 0.75 wt% graphene oxide by a micro-emulsion technique according to patent US8,206,813. X-ray diffraction, field emission scanning electron microscopy-energy dispersive spectroscopy, and atomic force microscopy were utilized to characterize the composite coating. The wettability of the coated and non-coated samples was assessed by optical contact angle measurement. Antibacterial action of the composite coating was explored against S. aureus and E. coli and cytotoxicity determined utilizing osteoblast-like cells and gingival fibroblasts. The findings showed that the nHA/GO composite coating, approximately 1.3 μm thick, was homogenous with few micro-cracks and adhered to the PEEK surface. The surface roughness was reduced to 21.26 nm and the wettability was improved to 54.6⁰ after coating with the composite coating. Antibacterial activity was moderate, killing 99% of S. aureus and E. coli, with acceptable levels of cytotoxicity to mammalian osteoblast-like cells and gingival fibroblasts.
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Affiliation(s)
- Ahmed Al-Noaman
- Department of Oral Surgery, College of Dentistry, University of Babylon, Babylon City, Iraq
| | - Simon C F Rawlinson
- School of Medicine and Dentistry, Queen Mary University of London, London, UK
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4
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Mulla SA, Kondkari SA, Patil A, Jain A, Mali S, Jaiswal HC, Jakhar A, Ansari ZM, Agarwal S, Yadav P. A Look Into the Cytotoxicity of Composite Fillings: Friend or Foe? Cureus 2023; 15:e46327. [PMID: 37916229 PMCID: PMC10617805 DOI: 10.7759/cureus.46327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2023] [Indexed: 11/03/2023] Open
Abstract
Dental resin composites are widely used restorative materials in dentistry for the treatment of carious and non-carious lesions as well as pit and fissure sealants, cavity liners, and endodontic sealers. They consist of two parts: an organic resin matrix and an inorganic/organic filler. The organic resin matrix phase is made up of multifunctional monomers and light-sensitive initiators, while the inorganic/organic filler phase is made up of micro/nano-sized fillers that primarily serve as reinforcement. Despite being a very promising dental material, its monomeric component has some drawbacks. It is well known for leaching out during incomplete polymerization, which can result in cytotoxicity. Bis-GMA (bisphenol A-glycidyl methacrylate) is the most cytotoxic of all monomeric components that exhibit synthetic estrogenic effects. The purpose of this article is to assess the cytotoxic effects of dental composite, understand the possible mechanism behind them, and explore ways to screen for and reduce this harmful effect, as well as shed light on its future prospects.
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Affiliation(s)
- Sayem A Mulla
- Dentistry, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Saba A Kondkari
- Dentistry, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Amit Patil
- Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Ashish Jain
- Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Sheetal Mali
- Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Himmat C Jaiswal
- Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Ashima Jakhar
- Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Zoha M Ansari
- Dentistry, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Sumeet Agarwal
- Prosthodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Pooja Yadav
- Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
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Chrószcz-Porębska MW, Barszczewska-Rybarek IM, Kazek-Kęsik A, Ślęzak-Prochazka I. Cytotoxicity and Microbiological Properties of Copolymers Comprising Quaternary Ammonium Urethane-Dimethacrylates with Bisphenol A Glycerolate Dimethacrylate and Triethylene Glycol Dimethacrylate. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16103855. [PMID: 37241482 DOI: 10.3390/ma16103855] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/15/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023]
Abstract
Using dental composite restorative materials with a copolymeric matrix chemically modified towards bioactive properties can help fight secondary caries. In this study, copolymers of 40 wt.% bisphenol A glycerolate dimethacrylate, 40 wt.% quaternary ammonium urethane-dimethacrylates (QAUDMA-m, where m represents 8, 10, 12, 14, 16 and 18 carbon atoms in the N-alkyl substituent), and 20 wt.% triethylene glycol dimethacrylate (BG:QAm:TEGs) were tested for (i) cytotoxicity on the L929 mouse fibroblast cell line; (ii) fungal adhesion, fungal growth inhibition zone, and fungicidal activity against C. albicans; and (iii) bactericidal activity against S. aureus and E. coli. BG:QAm:TEGs had no cytotoxic effects on L929 mouse fibroblasts because the reduction of cell viability was less than 30% compared to the control. BG:QAm:TEGs also showed antifungal activity. The number of fungal colonies on their surfaces depended on the water contact angle (WCA). The higher the WCA, the greater the scale of fungal adhesion. The fungal growth inhibition zone depended on the concentration of QA groups (xQA). The lower the xQA, the lower the inhibition zone. In addition, 25 mg/mL BG:QAm:TEGs suspensions in culture media showed fungicidal and bactericidal effects. In conclusion, BG:QAm:TEGs can be recognized as antimicrobial biomaterials with negligible biological patient risk.
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Affiliation(s)
- Marta W Chrószcz-Porębska
- Department of Physical Chemistry and Technology of Polymers, Faculty of Chemistry, Silesian University of Technology, Strzody 9 Str., 44-100 Gliwice, Poland
| | - Izabela M Barszczewska-Rybarek
- Department of Physical Chemistry and Technology of Polymers, Faculty of Chemistry, Silesian University of Technology, Strzody 9 Str., 44-100 Gliwice, Poland
| | - Alicja Kazek-Kęsik
- Department of Inorganic Chemistry, Analytical Chemistry and Electrochemistry, Faculty of Chemistry, Silesian University of Technology, Krzywoustego 6 Str., 44-100 Gliwice, Poland
- Biotechnology Centre, Silesian University of Technology, Krzywoustego 8 Str., 44-100 Gliwice, Poland
| | - Izabella Ślęzak-Prochazka
- Biotechnology Centre, Silesian University of Technology, Krzywoustego 8 Str., 44-100 Gliwice, Poland
- Department of Systems Biology and Engineering, Faculty of Automatic Control, Electronics and Computer Science, Silesian University of Technology, Akademicka 16 Str., 44-100 Gliwice, Poland
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Poly (Methyl Methacrylate)-Containing Silver-Phosphate Glass Exhibits Potent Antimicrobial Activity without Deteriorating the Mechanical and Biological Properties of Dental Prostheses. Polymers (Basel) 2023; 15:polym15020297. [PMID: 36679178 PMCID: PMC9864078 DOI: 10.3390/polym15020297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/30/2022] [Accepted: 01/03/2023] [Indexed: 01/10/2023] Open
Abstract
Poly (methyl methacrylate) (PMMA) is a commonly used denture material with poor antimicrobial effects. This study investigated the antimicrobial effects of PMMA-containing silver-phosphate glass. We fabricated a novel material comprising PMMA-containing silver-phosphate glass. Then, microhardness, flexural strength, and gloss unit were analyzed. Antimicrobial activity against Streptococcus mutans and Candida albicans was investigated. Colony-forming units were counted, and antimicrobial rates were measured. Biocompatibility tests were performed using a colorimetric MTT assay for evaluating cell metabolic activity. The microhardness, flexural strength, and gloss unit of the experimental groups (with silver-phosphate glass) were not significantly different from those of the control group (no silver-phosphate glass) (P > 0.05), which showed clinically valid values. With increasing proportions of silver-phosphate glass, the antimicrobial activity against the two microorganisms increased (P < 0.05). Furthermore, S. mutans showed more than 50% antimicrobial activity in 4%, 6%, and 8% experimental groups, C. albicans showed more than 50% antimicrobial activity in 6% and 8% groups, and a statistically significant difference in antimicrobial activity was observed compared to the control (P < 0.05). The cell viability of the experimental groups was not significantly different from that of the control group (P > 0.05). Both control and experimental groups showed approximately 100% cell viability. These results suggest that silver-phosphate glass is a promising antimicrobial material in dentistry.
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7
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Hiers RD, Huebner P, Khajotia SS, Florez FLE. Characterization of Experimental Nanoparticulated Dental Adhesive Resins with Long-Term Antibacterial Properties. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:3732. [PMID: 36364508 PMCID: PMC9656602 DOI: 10.3390/nano12213732] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
Experimental adhesives with functional nitrogen-doped titanium dioxide nanoparticles (N_TiO2) have been shown to display improved properties. However, these materials have not been characterized regarding their degree of conversion (DC), biaxial flexure strength (BFS), surface roughness (SR), elastic modulus (EM), and long-term antibacterial functionalities. Experimental adhesives were synthesized by dispersing N_TiO2 (10%, 20%, or 30%, v/v%) into OptiBond Solo Plus (OPTB, Kerr Corp., USA). Unpolymerized adhesives (volume = 50 μL/drop, n = 3/group) were individually placed onto a heated (37 °C) attenuated total reflectance (ATR) monolithic diamond crystal (Golden Gate, Specac). The spectra of composites were obtained with a Fourier-transform infrared (FTIR) spectrometer (Nicolet IS50; 500-4500 cm-1; resolution = 4 cm-1, 10 internal scans/spectrum) before and after polymerization. Disk-shaped specimens (diameter = 6.0 mm, thickness = 0.5 mm) for BFS (n = 12/group), SR and EM (n = 3/group), and for antibacterial testing (n = 18/group/time-point) were fabricated and photopolymerized (1 min each; 385-515 nm, 1000 mW/cm2; VALO). DC values (%) were calculated from pre- and post-polymerization spectra using the two-frequency method and tangent-baseline technique. BFS was assessed using a universal testing machine (Instron 68TM-5, crosshead speed = 1.27 mm/min, 25 °C). SR and EM were investigated using an atomic force microscope (Multimode 8) with aluminum-coated silicon probes (8 nm pyramidal tip, spring constant 40 N/m, Bruker). Antibacterial testing was performed by growing Streptococcus mutans biofilms (UA159-ldh, 37 °C, microaerophilic) on the surfaces of specimens for 24 h and then measuring the relative luminescence units (RLU) with a Biotek Synergy HT multi-well plate reader. Results demonstrate that experimental materials containing 10%, 20%, and 30% of N_TiO2 displayed higher levels of DC, had better mechanical properties, and were able to exert strong and durable antibacterial properties without visible light irradiation and after extended periods of simulated shelf-life and aging in PBS. The reported experimental materials are expected to increase the service lives of polymer-based bonded restorations by decreasing the incidence of secondary caries.
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Affiliation(s)
- Rochelle Denise Hiers
- Division of Dental Biomaterials, Department of Restorative Sciences, College of Dentistry, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA
| | - Pedro Huebner
- Department of Mechanical Engineering, University of Utah, Salt Lake City, UT 84112, USA
| | - Sharukh Soli Khajotia
- Division of Dental Biomaterials, Department of Restorative Sciences, College of Dentistry, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA
| | - Fernando Luis Esteban Florez
- Division of Dental Biomaterials, Department of Restorative Sciences, College of Dentistry, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA
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Oh SH, Jung YS, Lee MJ. Assessment of Zinc-Bound Phosphate-Based Glass-Coated Denture-Relining Material with Antifungal Efficacy for Inhibiting Denture Stomatitis. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:3048. [PMID: 36080085 PMCID: PMC9457723 DOI: 10.3390/nano12173048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/28/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
This study investigated the surface properties, biocompatibility, and antifungal activity against Candida albicans of a denture-relining material coated with zinc-bound phosphate-based glass. First, zinc-bound phosphate-based glass was fabricated. A polymerized denture-relining disk was coated with zinc-bound phosphate-based glass (2%, 4%, and 6%). The surface properties of the control and experimental groups were measured, including the wettability, microhardness, color difference, and gloss. The biocompatibility was evaluated using the MTT assay according to ISO 10993-5. The antifungal activity was investigated by counting the number of colony-forming units of Candida albicans. The results were analyzed using a one-way ANOVA and Tukey's test (p = 0.05). The results of this study indicate that, despite the antimicrobial effect of zinc-bound phosphate-based glass, a coated denture-relining material does not degrade the surface properties and biocompatibility. Therefore, this novel material is considered promising for use as a dental material with antimicrobial properties that can potentially prevent denture stomatitis.
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Affiliation(s)
- Sang-Hwan Oh
- Department of Dental Hygiene, Konyang University, Daejeon 35365, Korea
| | - Yun-Sook Jung
- Department of Dental Hygiene, College of Science & Technology, Kyungpook National University, Sangju 37224, Korea
| | - Myung-Jin Lee
- Department of Dental Hygiene, Division of Health Science, Baekseok University, Cheonan 31065, Korea
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Raszewski Z, Kulbacka J, Nowakowska-Toporowska A. Mechanical Properties, Cytotoxicity, and Fluoride Ion Release Capacity of Bioactive Glass-Modified Methacrylate Resin Used in Three-Dimensional Printing Technology. MATERIALS 2022; 15:ma15031133. [PMID: 35161076 PMCID: PMC8838011 DOI: 10.3390/ma15031133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/12/2022] [Accepted: 01/19/2022] [Indexed: 01/15/2023]
Abstract
Background: Clinically, three-dimensional (3D) printing technology is becoming a popular and efficient dental processing technology. Recently, there has been an increasing demand for dental materials that exhibit bioactive properties. The present study aimed to evaluate the mechanical properties, cytotoxicity, and fluoride ion release capacity of 3D-printed dental resins modified with bioactive glass. Materials and methods: The resin FotoDent splint used in the production of removable orthodontic splints, was modified by the addition of two types of bioactive glasses that are capable of releasing fluoride ions. The novel materials used for the production of dental splints were examined for their mechanical, physical, and biological properties (fracture resistance, sorption, solubility, elution of nonpolymeric substances, and release of fluoride ions over time) and cytotoxic effects on cell cultures. Results: Initially, the fracture toughness of the 3D-printed resin was found to be 55 MPa, but after modification with glass, the resistance was reduced to about 50 MPa. Sorption and solubility values of the materials (19.01 ÷ 21.23 µg/mm3 and 0.42 ÷ 1.12 µg/mm3, respectively) complied with the safety limits imposed by ISO standard. Modified resins were capable of releasing fluoride ions, and the maximum releasing effect was observed after 14 days of incubation. Both the modified resins, after four days of contact with human gingival fibroblasts, exhibited moderate cytotoxic properties. Conclusions: The experimental results showed that modification of methacrylate resin, used in 3D printing technology, with bioactive glasses produces novel dental materials that possess desirable bioactive properties. The findings of this study indicate the potential ability of modified polymethacrylate resins to release fluoride ions in the oral cavity environment. The modified materials are characterized with a moderate decrease in physical properties and mild cytotoxicity on direct contact with human fibroblasts.
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Affiliation(s)
| | - Julita Kulbacka
- Department of Molecular and Cellular Biology, Faculty of Pharmacy, Wroclaw Medical University, Borowska 211A, 50-556 Wroclaw, Poland;
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De Angelis F, Sarteur N, Buonvivere M, Vadini M, Šteffl M, D'Arcangelo C. Meta-analytical analysis on components released from resin-based dental materials. Clin Oral Investig 2022; 26:6015-6041. [PMID: 35870020 PMCID: PMC9525379 DOI: 10.1007/s00784-022-04625-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 07/11/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Resin-based materials are applied in every branch of dentistry. Due to their tendency to release substances in the oral environment, doubts have been raised about their actual safety. This review aims to provide a comprehensive analysis of the last decade literature regarding the concentrations of elutable substances released from dental resin-based materials in different type of solvents. MATERIALS AND METHODS All the literature published on dental journals between January 2010 and April 2022 was searched using international databases (PubMed, Scopus, Web of Science). Due to strict inclusion criteria, only 23 papers out of 877 were considered eligible. The concentration of eluted substances related to surface and volume of the sample was analyzed, considering data at 24 h as a reference. The total cumulative release was examined as well. RESULTS The most eluted substances were HEMA, TEGDMA, and BPA, while the less eluted were Bis-GMA and UDMA. Organic solvents caused significantly higher release of substances than water-based ones. A statistically significant inverse correlation between the release of molecules and their molecular mass was observed. A statistically significant positive correlation between the amount of released molecule and the specimen surface area was detected, as well as a weak positive correlation between the release and the specimen volume. CONCLUSIONS Type of solvent, molecular mass of eluates, and specimen surface and volume affect substances release from materials. CLINICAL RELEVANCE It could be advisable to rely on materials based on monomers with a reduced elution tendency for clinical procedures.
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Affiliation(s)
- Francesco De Angelis
- Unit of Restorative Dentistry and Endodontics, Department of Medical, Oral and Biotechnological Sciences, School of Dentistry, "G. D'Annunzio" University Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy.
| | - Nela Sarteur
- Unit of Restorative Dentistry and Endodontics, Department of Medical, Oral and Biotechnological Sciences, School of Dentistry, "G. D'Annunzio" University Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
| | - Matteo Buonvivere
- Unit of Restorative Dentistry and Endodontics, Department of Medical, Oral and Biotechnological Sciences, School of Dentistry, "G. D'Annunzio" University Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
| | - Mirco Vadini
- Unit of Restorative Dentistry and Endodontics, Department of Medical, Oral and Biotechnological Sciences, School of Dentistry, "G. D'Annunzio" University Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
| | - Michal Šteffl
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Camillo D'Arcangelo
- Unit of Restorative Dentistry and Endodontics, Department of Medical, Oral and Biotechnological Sciences, School of Dentistry, "G. D'Annunzio" University Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
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11
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Sochacki S, Karczewski A, Platt J, Roberts HW. Effect of post-irradiation polymerization on selected mechanical properties of six direct resins. Dent Mater J 2021; 41:230-240. [PMID: 34789623 DOI: 10.4012/dmj.2021-175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study evaluated the post-irradiation mechanical property development of six resin composite-based restorative materials from the same manufacturer starting at 1 h post irradiation, followed by 24 h, 1 week, and 1 month after fabrication. Samples were stored in 0.2M phosphate buffered saline until testing. Flexural strength, flexural modulus, flexural toughness, modulus of resiliency, fracture toughness, and surface microhardness were performed at each time interval. Mean data was analyzed by Kruskal Wallis and Dunn's post hoc testing at a 95% level of confidence (α=0.05). Results were material specific but overall, all resin composite material mechanical properties were found to be immature at 1 h after polymerization as compared to that observed at 24 h. It may be prudent that clinicians advise patients, especially those receiving complex posterior composite restorations, to guard against overly stressing these restorations during the first 24 h.
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Affiliation(s)
- Sabrina Sochacki
- Department of Biomedical Sciences and Comprehensive Care, School of Dentistry, Indiana University
| | - Ashley Karczewski
- Department of Biomedical Sciences and Comprehensive Care, School of Dentistry, Indiana University
| | - Jeffrey Platt
- Department of Biomedical Sciences and Comprehensive Care, School of Dentistry, Indiana University
| | - Howard W Roberts
- Director of Graduate Studies, University of Kentucky, College of Dentistry
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Evaluation of Residual Monomers Eluted from Pediatric Dental Restorative Materials. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6316171. [PMID: 34580639 PMCID: PMC8464417 DOI: 10.1155/2021/6316171] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/02/2021] [Accepted: 09/04/2021] [Indexed: 01/18/2023]
Abstract
Unreacted monomers eluted from resin-based restorative materials have been considered a reason of local and systemic adverse reactions. This study was designed to determine the effect of finishing and polishing procedures on the elution of Bis-GMA, TEGDMA, UDMA, and HEMA monomers from compomer and bulk-fill composite resins. Bulk-fill composite (3M ESPE GmbH, Seefeld, Germany) and compomer (Dentsply DeTrey GmbH, Konstanz, Germany) specimens with 3 × 4 mm diameters were prepared. The specimens were randomly divided into two groups, and finishing-polishing procedures were applied only to the experimental groups. Release of residual monomers was analyzed by using High-Performance Liquid Chromatography (HPLC) after 24, 48, and 72 hours. Repeated measures ANOVA and Tukey post hoc tests were used for comparisons. Finishing and polishing procedures had a significant effect on reducing the quantity of UDMA release in the Filtek™ Bulk Fill composite and Bis-GMA, HEMA, and TEGDMA in the Dyract XP compomer (p < 0.05). The restorative materials investigated here are not chemically stable after polymerization, and concentrations of eluted monomers may reach critical toxicity levels even after one restoration placement. Finishing and polishing procedures are mandatory to reduce residual monomers.
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Yoo H, Kim SY, Shin SJ, Park JW. The physical properties and anticariogenic effect of experimental resin cement containing ursolic acid. Odontology 2021; 109:641-648. [PMID: 33423144 DOI: 10.1007/s10266-020-00584-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 12/16/2020] [Indexed: 12/01/2022]
Abstract
The aim was to evaluate the physical properties and anti-bacterial activity of resin cement containing ursolic acid (UA) and determine the optimal concentration of UA. Five types of experimental resin cement were prepared according to UA concentration (0, 0.1, 0.5, 1.0, and 2.0 wt%). Flexural strength, film thickness and in vitro cytotoxicity were measured to confirm whether the resin was appropriate under International Organization for Standardization (ISO) criteria. Fifty extracted human molars were prepared, and indirect resin inlays were cemented with experimental resins. Acid-resistant nail varnish was applied, except for the 2-mm area around the restoration. Artificial caries were induced for 6 days through Streptococcus (S.) mutans (ATCC25175). Quantitative light-induced fluorescence (QLF) was used to evaluate the caries progression. One-way analysis of variance (ANOVA) followed by the Dunnett correction were used to statistically analyze the data. In all groups, the physical property of flexural strength, film thickness, and cytotoxicity were satisfied for ISO criteria (p > 0.05). On ∆F (-%) and ∆Q (-%⋅Px) values as QLF parameters, there was a tendency of being lower in groups of resin cement containing higher concentration of UA. Resin cement containing UA of greater than or equal to 0.5% significantly inhibited caries in the area around restoration (p < 0.05). There was no difference between the groups containing UA of greater than or equal to 0.5%. Resin cement containing 0.5% or more UA showed anti-carious effect in the limited range of 2% and satisfied the ISO criteria for flexural strength, film thickness and cytotoxicity.
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Affiliation(s)
- Hyunkyung Yoo
- Department of Conservative Dentistry, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Eonju-ro 211, Gangnam-gu, Seoul, 06273, South Korea
| | - So Youn Kim
- Department of Conservative Dentistry, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Eonju-ro 211, Gangnam-gu, Seoul, 06273, South Korea
| | - Su-Jung Shin
- Department of Conservative Dentistry, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Eonju-ro 211, Gangnam-gu, Seoul, 06273, South Korea
| | - Jeong-Won Park
- Department of Conservative Dentistry, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Eonju-ro 211, Gangnam-gu, Seoul, 06273, South Korea.
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Evaluation of Restorative Techniques for Vertically Fractured Roots. MATERIALS 2021; 14:ma14092099. [PMID: 33919304 PMCID: PMC8122698 DOI: 10.3390/ma14092099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/09/2021] [Accepted: 04/20/2021] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to examine the effects of combining specific adhesive materials and various surface treatments on bonding durability and microleakage of vertically fractured roots. Adhesive models were prepared using bovine lower incisors. The experiment included the following five groups: SB-G group (control) (10% citric acid with 3% ferric chloride solution (10-3 solution) + an adhesive resin cement (4-META/MMA-TBB; Super-Bond®)), EC group (self-cure bonding agent (UB) + core composite resin (EC)), EC-G group (10-3 solution + UB + EC), EC-P group (40% phosphate solution + UB + EC), and EC-E group (18% ethylenediaminetetraacetic acid (EDTA) solution + UB + EC). After applying a load of 50,000 cycles, microleakage, microtensile bond strength (μTBS), and failure modes were examined. Microleakage of the EC, EC-G, and EC-E groups was significantly lower than that of the EC-P group. The μTBS of the EC-G group was significantly higher than that of the other groups. All EC groups showed that mixed (cohesive and adhesive) and adhesive failures were the most prevalent types of failure modes. The EC-G group showed the highest bonding durability and the lowest microleakage results, which indicates a possible alternative to current adhesive and tooth surface treatments.
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Surface Characterization, Biocompatibility and Antifungal Efficacy of a Denture-Lining Material Containing Cnidium officinale Extracts. Molecules 2021; 26:molecules26051440. [PMID: 33799919 PMCID: PMC7962000 DOI: 10.3390/molecules26051440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 02/24/2021] [Accepted: 03/01/2021] [Indexed: 11/16/2022] Open
Abstract
Herein, we investigated the surface characterization and biocompatibility of a denture-lining material containing Cnidium officinale extracts and its antifungal efficacy against Candida albicans. To achieve this, a denture-lining material containing various concentrations of C. officinale extract and a control group without C. officinale extract were prepared. The surface characterization and biocompatibility of the samples were investigated. In addition, the antifungal efficacy of the samples on C. albicans was investigated using spectrophotometric growth and a LIVE/DEAD assay. The results revealed that there was no significant difference between the biocompatibility of the experimental and control groups (p > 0.05). However, there was a significant difference between the antifungal efficiency of the denture material on C. albicans and that of the control group (p < 0.05), which was confirmed by the LIVE/DEAD assay. These results indicate the promising potential of the C. officinale extract-containing denture-lining material as an antifungal dental material.
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Diemer F, Stark H, Helfgen EH, Enkling N, Probstmeier R, Winter J, Kraus D. In vitro cytotoxicity of different dental resin-cements on human cell lines. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2021; 32:4. [PMID: 33471194 PMCID: PMC7817560 DOI: 10.1007/s10856-020-06471-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 12/08/2020] [Indexed: 05/07/2023]
Abstract
Adhesive resin-cements are increasingly used in modern dentistry. Nevertheless, released substances from resin materials have been shown to cause cellular toxic effects. Disc-shaped specimens from 12 different resin cements and one conventional zinc phosphate cement were prepared and used for direct stimulation of five different human cell lines via transwell cell culture system or in an indirect way using conditioned cell culture media. Cytotoxicity was determined using LDH and BCA assays. All tested cements led to a decrease of cell viability but to a distinct extent depending on cell type, luting material, and cytotoxicity assay. In general, cements exhibited a more pronounced cytotoxicity in direct stimulation experiments compared to stimulations using conditioned media. Interestingly, the conventional zinc phosphate cement showed the lowest impact on cell viability. On cellular level, highest cytotoxic effects were detected in osteoblastic cell lines. All resin cements reduced cell viability of human cells with significant differences depending on cell type and cement material. Especially, osteoblastic cells demonstrated a tremendous increase of cytotoxicity after cement exposure. Although the results of this in vitro study cannot be transferred directly to a clinical setting, it shows that eluted substances from resin cements may disturb osteoblastic homeostasis that in turn could lead to conditions favoring peri-implant bone destruction. Thus, the wide use of resin cements in every clinical situation should be scrutinized. A correct use with complete removal of all cement residues and a sufficient polymerization should be given the utmost attention in clinical usage.
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Affiliation(s)
- Freya Diemer
- Department of Oral Surgery, University of Bonn, Bonn, Germany
| | - Helmut Stark
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, University of Bonn, Bonn, Germany
| | - Ernst-Heinrich Helfgen
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, University of Bonn, Bonn, Germany
| | - Norbert Enkling
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, University of Bonn, Bonn, Germany
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Rainer Probstmeier
- Neuro- and Tumor Cell Biology Group, Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany
| | - Jochen Winter
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - Dominik Kraus
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, University of Bonn, Bonn, Germany.
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Biocompatibility, mechanical, and bonding properties of a dental adhesive modified with antibacterial monomer and cross-linker. Clin Oral Investig 2020; 25:2877-2889. [PMID: 33006665 DOI: 10.1007/s00784-020-03605-w] [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: 05/22/2020] [Accepted: 09/23/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES This study investigated the antibacterial, cytotoxicity, and mechanical properties of a dental adhesive modified with quaternary ammonium monomer ((2-acryloyloxyethyl)dimethyldodecylammonium bromide) and cross-linker (bis(2-acryloyloxyethyl)methyldodecylammonium bromide). MATERIALS AND METHODS Monomer (M), cross-linker (C), or a combination of these (M + C) were incorporated into adhesive Adper Single Bond Plus (SB) in 5, 10, or 25% (as wt%). A colony-forming unit and MTT assays were used to evaluate antibacterial properties against Streptococcus mutans and cell viability. Resin-dentin beams (0.9 ± 0.1 mm2) were evaluated for micro-tensile bond strength (μTBS) after 24 h, 6 months, and 3 years. Hourglass specimens were evaluated for ultimate tensile strength (UTS) after 24 h, 1 week, and 6 months. Micro-hardness measurements after softening in ethanol were taken as an indirect assessment of the polymer cross-linking density. Kruskal-Wallis, one-way ANOVA, two-way ANOVA, and Student's t test were used for analysis of the antibacterial, cytotoxicity, μTBS, UTS, and hardness data, all with a significance level of p < 0.05. RESULTS 10%M and 25%M demonstrated a significant reduction in S. mutans relative to SB (p < 0.001). No differences in cytotoxicity were detected for any of the groups. After 6 months, no changes in μTBS were shown for any of the groups. After 3 years, all groups evidenced a significant decrease in μTBS (p < 0.05) except 5%M, 5%C, and 5%M + 5%C. All groups demonstrated either stable or significantly increased UTS after 6 months. Except for the cross-linker groups, a significant decrease in micro-hardness was shown for all groups after softening in ethanol (p < 0.05). CONCLUSIONS A 5-10% of monomer may render the resin antibacterial without a compromise to its mechanical and bonding properties. CLINICAL RELEVANCE Biomodification of a resin adhesive with an antibacterial monomer and cross-linker may help improve the life span of adhesive restorations.
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Lee MJ, Kim MJ, Oh SH, Kwon JS. Novel Dental Poly (Methyl Methacrylate) Containing Phytoncide for Antifungal Effect and Inhibition of Oral Multispecies Biofilm. MATERIALS 2020; 13:ma13020371. [PMID: 31941105 PMCID: PMC7014161 DOI: 10.3390/ma13020371] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 01/02/2020] [Accepted: 01/09/2020] [Indexed: 12/19/2022]
Abstract
Despite the many advantages of poly (methyl methacrylate) (PMMA) as a dental polymer, its antifungal and antibacterial effects remain limited. Here, phytoncide was incorporated into PMMA to inhibit fungal and biofilm accumulation without impairing the basic and biological properties of PMMA. A variable amount of phytoncide (0 wt % to 5 wt %) was incorporated into PMMA, and the basic material properties of microhardness, flexural strength and gloss were evaluated. In addition, cell viability was confirmed by MTT assay. This MTT assay measures cell viability via metabolic activity, and the color intensity of the formazan correlates viable cells. The fungal adhesion and viability on the PMMA surfaces were evaluated using Candida albicans (a pathogenic yeast). Finally, the thickness of saliva-derived biofilm was estimated. The flexural strength of PMMA decreased with increasing phytoncide contents, whereas there were no significant differences in the microhardness and gloss (p > 0.05) and the cell viability (p > 0.05) between the control and the phytoncide-incorporated PMMA samples. The amounts of adherent Candida albicans colony-forming unit (CFU) counts, and saliva-derived biofilm thickness were significantly lower in the phytoncide-incorporated PMMA compared to the control (p < 0.05). Hence, it was concluded that the incorporation of appropriate amounts of phytoncide in PMMA demonstrated antifungal effects while maintaining the properties, which could be a possible use in dentistry application such as denture base resin.
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Affiliation(s)
- Myung-Jin Lee
- Department and Research Institute of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry, Seoul 03722, Korea; (M.-J.L.); (M.-J.K.)
| | - Min-Ji Kim
- Department and Research Institute of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry, Seoul 03722, Korea; (M.-J.L.); (M.-J.K.)
- BK21 PLUS Project, Yonsei University College of Dentistry, Seoul 03722, Korea
| | - Sang-Hwan Oh
- Department of Dental Hygiene, College of Medical Science, Konyang University, Daejeon 35365, Korea;
| | - Jae-Sung Kwon
- Department and Research Institute of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry, Seoul 03722, Korea; (M.-J.L.); (M.-J.K.)
- BK21 PLUS Project, Yonsei University College of Dentistry, Seoul 03722, Korea
- Correspondence: ; Tel.: +82-2-2228-3081
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Kwon JS, Lee MJ, Kim JY, Kim D, Ryu JH, Jang S, Kim KM, Hwang CJ, Choi SH. Novel anti-biofouling light-curable fluoride varnish containing 2-methacryloyloxyethyl phosphorylcholine to prevent enamel demineralization. Sci Rep 2019; 9:1432. [PMID: 30723241 PMCID: PMC6363795 DOI: 10.1038/s41598-018-38255-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 12/20/2018] [Indexed: 12/27/2022] Open
Abstract
We evaluated the efficacy of light-curable fluoride varnish (LCFV) that contains 2-methacryloyloxyethyl phosphorylcholine (MPC) in terms of anti-biofouling properties and prevention of tooth enamel demineralization. MPC was mixed with and incorporated into LCFV at 0 (control), 1.5, 3.0, 5.0, 10.0, 20.0, and 40.0 weight percentage (wt%). Addition of high wt% of MPC resulted in increased film thickness and decreased the degree of conversion, indicating loss of the advantageous properties of LCFV. Addition of 1.5, 3, or 5 wt% MPC significantly reduced the amount of bovine serum albumin adsorbed from a solution and proteins adsorbed from brain heart infusion medium compared to the control (P < 0.001). A similar pattern was observed for bacterial adhesion: significantly less Streptococcus mutans cells adhered on the surface of LCFV with 1.5, 3, or 5 wt% MPC (P < 0.001) than on the control, and similar results were obtained for Actinomyces naeslundii and Streptococcus sanguinis adherence to LCFV with 3 wt% MPC. Finally, bacterial adhesion, surface microhardness loss, and the depth of demineralization were substantially lower on bovine tooth enamel surface coated with LCFV containing 3 wt% of MPC than in the control treatment (0 wt% MPC). Therefore, this novel LCFV containing a low concentration of MPC (e.g., 3 wt%) would be effective in anti-biofouling while maintaining the important advantageous features of light-curable fluoride in preventing demineralization.
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Affiliation(s)
- Jae-Sung Kwon
- Department and Research Institute of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Myung-Jin Lee
- Department and Research Institute of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Ji-Young Kim
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Dohyun Kim
- Department of Conservative Dentistry, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jeong-Hyun Ryu
- Department and Research Institute of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry, Seoul, Republic of Korea.,BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Sungil Jang
- BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Republic of Korea.,Department of Oral Biology, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Kwang-Mahn Kim
- Department and Research Institute of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Chung-Ju Hwang
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Sung-Hwan Choi
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Republic of Korea.
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