A Study of 3D-Printable Reinforced Composite Resin: PMMA Modified with Silver Nanoparticles Loaded Cellulose Nanocrystal

The influence of the addition of titanium oxide nanotubes on the properties of 3D printed denture base materials

INTRODUCTION

In this study, the effects of adding titanium dioxide nanotubes (TiO2) to 3D-printed denture base resin on the mechanical and physical properties of denture bases were examined for the first time.

METHODS

The specimens were digitally created using 3D builder software from Microsoft Corporation through computer-aided design. In accordance with the test specifications for transverse strength, impact strength, hardness, surface roughness, and color stability, specimens were designed and printed with certain dimensions following relevant standards. TiO2 nanotubes (diameter: 15-30 nm and length: 2-3 μm) were added to the 3D-printed denture base resin (DentaBase, Asiga, Australia) at 1.0% and 1.5% by weight. Flexural strength, impact strength (Charpy impact), hardness, surface roughness, and color stability were evaluated, and the collected data were analyzed with ANOVA followed by Tukey's post hoc test (α = 0.05). Field emission scanning electron microscopy (FESEM) and energy dispersive x-ray spectroscopy (EDX) mapping were used to evaluate the dispersion of the nanotubes.

RESULTS

Compared with those of the control group (0.0 wt.% TiO2 nanotubes), the average flexural, impact, and hardness values of the 1.0 and 1.5 wt.% TiO2 nanotube reinforcement groups increased significantly. Both nanocomposite groups showed significant color changes compared to that of the pure resin, and there was a considerable reduction in the surface roughness of the nanocomposites compared to that of the control group.

CONCLUSION

Adding TiO2 nanotubes to 3D-printed denture base materials at 1.0 and 1.5 wt.% could enhance the mechanical and physical properties of the material, leading to better clinical performance.

CLINICAL SIGNIFICANCE

In terms of clinical applications, 3D-printed denture base material has been shown to be a viable substitute for traditional heat-cured materials. By combining this with nanotechnology, existing dentures could be significantly enhanced, promoting extended service life and patient satisfaction while addressing the shortcomings of the current standard materials.

Silver Nanoparticles in Therapeutics and Beyond: A Review of Mechanism Insights and Applications

Silver nanoparticles (NPs) have become highly promising agents in the field of biomedical science, offering wide therapeutic potential due to their unique physicochemical properties. The unique characteristics of silver NPs, such as their higher surface-area-to-volume ratio, make them ideal for a variety of biological applications. They are easily processed thanks to their large surface area, strong surface plasmon resonance (SPR), stable nature, and multifunctionality. With an emphasis on the mechanisms of action, efficacy, and prospective advantages of silver NPs, this review attempts to give a thorough overview of the numerous biological applications of these particles. The utilization of silver NPs in diagnostics, such as bioimaging and biosensing, as well as their functions in therapeutic interventions such as antimicrobial therapies, cancer therapy, diabetes treatment, bone repair, and wound healing, are investigated. The underlying processes by which silver NPs exercise their effects, such as oxidative stress induction, apoptosis, and microbial cell membrane rupture, are explored. Furthermore, toxicological concerns and regulatory issues are discussed, as well as the present difficulties and restrictions related to the application of silver NPs in medicine.

Biaxial flexural strength of nanoglass and multiwalled carbon nanotubes reinforced 3D-printed denture base resins and their shear bond strength to 3D-printed and acrylic denture teeth

OBJECTIVE

Evaluation of biaxial flexural strength (BFS) of nanoglass (NG) and multiwalled carbon nanotubes (MWCNTs) reinforced 3D-printed denture base resins and their shear bond strength (SBS) to 3D-printed and acrylic denture teeth.

METHODS

Silanized NG and MWCNTs were added to 3D-printed denture base resin to obtain four groups: Control, 0.25 wt% NG, 0.25 wt% MWCNTs, and a combination group with 0.25 wt% of both fillers. All specimens were tested before and after 600 cycles of thermal aging. BFS (n = 88) was tested using disk-shaped specimens (12 ×2 mm) centralized on an O ring in a universal testing machine. Weibull analysis was conducted to assess predictability of failure. SBS (n = 176) was tested for acrylic and 3D-printed denture teeth attached to bar-shaped specimens in a universal testing machine followed by failure mode analysis using stereomicroscope. Two and three-way ANOVA tests followed by Tukey post hoc test were conducted for BFS and SBS. Kruskal-Wallis test compared percent change among groups with subsequent Dunn post hoc test with Bonferroni correction (α = 0.05).

RESULTS

BFS was affected significantly by filler content (P < 0.001) and thermal cycling (P < 0.001), with thermal cycling displaying the uppermost effect (Ƞp2 =0.551). A significant interaction between filler content, thermal cycling, and teeth type was displayed by SBS results (P < 0.001, F=10.340, Ƞp2 =0.162). The highest BFS values belonged to 0.25 % MWCNTs while the highest SBS to printed teeth was displayed by the combination.

SIGNIFICANCE

The combination group displayed higher BFS and SBS to printed teeth compared to control which allows 3D-printed materials to have a long-term clinical success.

Evaluation of microhardness, degree of conversion, and abrasion resistance of nanoglass and multiwalled carbon nanotubes reinforced three-dimensionally printed denture base resins

PURPOSE

To assess the effect of nanoglass (NG) particles and multiwalled carbon nanotubes' (MWCNTs) addition on Vickers hardness (VH), degree of conversion (DC), and abrasion resistance of 3D-printed denture base resin.

MATERIALS AND METHODS

3D-printed denture base resin was reinforced using silanized NG and MWCNTs to obtain four groups: Control, 0.25 wt% NG reinforced resin, 0.25 wt% MWCNTs reinforced resin, and a combination group of 0.25 wt% of both fillers. All specimens (N = 176) were tested before and after thermal aging (600 cycles) for VH (n = 22), DC, and abrasion resistance (n = 22). Abrasion resistance specimens were subjected to 60,000 brushing strokes, and then assessed for surface roughness (Ra) and weight loss. Specimens were then scanned with a benchtop scanner before and after abrasion to produce a color map of topographical changes from superimposed images. Data were analyzed using ANOVA tests followed by Tukey post hoc test. Kruskal-Wallis test was used to compare percent change among groups, followed by Dunn post hoc test (α = 0.05).

RESULTS

The interaction between nanofiller content and thermal cycling displayed a significant effect on VH and DC. The 0.25% NG expressed the highest VH before aging but revealed the highest percent decrease after aging. Nanofiller content, thermal aging, and brushing displayed a significant interaction impact on the Ra values.

CONCLUSIONS

The addition of nanofillers resulted in an overall improvement in resin microhardness and abrasion resistance. The 0.25% MWCNTs group revealed the lowest Ra with the least percent change in VH and DC, while the combination one displayed the least change in weight.

Effect of postpolymerization time and atmosphere on surface properties and biofilm formation in additively manufactured resins for definitive restorations

OBJECTIVES

To investigate how postpolymerization time (PPT) and atmosphere (PPA) influence the surface properties, protein adsorption, and microbial adhesion of two types of additively manufactured (AM) resins used for definitive restorations.

METHODS

Two different types of commercially available AM resins for definitive restorations (UR and CR) were used to create disk-shaped specimens. These specimens were divided into eight groups based on resin type (UR and CR), PPT (standard or extended), and PPA (air or nitrogen). After postpolymerization, the surface roughness (Ra and Sa) and surface free energy (SFE) of all specimens were measured. The study also evaluated protein adsorption, microbial attachment, and cytotoxicity. A non-parametric factorial analysis of variance with post-hoc analyses was conducted, using a significance level (α) of 0.05.

RESULTS

The Ra and Sa values for CR were higher than those for UR, regardless of PPT or PPA (P < 0.05). For UR, SFE was higher with extended PPT compared to standard PPT. CR had higher SFE than UR under standard PPT. The interaction between PPT and PPA had a significant effect on protein adsorption (P < 0.05). When PPT was standard, nitrogen significantly increased protein adsorption compared to air. The interaction between resin type and PPA, and between resin type and PPT, significantly affected microbial adhesion (P < 0.05). The changes in PPT or PPA did not affect the cytotoxicity of either AM resin.

CONCLUSION

Surface properties, protein adsorption, and microbial attachment were influenced by the interactions among PPT, PPA, and resin type. These factors can have implications for resin-based definitive restorations.

CLINICAL SIGNIFICANCES

Clinicians should understand the impact of PPT and PPA on the surface properties of AM resins for definitive restorations, particularly regarding protein adsorption and microbial adhesion. Additionally, the type of AM resin (based on chemical composition) could affect its biological properties.

Enhancing 3D-printed denture base resins: A review of material innovations

The limited physical and mechanical properties of polymethyl methacrylate (PMMA), the current gold standard, necessitates exploring improved denture base materials. While three-dimensional (3D) printing offers accuracy, efficiency, and patient comfort advantages, achieving superior mechanics in 3D-printed denture resins remains challenging despite good biocompatibility and esthetics. This review investigates the potential of innovative materials to address the limitations of 3D-printed denture base materials. Thus, this article is organized to provide a comprehensive overview of recent efforts to enhance 3D-printed denture base materials, highlighting advancements. It critically examines the impact of incorporating various nanoparticles (zirconia, titania, etc.) on these materials' physical and mechanical properties. Additionally, it delves into recent strategies for nanofiller surface treatment and biocompatibility evaluation and explores potential future directions for polymeric composites in denture applications. The review finds that adding nanoparticles significantly improves performance compared to unmodified resins, and properties can be extensively enhanced through specific modifications, particularly silanized nanoparticles. Optimizing 3D-printed denture acrylics requires a multifaceted approach, with future research prioritizing novel nanomaterials and surface modification techniques for a novel generation of superior performance, esthetically pleasing, and long-lasting dentures.

Effects of postpolymerization conditions on the physical properties, cytotoxicity, and dimensional accuracy of a 3D printed dental restorative material

STATEMENT OF PROBLEM

Although the introduction of high-speed 3-dimensional (3D) printing technology has significantly reduced printing time, the time required for postpolymerization is a speed-determining step because of the long wait time. How postpolymerization conditions affect material properties is unclear.

PURPOSE

The purpose of this in vitro study was to assess the physical properties, accuracy, and biosafety of a 3D printed dental restorative material according to postpolymerization conditions.

MATERIAL AND METHODS

Specimens were prepared by 3D printing with a digital light processing 3D printer with 1 interim dental material (C&B MFH). All printed specimens underwent a postpolymerization process with 5 different postpolymerization devices and were designated as groups D1 (D102H), FO (Form Cure), LC (LC-3DPrintBox), ME (Medusa), and MP (MP100). The light intensity and temperature of each device were measured, and the Vickers hardness, flexural strength and modulus, degree of conversion (DC), cytotoxicity, and polymerization shrinkage were analyzed. Statistical analyses were conducted with 1-way analysis of variance, the Tukey post hoc test, and regression testing (α=.05). Scanning electron microscopy was used to assess the fracture surface characteristics of the specimens.

RESULTS

Light intensity was strongest with the ME device, and the temperature inside the device during postpolymerization showed the highest increase with the LC device and the lowest increase with the D1 device. The LC group specimens showed the highest mean Vickers hardness, and the MP group showed the lowest. The flexural strength was ≥100 MPa in all groups, with a flexural modulus ranging from 1.17 to 1.5 GPa. The DC results were similar to the physical properties test results. The D1, FO, LC, and ME groups all showed ≥70% cell viability, indicating no toxicity. The FO group showed the highest shrinkage rate of 0.52%.

CONCLUSIONS

When the light intensity was strong, the surface was sufficiently hard, and toxic substances were not eluted even after a short postpolymerization time, suggesting that light intensity modulation and time management can be used to improve the postpolymerization process.

Assessing the Dispersion Stability of Antimicrobial Fillers in Photosensitive Resin for Vat Polymerization 3D Printing

Polymers are widely used in healthcare due to their biocompatibility and mechanical properties; however, the use of polymers in medical products can promote biofilm formation, which can be a source of hospital-acquired infections. Due to this, there is a rising demand for inherently antimicrobial polymers for devices in contact with patients. 3D printing as a manufacturing technology has increased exponentially in recent years. Surgical guides, orthotics, and prosthetics, among other medical devices, created by vat polymerization have been used in hospitals to treat patients. Biocompatible resins are available for these applications, but there is a lack of antimicrobial resins, which would further improve the technology for clinical use. The focus of this study was to assess settling of candidate antimicrobial metal and metal oxide fillers in vat polymerization resin to determine which fillers were compatible with the resin. Dispersion stability was assessed by measuring settling over the maximum print duration of the medium priced desktop 3D printers to evaluate printability of 17 potentially antimicrobial resins. Eight materials displayed settling behavior during the test period: molybdenum oxide, zirconium oxide nanopowder, scandium oxide, zirconium oxide, titanium oxide, tungsten oxide, lanthanum oxide, and magnesium oxide. No settling was observed for manganese oxide, magnesium oxide nanopowder, titanium oxide nanopowder, copper oxide, silver oxide, zinc oxide nanopowder, zinc oxide, silver nanopowder, and gold nanopowder during the test period. This method could be applied to assess settling of other fillers introduced into 3D printing resins before actual printing.

The effects of nano-silver loaded zirconium phosphate on antibacterial properties, mechanical properties and biosafety of room temperature curing PMMA materials

Polymethyl methacrylate (PMMA) frequently features in dental restorative materials due to its favorable properties. However, its surface exhibits a propensity for bacterial colonization, and the material can fracture under masticatory pressure. This study incorporated commercially available RHA-1F-II nano-silver loaded zirconium phosphate (Ag-ZrP) into room-temperature cured PMMA at varying mass fractions. Various methods were employed to characterize Ag-ZrP. Subsequently, an examination of the effects of Ag-ZrP on the antimicrobial properties, biosafety, and mechanical properties of PMMA materials was conducted. The results indicated that the antibacterial rate against Streptococcus mutans was enhanced at Ag-ZrP additions of 0%wt, 0.5%wt, 1.0%wt, 1.5%wt, 2.0%wt, 2.5%wt, and 3.0%wt, achieving respective rates of 53.53%, 67.08%, 83.23%, 93.38%, 95.85%, and 98.00%. Similarly, the antibacterial rate against Escherichia coli registered at 31.62%, 50.14%, 64.00%, 75.09%, 86.30%, 92.98%. When Ag-ZrP was introduced at amounts ranging from 1.0% to 1.5%, PMMA materials exhibited peak mechanical properties. However, mechanical strength diminished beyond additions of 2.5%wt to 3.0%wt, relative to the 0%wt group, while PMMA demonstrated no notable cytotoxicity below a 3.0%wt dosage. Thus, it is inferred that optimal antimicrobial and mechanical properties of PMMA materials are achieved with nano-Ag-ZrP (RHA-1F-II) additions of 1.5%wt to 2.0%wt, without eliciting cytotoxicity.

Effect of titanium dioxide nanocoating on the colour stability of room temperature vulcanizing maxillofacial silicone-an invitro study

OBJECTIVE

The aim of this in vitro study was to evaluate the effect of an oxide nanocoating to prevent colour degradation of maxillofacial silicone elastomers following accelerated ageing.

MATERIAL AND METHODS

Specimens (N = 40) of specified dimensions were fabricated in Factor II room temperature vulcanizing (RTV) silicone and processed according to the manufacturer's instructions. Two groups were classified with 20 specimens each. Specimens in the first group were coated with titanium dioxide (TiO2) by atomic layer deposition technology. The colour stability test was conducted with a UV-VIS spectrometer (Schimadzu) for both titanium dioxide nanocoated and uncoated specimen groups after subjecting them to accelerated ageing. It was analysed using the CIE L*a*b method.

RESULTS

The average colour change was highest for uncoated specimens (2.868), and the average colour change for titanium dioxide-coated specimens was significantly low (1.774). The average colour change of uncoated specimens (2.868) was close to the acceptable threshold value (3), and that of coated specimens (1.774) was far below the acceptable threshold (3).

CONCLUSIONS

The colour change that occurred in titanium dioxide nanocoated specimens following accelerated ageing was significantly lower than that in the uncoated group, showing that the TiO2 nanocoating was effective in reducing the colour degradation of silicone elastomers.

CLINICAL RELEVANCE

Maxillofacial prostheses fabricated from silicone elastomers go through undesirable colour degradation over time. The development of a scientific technique that retards the colour deterioration of silicone prostheses would be of great clinical significance.

3D printed denture base material: The effect of incorporating TiO2 nanoparticles and artificial ageing on the physical and mechanical properties

OBJECTIVES

To evaluate the physical and mechanical properties of three-dimensional (3D) printed denture base resin incorporating TiO2 nanoparticles (NPs), subjected to a physical ageing process.

METHODS

Acrylic denture base samples were prepared by a Stereolithography (SLA) 3D printing technique reinforced with different concentrations (0.10, 0.25, 0.50, and 0.75) of silanated TiO2 NPs. The resulting nanocomposite materials were characterized in terms of degree of conversion (DC), and sorption/solubility flexural strength, impact strength, Vickers hardness and Martens hardness and compared with unmodified resin and conventional heat-cured (HC) material. The nanocomposites were reassessed after subjecting them to ageing in artificial saliva. A fractured surface was studied under a scanning electron microscope (SEM).

RESULTS

The addition of TiO2 NPs into 3D-printed resin significantly improved flexural strength/modulus, impact strength, Vickers hardness, and DC, while also slightly enhancing Martens hardness compared to the unmodified resin. Sorption values did not show any improvements, while solubility was reduced significantly. The addition of 0.10 wt% NPs provided the highest performance amongst the other concentrations, and 0.75 wt% NPs showed the lowest. Although ageing degraded the materials' performance to a certain extent, the trends remained the same. SEM images showed a homogenous distribution of the NPs at lower concentrations (0.10 and 0.25 wt%) but revealed agglomeration of the NPs with the higher concentrations (0.50 and 0.75 wt%).

SIGNIFICANCE

The outcomes of this study suggested that the incorporation of TiO2 NPs (0.10 wt%) into 3D-printed denture base material showed superior performance compared to the unmodified 3D-printed resin even after ageing in artificial saliva. The nanocomposite has the potential to extend service life of denture bases in future clinical use.

Recent advances in cellulose nanocrystals-based antimicrobial agents

Over the past five years, there has been growing interest in the design of modified cellulose nanocrystals (CNCs) as nanoscale antimicrobial agents in potential end-user applications such as food preservation/packaging, additive manufacturing, biomedical and water purification. The interest of applying CNCs-based antimicrobial agents arise due to their abilities to be derived from renewable bioresources and their excellent physicochemical properties including rod-like morphologies, large specific surface area, low toxicity, biocompatibility, biodegradability and sustainability. The presence of ample surface hydroxyl groups further allows easy chemical surface modifications for the design of advanced functional CNCs-based antimicrobial materials. Furthermore, CNCs are used to support antimicrobial agents that are subjected to instability issues. The current review summarizes recent progress in CNC-inorganic hybrid-based materials (Ag and Zn nanoparticles, other metal/metal oxide) and CNC-organic hybrid-based materials (polymers, chitosan, simple organic molecules). It focuses on their design, syntheses and applications with a brief discussion on their probable modes of antimicrobial action whereby the roles of CNCs and/or the antimicrobial agents are highlighted.

The germicidal effect, biosafety and mechanical properties of antibacterial resin composite in cavity filling

In recent years, dental resin materials have become increasingly popular for cavity filling. However, these materials can shrink during polymerization, leading to microleakages that enable bacteria to erode tooth tissue and cause secondary caries. As a result, there is great clinical demand for the development of antibacterial resins. The principle of antibacterial resin includes contact killing and filler-release killing of bacteria. For contact killing, quaternary ammonium salts (QACs) and antibacterial peptides (AMPs) can be added. For filler-release killing, chlorhexidine (CHX) and nanoparticles are used. These antibacterial agents are effective against gram-positive bacteria, gram-negative bacteria, fungi, and more. Among them, QACs has a lasting antibacterial effect, and silver nanoparticles even have a certain ability to kill viruses. Biocompatibility-wise, QACs, AMPs, and CHX have low cytotoxicity to cells when added into the resin. However, nanoparticles with smaller particle sizes have higher cytotoxicity. In terms of mechanical properties, QACs, AMPs, and CHX do not negatively affect the resin. However, the addition of magnesium oxide can have a negative impact. This paper reviews the types and antibacterial principles of commonly used antibacterial resins in recent years, evaluates their antibacterial effect, biological safety, and mechanical properties, and provides references for selecting clinical filling materials.

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.

Overview of incorporation of inorganic antimicrobial materials in denture base resin: A scoping review

STATEMENT OF PROBLEM

Dental hygiene for institutionalized patients and recurring Candida-associated denture stomatitis remain problematic because of a patient's limited dexterity or inability to eliminate Candida from denture surfaces. Although there has been extensive research into antimicrobial modification of denture base resins with inorganic materials, scoping reviews of the literature to identify knowledge gaps or efficacy of inorganic antimicrobial materials in denture base resins are lacking.

PURPOSE

The purpose of this scoping review was to provide a synopsis of the efficacy of the major classes of inorganic antimicrobial materials currently incorporated into denture base resins.

MATERIAL AND METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews was applied. Four electronic databases, including Embase, PubMed, Web of Science, and Google Scholar, were accessed for articles in the English language, up to February 2019, without restrictions on the date of publication.

RESULTS

From the 53 articles selected, 25 distinguishable inorganic materials were found and divided into 3 subgroups. Forty-three articles evaluated nanomaterials, where mostly silver ion nanoparticles and/or titanium dioxide nanoparticles were incorporated into denture base resins. Fourteen articles examined antimicrobial drugs and medications, including azole group medications, amphotericin-B, Bactekiller, chlorhexidine, Novaron, and Zeomic. Two articles classified as others explored hydroxyapatite- and fiber-incorporated denture base resins.

CONCLUSIONS

Although nanotechnology and antimicrobial medications or drugs have been successfully used to reduce Candida-associated denture stomatitis, long-term solutions are still lacking, and their disadvantages continue to outweigh their advantages.

3D Printed Materials for Combating Antimicrobial Resistance

Three-dimensional (3D) printing is a rapidly growing technology with a significant capacity for translational applications in both biology and medicine. 3D-printed living and non-living materials are being widely tested as a potential replacement for conventional solutions for testing and combating antimicrobial resistance (AMR). The precise control of cells and their microenvironment, while simulating the complexity and dynamics of an in vivo environment, provides an excellent opportunity to advance the modeling and treatment of challenging infections and other health conditions. 3D-printing models the complicated niches of microbes and host-pathogen interactions, and most importantly, how microbes develop resistance to antibiotics. In addition, 3D-printed materials can be applied to testing and delivering antibiotics. Here, we provide an overview of 3D printed materials and biosystems and their biomedical applications, focusing on ever increasing AMR. Recent applications of 3D printing to alleviate the impact of AMR, including developed bioprinted systems, targeted bacterial infections, and tested antibiotics are presented.

Review of Antimicrobial Nanocoatings in Medicine and Dentistry: Mechanisms of Action, Biocompatibility Performance, Safety, and Benefits Compared to Antibiotics

This review discusses topics relevant to the development of antimicrobial nanocoatings and nanoscale surface modifications for medical and dental applications. Nanomaterials have unique properties compared to their micro- and macro-scale counterparts and can be used to reduce or inhibit bacterial growth, surface colonization and biofilm development. Generally, nanocoatings exert their antimicrobial effects through biochemical reactions, production of reactive oxygen species or ionic release, while modified nanotopographies create a physically hostile surface for bacteria, killing cells via biomechanical damage. Nanocoatings may consist of metal nanoparticles including silver, copper, gold, zinc, titanium, and aluminum, while nonmetallic compounds used in nanocoatings may be carbon-based in the form of graphene or carbon nanotubes, or composed of silica or chitosan. Surface nanotopography can be modified by the inclusion of nanoprotrusions or black silicon. Two or more nanomaterials can be combined to form nanocomposites with distinct chemical or physical characteristics, allowing combination of different properties such as antimicrobial activity, biocompatibility, strength, and durability. Despite their wide range of applications in medical engineering, questions have been raised regarding potential toxicity and hazards. Current legal frameworks do not effectively regulate antimicrobial nanocoatings in matters of safety, with open questions remaining about risk analysis and occupational exposure limits not considering coating-based approaches. Bacterial resistance to nanomaterials is also a concern, especially where it may affect wider antimicrobial resistance. Nanocoatings have excellent potential for future use, but safe development of antimicrobials requires careful consideration of the "One Health" agenda, appropriate legislation, and risk assessment.

Mechanical Properties and Biocompatibility of 3D Printing Acrylic Material with Bioactive Components

The aim of this study was to create a 3D printing material with bioactive properties that potentially could be used for a transparent removable orthodontic appliance.

MATERIALS AND METHODS

To acrylic monomers, four bioactive glasses at 10% concentration were added, which release Ca, P, Si and F ions. The materials were printed on a 3D printer and tested for flexural strength (24 h and 30 days), sorption and solubility (7 days), ion release to artificial saliva pH = 4 and 7 (42 days) and cytotoxicity in the human fibroblast model. The released ions were determined by plasma spectrometry (Ca, P and Si ions) and ion-selective electrode (F measurement)s.

RESULTS

The material obtained released Ca2+ and PO43- ions for a period of 42 days when using glass Biomin C at pH 4. The flexural strength depended on the direction in which the sample was printed relative to the 3D printer platform. Vertically printed samples had a resistance greater than 20%. The 10% Biomin C samples post-cured for 30 min with light had a survival rate of the cells after 72 h of 85%.

CONCLUSIONS

Material for 3D printing with bioactive glass in its composition, which releases ions, can be used in the production of orthodontic aligners.

3D-Printable Denture Base Resin Containing SiO2 Nanoparticles: An In Vitro Analysis of Mechanical and Surface Properties

PURPOSE

To evaluate the flexural strength (FS), impact strength (IS), surface roughness (Ra), and hardness of 3D-printed resin incorporating silicon dioxide nanoparticles (SNPs).

MATERIALS AND METHODS

A total of 320 acrylic specimens were fabricated with different dimensions according to test specifications and divided into a control group of heat denture base resin, and 3 test groups (80/test (n = 10) of unmodified, 0.25 wt%, and 0.5 wt% SNPs modified 3D-printed resin. 10,000 thermal cycles were performed to half of the fabricated specimens. FS, IS (Charpy impact), Ra, and hardness were evaluated and the collected data was analyzed with ANOVA followed by Tukey's post hoc test (α = 0.05).

RESULTS

Incorporating SNPs into 3D-printed resin significantly increased the FS, IS (at 0.5%) and hardness compared to unmodified 3D-printed resin (p < 0.001). However, the FS of pure 3D-printed and 3D/SNP-0.50% resin and IS of all 3D-printed resin groups were significantly lower than the control group (p < 0.0001). Hardness of 3D/SNP-0.25% and 3D/SNP-0.50% was significantly higher than control and unmodified 3D-printed resin (p < 0.0001), with insignificant differences between them. The Ra of all 3D-printed resin groups were significantly higher than control group (p < 0.001), while insignificant difference was found between 3D-printed groups. Thermal cycling significantly reduced FS and hardness for all tested groups, while for IS the reduction was significant only in the control and 3D/SNP-0.50% groups. Thermal cycling significantly increased Ra of the control group and unmodified 3D-printed resin (p < 0.001).

CONCLUSION

The addition of SNPs to 3D-printed denture base resin improved its mechanical properties while Ra was not significantly altered. Thermal cycling adversely affected tested properties, except IS of unmodified 3D-printed resin and 3D/SNP-0.25%, and Ra of modified 3D-printed resin.

Influence of ZrO2 Nanoparticle Addition on the Optical Properties of Denture Base Materials Fabricated Using Additive Technologies

This study investigated the translucency of 3D-printed denture base resins modified with zirconium dioxide nanoparticles (ZrO₂NPs) under thermal cycling. A total of 110 specimens were fabricated and divided into 3 groups according to the materials, i.e., heat-polymerized resin, and 3D-printed resins (NextDent, and ASIGA). The 3D-printed resins were modified with 0, 0.5, 1, 3, and 5 wt.% of ZrO₂NPs. All the specimens were subjected to 5000 thermal cycles. The translucency was measured using a spectrophotometer. The results showed that the heat-polymerized resin had considerably higher translucency than the 3D-printed resins. Compared to the unmodified group, the translucency decreased significantly after adding 5% ZrO₂NPs to NextDent and 3% ZrO₂NPs to ASIGA resins. The highest translucency was achieved for NextDent by adding 0.5% ZrO₂NPs and for ASIGA without any ZrO₂NPs. It was found that the average concentration level in ASIGA was significantly higher than that in NextDent. These findings revealed that 3D-printed resins have lower translucency than heat-polymerized acrylic resin, and adding ZrO₂NPs at low concentrations did not affect the translucency of the 3D-printed resins. Therefore, in terms of translucency, 3D-printed nanocomposite denture base resins could be considered for clinical applications when ZrO₂NPs are added at low concentrations.

Dispersibility Characterization of Cellulose Nanocrystals in Polymeric-Based Composites

Cellulose nanocrystals (CNCs) are hydrophilic nanoparticles extracted from biomass with properties and functions different from cellulose and are being developed for property-oriented applications such as high stiffness, abundant active groups, and biocompatibility. It has broad application prospects in the field of composite materials, while the dispersibility of the CNC in polymers is the key to its application performance. Many reviews have discussed in-depth the modification strategies to improve the dispersibility of the CNC and summarized all characterization for the CNC, but there are no reviews on the in-depth exploration of dispersion characterization. This review is a comprehensive summary of the characterization of CNC dispersion in the matrix in terms of direct observation, indirect evaluation, and quantified evaluation, summarizing how and why different characterization tools reveal dispersibility. In addition, "decision tree" flowcharts are presented to provide the reader with a reference for selecting the appropriate characterization method for a specific composite.

Effect of surface prereacted glass ionomer nanofillers on fluoride release, flexural strength, and surface characteristics of polymethylmethacrylate resin

OBJECTIVE

Dentures should have proper fluoride release and physical properties. We evaluated how surface prereacted glass ionomer (S-PRG) nanofillers influenced fluoride release, flexural strength, and surface characteristics of polymethylmethacrylate (PMMA) resin.

MATERIALS AND METHODS

PMMA resin disc (n = 14) and rectangular (n = 5) specimens containing 0, 20 wt% microparticles, and 20 wt% nanoparticles of S-PRG were prepared. Six-disc specimens were examined for surface roughness; eight-disc specimens were immersed in 5 ml of deionized water for 24 h before analyzing the fluoride levels on days 1-3, 12, and 15. They were recharged with 1000 ppm fluoride solution for 24 h and stored in deionized water for five cycles. Fluoride release was examined. The flexural strength of the rectangular specimens was determined using a three-point bending test. Data were analyzed by two-way repeated-measures ANOVA.

RESULTS

S-PRG nanofiller had the highest fluoride exchange rate and did not significantly change the surface roughness compared with the microparticle and control groups; however, the nanofillers agglomerated and reduced the flexural strength to below 65 MPa.

CONCLUSIONS

Incorporating 20 wt% nanofillers into resin enhanced the fluoride exchange property greater than microfillers at the same content, but diminished the mechanical properties of the resin.

CLINICAL SIGNIFICANCE

Incorporating 20 wt% S-PRG nanofillers in resin denture base can improve the fluoride releasing property without affecting the surface roughness.

Nanoparticle and Nanostructure Synthesis and Controlled Growth Methods

Nanomaterials are materials with one or more nanoscale dimensions (internal or external) (i.e., 1 to 100 nm). The nanomaterial shape, size, porosity, surface chemistry, and composition are controlled at the nanoscale, and this offers interesting properties compared with bulk materials. This review describes how nanomaterials are classified, their fabrication, functionalization techniques, and growth-controlled mechanisms. First, the history of nanomaterials is summarized and then the different classification methods, based on their dimensionality (0-3D), composition (carbon, inorganic, organic, and hybrids), origin (natural, incidental, engineered, bioinspired), crystal phase (single phase, multiphase), and dispersion state (dispersed or aggregated), are presented. Then, the synthesis methods are discussed and classified in function of the starting material (bottom-up and top-down), reaction phase (gas, plasma, liquid, and solid), and nature of the dispersing forces (mechanical, physical, chemical, physicochemical, and biological). Finally, the challenges in synthesizing nanomaterials for research and commercial use are highlighted.

3D-Printed Nanocomposite Denture-Base Resins: Effect of ZrO2 Nanoparticles on the Mechanical and Surface Properties In Vitro

Due to the low mechanical performances of 3D-printed denture base resins, ZrO2 nanoparticles (ZrO2NPs) were incorporated into different 3D-printed resins and their effects on the flexure strength, elastic modulus, impact strength, hardness, and surface roughness were evaluated. A total of 286 specimens were fabricated in dimensions per respective test and divided according to materials into three groups: heat-polymerized as a control group and two 3D-printed resins (NextDent and ASIGA) which were modified with 0.5 wt.%, 1 wt.%, 3 wt.%, and 5 wt.% ZrO2NPs. The flexure strength and elastic modulus, impact strength, hardness, and surface roughness (µm) were measured using the three-point bending test, Charpy’s impact test, Vickers hardness test, and a profilometer, respectively. The data were analyzed by ANOVA and Tukey’s post hoc test (α = 0.05). The results showed that, in comparison to heat-polymerized resin, the unmodified 3D-printed resins showed a significant decrease in all tested properties (p < 0.001) except surface roughness (p = 0.11). In between 3D-printed resins, the addition of ZrO2NPs to 3D-printed resins showed a significant increase in flexure strength, impact strength, and hardness (p < 0.05) while showing no significant differences in surface roughness and elastic modulus (p > 0.05). Our study demonstrated that the unmodified 3D-printed resins showed inferior mechanical behavior when compared with heat-polymerized acrylic resin while the addition of ZrO2NPs improved the properties of 3D-printed resins. Therefore, the introduced 3D-printable nanocomposite denture-base resins are suitable for clinical use.

Utilization of a 3D Printed Orthodontic Distalizer for Tooth-Borne Hybrid Treatment in Class II Unilateral Malocclusions

This paper introduces a novel method of 3D designing and 3D printing of a hybrid orthodontic tooth-borne personalized distalizer for treatment of unilateral Class II malocclusion. Research objectives were to clinically utilize 3D printed distalizers, appraise feasibility of this technique and compare two different biocompatible photopolymers (white and transparent). Frequency of distalizers’ debonding and patients’ aesthetical perception was evaluated on the set of 12 complete orthodontic treatments. The mean duration of treatment period with a bonded distalizer was 6.4 months. All cases were adults with unilateral Class II malocclusion managed with a hybrid approach as a part of Invisalign® comprehensive treatment. Results showed that such perspective practice is feasible for 3D design and in-office 3D printing of a personalized distalizer. Results also showed no clinically significant differences between both studied biopolymers. The paper discusses an evaluation of such personalized distalizer functionality with regard to the current state of the art and compares to conventional prefabricated alternatives like a Carriere® Distalizer™ appliance. Research showed a preference of patients towards transparent biocompatible photopolymer instead of the white A2 shade. The paper concludes that additive manufacturing from dental resins is a viable method in personalization and in-office 3D printing of orthodontic auxiliaries, particularly distalizers. New materials for orthodontic 3D printing endow enhanced individualization, thus more efficient treatment.

Therapeutic Applications of Antimicrobial Silver-Based Biomaterials in Dentistry

Microbial infection accounts for many dental diseases and treatment failure. Therefore, the antibacterial properties of dental biomaterials are of great importance to the long-term results of treatment. Silver-based biomaterials (AgBMs) have been widely researched as antimicrobial materials with high efficiency and relatively low toxicity. AgBMs have a broad spectrum of antimicrobial properties, including penetration of microbial cell membranes, damage to genetic material, contact killing, and dysfunction of bacterial proteins and enzymes. In particular, advances in nanotechnology have improved the application value of AgBMs. Hence, in many subspecialties of dentistry, AgBMs have been researched and employed, such as caries arresting or prevention, root canal sterilization, periodontal plaque inhibition, additives in dentures, coating of implants and anti-inflammatory material in oral and maxillofacial surgery. This paper aims to provide an overview of the application approaches of AgBMs in dentistry and present better guidance for oral antimicrobial therapy via the development of AgBMs.

Prosthetic Materials Used for Implant-Supported Restorations and Their Biochemical Oral Interactions: A Narrative Review

The purpose of this study is to outline relevant elements regarding the biochemical interactions between prosthetic materials used for obtaining implant-supported restorations and the oral environment. Implant-supported prostheses have seen unprecedented development in recent years, benefiting from the emergence of both new prosthetic materials (with increased biocompatibility and very good mechanical behavior), and computerized manufacturing technologies, which offer predictability, accuracy, and reproducibility. On the other hand, the quality of conventional materials for obtaining implant-supported prostheses is acknowledged, as they have already proven their clinical performance. The properties of PMMA (poly (methyl methacrylate))-which is a representative interim material frequently used in prosthodontics-and of PEEK (polyether ether ketone)-a biomaterial which is placed on the border between interim and final prosthetic use-are highlighted in order to illustrate the complex way these materials interact with the oral environment. In regard to definitive prosthetic materials used for obtaining implant-supported prostheses, emphasis is placed on zirconia-based ceramics. Zirconia exhibits several distinctive advantages (excellent aesthetics, good mechanical behavior, biocompatibility), through which its clinical applicability has become increasingly wide. Zirconia's interaction with the oral environment (fibroblasts, osteoblasts, dental pulp cells, macrophages) is presented in a relevant synthesis, thus revealing its good biocompatibility.

Metal and Metal Oxide Nanoparticles in Caries Prevention: A Review

Nanoparticles based on metal and metallic oxide have become a novel trend for dental use as they interfere with bacterial metabolism and prevent biofilm formation. Metal and metal oxide nanoparticles demonstrate significant antimicrobial activity by metal ion release, oxidative stress induction and non-oxidative mechanisms. Silver, zinc, titanium, copper, and magnesium ions have been used to develop metal and metal oxide nanoparticles. In addition, fluoride has been used to functionalise the metal and metal oxide nanoparticles. The fluoride-functionalised nanoparticles show fluoride-releasing properties that enhance apatite formation, promote remineralisation, and inhibit demineralisation of enamel and dentine. The particles' nanoscopic size increases their surface-to-volume ratio and bioavailability. The increased surface area facilitates their mechanical bond with tooth tissue. Therefore, metal and metal oxide nanoparticles have been incorporated in dental materials to strengthen the mechanical properties of the materials and to prevent caries development. Another advantage of metal and metal oxide nanoparticles is their easily scalable production. The aim of this study is to provide an overview of the use of metal and metal oxide nanoparticles in caries prevention. The study reviews their effects on dental materials regarding antibacterial, remineralising, aesthetic, and mechanical properties.

Strategies toward development of antimicrobial biomaterials for dental healthcare applications

Several approaches for elimination of oral pathogens are being explored at the present time since oral diseases remain prevalent affecting approximately 3.5 billion people worldwide. Need for antimicrobial biomaterials in dental healthcare include but is not restricted to designing resin composites and adhesives for prevention of dental caries. Constant efforts are also being made to develop antimicrobial strategies for clearance of endodontic space prior root canal treatment and for treatment of periimplantitis and periodontitis. This article discusses various conventional and nanotechnology-based strategies to achieve antimicrobial efficacy in dental biomaterials. Recent developments in the design and synthesis of antimicrobial peptides and antifouling zwitterionic polymers to effectively lessen the risks of antimicrobial drug resistance are also outlined in this review. Further, the role of contemporary strategies such as use of smart biomaterials, ionic solvent-based biomaterials and quorum quenchers incorporated biomaterials in the elimination of dental pathogens are described in detail. Lastly, we mentioned the approach of using polymers to print custom-made three-dimensional antibacterial dental products via additive manufacturing technologies. This review provides a critical perspective on the chemical, biomimetic, and engineering strategies intended for developing antimicrobial biomaterials that have the potential to substantially improve the dental health.

Current Status of Digital Complete Dentures Technology

Fabrication of complete dentures (CDs) utilizing computer-aided design and computer-aided manufacturing (CAD/CAM) methods has attracted a lot of attention. The purpose of this paper was to summarize current knowledge about digital CDs and the relevant technology, and to present the application of the new technology in a dental geriatrics case. Initially, some of the challenges regarding digitization of the oral mucosa as a supporting surface of the CDs’ intaglio surface are listed. Next, a brief introduction of the CAD software capabilities regarding CDs is presented. The latest CAM additive and subtractive techniques for CDs are following. Subsequently, the consecutive steps for the construction of a digital CD as part of the prosthodontic treatment of a 90-year-old ambulative female patient are presented. Finally, some considerations about the digital workflow in CD manufacturing are discussed. In conclusion, the new digital technology has clear advantages; however, implementation requires careful planning. The digital workflow is applicable and versatile.

A Review on the Application of Silver Nanoparticles in Oral and Maxillofacial Surgery

Silver nanoparticles (AgNPs) have been taken advantage of in dentistry because of their good antibacterial resistance and self-sustaining potential. However, in oral and maxillofacial surgery and implantology, there is a lesser amount of evidence. The few pieces of evidence need to be accentuated for possible amplification of its use in the dental setting. AgNPs in oral and maxillofacial surgery can be used in wound healing, bone healing, extractions, guided tissue regeneration, apical surgeries, oral cancer, and dental implants. This review aims to feature the utilization and application of AgNPs in oral and maxillofacial surgery and implant dentistry, emphasizing its need for potential future development in clinical settings.

Decoupling manufacturing from application in additive manufactured antimicrobial materials

3D printable materials based on polymeric ionic liquids (PILs) capable of controlling the synthesis and stabilisation of silver nanoparticles (AgNPs) and their synergistic antimicrobial activity are reported. The interaction of the ionic liquid moieties with the silver precursor enabled the controlled in situ formation and stabilisation of AgNPs via extended UV photoreduction after the printing process, thus demonstrating an effective decoupling of the device manufacturing from the on-demand generation of nanomaterials, which avoids the potential aging of the nanomaterials through oxidation. The printed devices showed a multi-functional and tuneable microbicidal activity against Gram positive (B. subtilis) and Gram negative (E. coli) bacteria and against the mould Aspergillus niger. While the polymeric material alone was found to be bacteriostatic, the AgNPs conferred bactericidal properties to the material. Combining PIL-based materials with functionalities, such as in situ and photoactivated on-demand fabricated antimicrobial AgNPs, provides a synergistic functionality that could be harnessed for a variety of applications, especially when coupled to the freedom of design inherent to additive manufacturing techniques.

Recent Advances in the Development of Antimicrobial and Antifouling Biocompatible Materials for Dental Applications

The risk of secondary bacterial infections resulting from dental procedures has driven the design of antimicrobial and antifouling dental materials to curb pathogenic microbial growth, biofilm formation and subsequent oral and dental diseases. Studies have investigated approaches based primarily on contact-killing or release-killing materials. These materials are designed for addition into dental resins, adhesives and fillings or as immobilized coatings on tooth surfaces, titanium implants and dental prosthetics. This review discusses the recent developments in the different classes of biomaterials for antimicrobial and antifouling dental applications: polymeric drug-releasing materials, polymeric and metallic nanoparticles, polymeric biocides and antimicrobial peptides. With modifications to improve cytotoxicity and mechanical properties, contact-killing and anti-adhesion materials show potential for incorporation into dental materials for long-term clinical use as opposed to short-lived antimicrobial release-based coatings. However, extended durations of biocompatibility testing, and adjustment of essential biomaterial features to enhance material longevity in the oral cavity require further investigations to confirm suitability and safety of these materials in the clinical setting. The continuous exposure of dental restorative and regenerative materials to pathogenic microbes necessitates the implementation of antimicrobial and antifouling materials to either replace antibiotics or improve its rational use, especially in the day and age of the ever-increasing problem of antimicrobial resistance.

Applications of Silver Nanoparticles in Dentistry: Advances and Technological Innovation

Silver nanoparticles (AgNPs) have been successfully applied in several areas due to their significant antimicrobial activity against several microorganisms. In dentistry, AgNP can be applied in disinfection, prophylaxis, and prevention of infections in the oral cavity. In this work, the use of silver nanoparticles in dentistry and associated technological innovations was analyzed. The scientific literature was searched using PubMed and Scopus databases with descriptors related to the use of silver nanoparticles in dentistry, resulting in 90 open-access articles. The search for patents was restricted to the A61K code (International Patent Classification), using the same descriptors, resulting in 206 patents. The results found were ordered by dental specialties and demonstrated the incorporation of AgNPs in different areas of dentistry. In this context, the search for patents reaffirmed the growth of this technology and the dominance of the USA pharmaceutical industry over AgNPs product development. It could be concluded that nanotechnology is a promising area in dentistry with several applications.

Imminent antimicrobial bioink deploying cellulose, alginate, EPS and synthetic polymers for 3D bioprinting of tissue constructs

3D printing, one of its kinds has been a recent technological trend to fabricate complex and patterned biomaterial with controlled precision. With the conventional kick-start of printing metals and plastics, advancements in printing viable cells, polysaccharides or microbes themselves have been achieved. The additive antimicrobial properties in bioinks sourced from organic and inorganic materials have profound implications in tissue engineering. Cellulose, alginate, exopolysaccharides, ceramics and synthetic polymers are integrated as a viable component in inks and used for bio-printing. To date, bacterial infection and immunogenicity pose a potential health risk during a tissue implant or bone substitution. In order to mitigate microbial infection, antimicrobial bioinks with significant antimicrobial potential have been the much sought after strategies. This approach could be an effective frontline defense against microbial interference in tissue engineering and biomedical applications. An overview on the antimicrobial potential of polysaccharides as bioinks for 3D bioprinting has been critically reviewed.

3D printing restorative materials using a stereolithographic technique: a systematic review

OBJECTIVE

To present through a systematic review a qualitative analysis of studies published on stereolithography-based 3D printing of restorative materials and their clinical applicability.

METHODS

The literature search was conducted based on the question: "What is the state-of-the-art of available restorative materials for 3D printing based on stereolithography?" Online search was conducted in three databases (MEDLINE/PubMed, Scopus and Web of Science) with no restriction for year of publication. Data are reported based on PRISMA, including publication details such as authors and their countries, year and journal of publication, and study design. The synthesis is focused on describing the dental restorative materials and properties evaluated, applied methods, 3D printers used and clinical applicability.

RESULTS

Studies that fit the inclusion criteria were performed in Asia (21), Europe (16) and USA (10), mostly using polymer-based restorative materials (38) for 3D printing constructs. Stereolithographic-printed ceramic-based restorative structures were evaluated by 9 studies. Many studies reported on dimensional accuracy (14), strength (11) and surface morphology (9) of the printed structures. Antibacterial response, cytotoxicity, internal and marginal fit, fracture and wear resistance, density, viscosity, elastic modulus, hardness, structural shrinkage and reliability, degree of conversion, layer cure depth, fatigue, and color were also evaluated by the included studies. Many of them (11) published a proof of concept as an attempt to demonstrate the clinical feasibility and applicability of the technology to print restorative materials, but only 5 studies actually applied the 3D printed restorative structures in patients, which highlights an increasing interest but limited early-stage translation.

SIGNIFICANCE

The fast expansion of stereolithographic-based 3D printing has been impressive and represents a great technological progress with significant disruptive potential. Dentistry has demonstrated an incredible willingness to adapt materials, methods and workflows to this promising digital technology. However, esthetic appearance, wear resistance, wet strength and dimensional accuracy are the main current clinical limitations restricting the progression to functional part production with 3D printing, which may explain the absence of clinical trials and reports on permanent/definitive dental restorative materials and structures.

Durable Oral Biofilm Resistance of 3D-Printed Dental Base Polymers Containing Zwitterionic Materials

Poly(methyl methacralyate) (PMMA) has long been used in dentistry as a base polymer for dentures, and it is recently being used for the 3D printing of dental materials. Despite its many advantages, its susceptibility to microbial colonization remains to be overcome. In this study, the interface between 3D-printed PMMA specimens and oral salivary biofilm was studied following the addition of zwitterionic materials, 2-methacryloyloxyethyl phosphorylcholine (MPC) or sulfobetaine methacrylate (SB). A significant reduction in bacterial and biofilm adhesions was observed following the addition of MPC or SB, owing to their protein-repellent properties, and there were no significant differences between the two test materials. Although the mechanical properties of the tested materials were degraded, the statistical value of the reduction was minimal and all the properties fulfilled the requirements set by the International Standard, ISO 20795-2. Additionally, both the test materials maintained their resistance to biofilm when subjected to hydrothermal fatigue, with no further deterioration of the mechanical properties. Thus, novel 3D-printable PMMA incorporated with MPC or SB shows durable oral salivary biofilm resistance with maintenance of the physical and mechanical properties.

Advances of Anti-Caries Nanomaterials

Caries is the most common and extensive oral chronic disease. Due to the lack of anti-caries properties, traditional caries filling materials can easily cause secondary caries and lead to treatment failure. Nanomaterials can interfere with the bacteria metabolism, inhibit the formation of biofilm, reduce demineralization, and promote remineralization, which is expected to be an effective strategy for caries management. The nanotechnology in anti-caries materials, especially nano-adhesive and nano-composite resin, has developed fast in recent years. In this review, the antibacterial nanomaterials, remineralization nanomaterials, and nano-drug delivery systems are reviewed. We are aimed to provide a theoretical basis for the future development of anti-caries nanomaterials.

Effect of the addition of functionalized TiO2 nanotubes and nanoparticles on properties of experimental resin composites

OBJECTIVE

To evaluate the influence of the addition of functionalized and non-functionalized TiO₂ nanostructures on properties of a resin composite.

METHODS

TiO₂ nanostructures were synthesized and functionalized, using 3-(aminopropyl)triethoxysilane (APTMS) and 3-(trimethoxysilyl)propyl methacrylate (TSMPM). Characterizations were performed with XRD, EDS, TEM, and TGA. Resin composites containing Bis-GMA/TEGDMA, CQ, DABE, and barium-aluminum silicate glass were produced according to TiO₂ nanostructure (nanotube or nanoparticle), concentration (0.3 or 0.9 wt%), and functionalization (APTMS or TSMPM). The resin composite without nanostructures was used as control. The amount of fillers was kept constant at 78.3 wt% for all materials. The degree of conversion (DC - at 0 h and 24 h), maximum polymerization rate (Rp_max), and Knoop microhardness (KHN before and after ethanol softening) were evaluated. Data were analyzed with two-way ANOVA with repeated measures and Tukey's HSD (α = 0.05).

RESULTS

TGA results demonstrated that functionalizations were effective for both nanostructures. For DC, resin composites, time and interaction effect were significant (p < 0.001). Higher DC was found for 0.3-wt%-functionalized-nanotubes at 24 h. For nanoparticles, only 0.9-wt%-non-functionalized and 0.3-wt%-APTMS-functionalized showed DC similar to the control and all other groups showed higher DC (p < 0.05). Rp_max was higher for 0.3-wt%-APTMS-nanotubes, which corresponded to higher DC after 24 h. The lowest Rp_max occurred for 0.9-wt%-TSMPM-nanotubes, which showed smaller DC at 0 h. For KHN, resin composites, ethanol softening and interaction effect were significant (p < 0.001). KHN decreased after ethanol softening all groups, except for 0.3-wt%-TSMPM-nanotubes, 0.9-wt%-TSMPM-nanotubes, and 0.3-wt%-non-functionalized-nanoparticles.

CONCLUSION

The resin with 0.3-wt%-TSMPM-nanotubes showed higher DC after 24 h, while being the most stable material after the ethanol softening.

SIGNIFICANCE

The addition of functionalized TiO₂ nanostructures in resin-based materials may improve the properties of the material.

The role of polymeric nanofibers on the mechanical behavior of polymethyl methacrylate resin

This study aimed to synthesize and characterize non-woven acrylonitrile butadiene styrene (ABS), polyamide-6 (P6), and polystyrene (PS) nanofibers, and evaluate their effects on the flexural strength and fracture resistance of fiber-modified polymethyl methacrylate (PMMA) resin. ABS, P6, and PS polymer solutions were prepared and electrospun into fiber mats, which were characterized by means of morphological, chemical, physical, and mechanical analyses. The fiber mats were then used to modify a thermally-activated PMMA resin, resulting in four testing groups: one unmodified group (control) and three fiber-modified groups incorporated with ABS, P6, or PS fiber mats. Flexural strength, work of fracture, and fractographic analysis were performed for all groups. Data were analyzed using Kruskal-Wallis or ANOVA tests (α = 0.05). The fiber diameter decreased, respectively, as follows: ABS > P6 > PS. Only the P6 fiber mats demonstrated a crystalline structure. Wettability was similar among the distinct fiber mats, although tensile strength was significantly greater for P6, followed by ABS, and then PS mats. Flexural strength of the fiber-modified PMMA resins was similar to the control, except for the weaker P6-based material. The work of fracture seemed to be greater and lower when the P6 and PS fibers were used, respectively. The fiber-modified groups exhibited a rougher pattern in the fractured surfaces when compared to the control, which may suggest that the presence of fibers deviates the direction of crack propagation, making the fracture mechanism of the PMMA resin more dynamic. While the neat PMMA showed a typical brittle response, the fiber-modified PMMA resins demonstrated a ductile response, combined with voids, suggesting large shear deformation during fracture. Altogether, despite the lack of direct reinforcement in the mechanical strength of the PMMA resin, the use of electrospun fibers showed promising application for the improvement of fracture behavior of PMMA resins, turning them into more compliant materials, although this effect may depend on the fiber composition.

Extending Cellulose-Based Polymers Application in Additive Manufacturing Technology: A Review of Recent Approaches

The materials for additive manufacturing (AM) technology have grown substantially over the last few years to fulfill industrial needs. Despite that, the use of bio-based composites for improved mechanical properties and biodegradation is still not fully explored. This limits the universal expansion of AM-fabricated products due to the incompatibility of the products made from petroleum-derived resources. The development of naturally-derived polymers for AM materials is promising with the increasing number of studies in recent years owing to their biodegradation and biocompatibility. Cellulose is the most abundant biopolymer that possesses many favorable properties to be incorporated into AM materials, which have been continuously focused on in recent years. This critical review discusses the development of AM technologies and materials, cellulose-based polymers, cellulose-based three-dimensional (3D) printing filaments, liquid deposition modeling of cellulose, and four-dimensional (4D) printing of cellulose-based materials. Cellulose-based AM material applications and the limitations with future developments are also reviewed.

Surface silanization and grafting reaction of nano-silver loaded zirconium phosphate and properties strengthen in 3D-printable dental base composites

In this work, surface modification of nano silver-loaded zirconium phosphate (6S-NP3) were obtained from simultaneous silanization of γ-methacryloxypropyltrimethoxysilane (MPS) and grafting reaction of methyl methacrylate (MMA), and then mixed with denture base resin (E-Denture) to prepare denture base composites using 3D printer printing. FT-IR spectra confirmed that surface silanization and grafting reaction had occurred and MPS and MMA were successfully anchored on the surface of 6S-NP3. XRD results demonstrated that surface modification had occurred on the surface of hexagonal lattice. The average diameter data indicated that the surface modification decreased the average diameter of nanoparticles. The water contact angle (WCA) was found increasing as the surface modification. SEM images illustrated that the dispersion and compatibility of nanoparticles in denture base composite materials had improved. The results of mechanical properties presented that composites with the addition of P-6S-NP3 nanoparticles achieved higher flexural strength, flexural modulus and impact strength. The data of antibacterial activities revealed that composites had exhibited good antibacterial activities against either S. aureus or E. coli and the latter showed better antibacterial efficacy than the former.

Polymeric and inorganic nanoscopical antimicrobial fillers in dentistry

Failure of dental treatments is mainly due to the biofilm accumulated on the dental materials. Many investigations have been conducted on the advancements of antimicrobial dental materials. Polymeric and inorganic nanoscopical agents are capable of inhibiting microorganism proliferation. Applying them as fillers in dental materials can achieve enhanced microbicidal ability. The present review provides a broad overview on the state-of-the-art research in the field of antimicrobial fillers which have been adopted for incorporation into dental materials over the last 5 years. The antibacterial agents and applications are described, with the aim of providing information for future investigations. STATEMENT OF SIGNIFICANCE: Microbial infection is the primary cause of dental treatment failure. The present review provides an overview on the state-of-art in the field of antimicrobial nanoscopical or polymeric fillers that have been applied in dental materials. Trends in the biotechnological development of these antimicrobial fillers over the last 5 years are reviewed to provide a backdrop for further advancement in this field of research.

TiO2 and PEEK Reinforced 3D Printing PMMA Composite Resin for Dental Denture Base Applications

The future of manufacturing applications in three-dimensional (3D) printing depends on the improvement and the development of materials suitable for 3D printing technology. This study aims to develop an applicable and convenient protocol for light-curing resin used in 3D industry, which could enhance antibacterial and mechanical properties of polymethyl methacrylate (PMMA) resin through the combination of nano-fillers of surface modified titanium dioxide (TiO₂) and micro-fillers of polyetheretherketone (PEEK). PMMA-based composite resins with various additions of TiO₂ and PEEK were prepared and submitted to characterizations including mechanical properties, distribution of the fillers (TiO₂ or/and PEEK) on the fractured surface, cytotoxicity, antibacterial activity, and blood compatibility assessment. These results indicated that the reinforced composite resins of PMMA (TiO₂-1%-PEEK-1%) possessed the most optimized properties compared to the other groups. In addition, we found the addition of 1% of TiO₂ would be an effective amount to enhance both mechanical and antibacterial properties for PMMA composite resin. Furthermore, the model printed by PMMA (TiO₂-1%-PEEK-1%) composite resin showed a smooth surface and a precise resolution, indicating this functional dental restoration material would be a suitable light-curing resin in 3D industry.

Antibiotics in 3D-printed implants, instruments and materials: benefits, challenges and future directions

3D printing is an additive manufacturing technology, which permits innovative approaches for incorporating antibiotics into 3D printed constructs. Antibiotic-incorporating applications in medicine have included medical implants, prostheses, along with procedural and surgical instruments. 3D-printed antibiotic-impregnated devices offer the advantages of increased surface area for drug distribution, sequential layers of antibiotics produced through layer-by-layer fabrication, and the ability to rapidly fabricate constructs based on patient-specific anatomies. To date, fused deposition modeling has been the main 3D printing method used to incorporate antibiotics, although inkjet and stereolithography techniques have also been described. This review offers a state-of-the-art summary of studies that incorporate antibiotics into 3D-printed constructs and summarizes the rationale, challenges, and future directions for the potential use of this technology in patient care.