Advances in Nanotechnology for Restorative Dentistry

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

CLINICAL SIGNIFICANCE

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

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

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

Clinical Performance of Glass Ionomer Cement in Load-Bearing Restorations: A Systematic Review

Glass ionomer cement (GIC) is a self-adhesive dental restorative material composed of a polyacrylic acid liquid and fluoro-aluminosilicate glass powder. It is commonly used for cementation during dental restoration. This study aimed to systematically review the existing literature regarding the clinical performance of GIC in load-bearing dental restorations. A comprehensive literature search was conducted in EBSCO, PubMed, Embrace, and Cochrane databases. Only randomized controlled trials (RCTs) were included in the search, and a broad search technique was used, where inclusion and exclusion criteria were applied. After a thorough evaluation, 12 RCTs were extensively reviewed, and whether GIC is suitable for load-bearing restorations was determined. Significant variations in staining surface or margin, color match, translucency, esthetic anatomical form, retention, material fracture, marginal adaptation, surface luster, occlusal contour, wear, and approximal anatomical form indicated the unsuitability of GIC. By contrast, significance differences in patient view and periodontal response indicated that GIC is suitable. No significant differences in postoperative sensitivity, recurrence of caries, or tooth integrity were observed. Nevertheless, the results of the review demonstrated that the clinical performance of GIC is comparable to that of traditional restorative materials with regard to the parameters analyzed. GIC is a suitable restorative material for load-bearing restorations regarding surface margin, esthetic anatomical form, material retention and fracture, marginal adaptation, occlusal contour, wear, and approximal anatomical form. It reduces other parameters, such as postoperative sensitivity, recurrence of caries, and tooth integrity.

Microleakage Under Orthodontic Brackets Bonded Using a Conventional Adhesive System, Nanocomposites, and Nanoionomers: A Comparative Study

Background Microleakage under orthodontic brackets has a role in early bracket debonding and white spot lesions due to the ingress of oral fluids in the bracket-adhesive-tooth interface. This in vitro study aimed to evaluate and compare the microleakage under orthodontic brackets bonded with the conventional adhesive system, nanocomposites, and nanoionomers. Materials and methods Forty-five human premolars were extracted for therapeutic reasons and collected for this study. Teeth were randomly assigned to three groups: Group A: conventional etching with conventional adhesive, Group B: conventional etching with nanocomposite, and Group C: conventional etching with nanoionomer. Stainless steel premolar brackets were used for bonding. After thermocycling, the extracted teeth were submerged in a 0.5% solution of basic fuchsine for 24 hours. They were then cut longitudinally. A stereomicroscope was used to assess microleakage along the occlusal and gingival interfaces. Results To compare the microleakage scores between gingival and occlusal aspects within each group, the student's t-test was performed. Analysis of variance (ANOVA) and the post-hoc Tukey test were applied to the data for intergroup comparison of microleakage scores. On comparing the microleakage scores, the gingival side of interfaces depicted higher microleakage than the occlusal side gingival side across all groups, demonstrating statistically significant results (P <0.05).On intergroup comparison, the occlusal bracket adhesive interface and gingival tooth adhesive interface revealed significantly higher microleakage values for Group B followed by Group C with Group A the least. However, there was no significant difference in the microleakage scores between Group B and Group C on intergroup comparison of mean microleakage scores (P <0.05). Conclusion The gingival side showed higher microleakage scores than the occlusal side. Nanoionomers showed microleakage values higher than the Transbond XT but lower than nanocomposites. Based on the results of the present study, in terms of microleakage, Transbond XT demonstrated lower microleakage when compared to nanoionomers and nanocomposites.

Functional fluorescent nanomaterials for the detection, diagnosis and control of bacterial infection and biofilm formation: Insight towards mechanistic aspects and advanced applications

Infectious diseases resulting from the high pathogenic potential of several bacteria possesses a major threat to human health and safety. Traditional methods used for screening of these microorganisms face major issues with respect to detection time, selectivity and specificity which may delay treatment for critically ill patients past the optimal time. Thus, a convincing and essential need exists to upgrade the existing methodologies for the fast detection of bacteria. In this context, increasing number of newly emerging nanomaterials (NMs) have been discovered for their effective use and applications in the area of diagnosis in bacterial infections. Recently, functional fluorescent nanomaterials (FNMs) are extensively explored in the field of biomedical research, particularly in developing new diagnostic tools, nanosensors, specific imaging modalities and targeted drug delivery systems for bacterial infection. It is interesting to note that organic fluorophores and fluorescent proteins have played vital role for imaging and sensing technologies for long, however, off lately fluorescent nanomaterials are increasingly replacing these due to the latter's unprecedented fluorescence brightness, stability in the biological environment, high quantum yield along with high sensitivity due to enhanced surface property etc. Again, taking advantage of their photo-excitation property, these can also be used for either photothermal and photodynamic therapy to eradicate bacterial infection and biofilm formation. Here, in this review, we have paid particular attention on summarizing literature reports on FNMs which includes studies detailing fluorescence-based bacterial detection methodologies, antibacterial and antibiofilm applications of the same. It is expected that the present review will attract the attention of the researchers working in this field to develop new engineered FNMs for the comprehensive diagnosis and treatment of bacterial infection and biofilm formation.

In Vitro Effect of Mouthrinses on the Microhardness of Three Different Nanohybrid Composite Resins

Introduction

Daily use of different mouthrinses at home or in the dental office can alter the properties of resin hardness. The present study aimed to compare Vickers microhardness (VHN) in vitro of nanohybrid composite resins (NCRs) immersed in mouthrinses.

Materials and Methods

In total, 120 discs (10 ⨯ 2 mm) were prepared from three NCR shade A2 (n = 40/group) with FiltekTM Z350 XT (Z350XT), Tetric EvoCeram (TEC), and Polofil NHT (PNHT). The specimens were incubated in artificial saliva (37°C ⨯ 24 hr). Specimens were distributed into four mouthrinses (n = 10/group) of artificial saliva (control), chlorhexidine (CHX 0.12%, pH 5.6), cetylpyridine chloride (CPC 0.075%, pH 5.84), and CHX 0.12% + CPC 0.05% (pH 6.2) (2 times/day, 2' ⨯ 12 hr). The VHN (300 gf/10") was measured after 24 hr, 14, and 21 days. Data were analyzed by three-way analysis of variance, followed by post hoc Tukey analysis at 0.05 level of significance.

Results

The results revealed a global effect of the interaction of the mouthrinses ⨯ time between NRC evaluated (P=0.001). Baseline VHN in PNHT and Z350XT was higher than TEC. Within each group of NCR, VHN of CHX + CPC > other mouthrinses (PNHT/14 days; Z350XT/21 days), and >CPC (Z350XT/14 days). In mouthrinses-intragroups, VHN of PNHT and Z350XT decreased at 14 days (CHX, CPC) and was maintained over time in NCR (CHX + CPC). VHN-TEC was similar among groups.

Conclusion

Microhardness showed differences due to the interaction of the type of NCR, the composition of the mouthrinses, and time. VHN decreased after 14 days and was more affected in composite resins with lower filler content and in mouthrinses with a lower pH.

Contribution to Knowledge on Bioapatites: Does Mg Level Reflect the Organic Matter and Water Contents of Enamel?

The matter constituting the enamels of four types of organisms was studied. The variability of the ions was presented in molar units. It was proven that the changes in water contents of the enamel are significantly positively related to changes in Mg; inversely, there is also a strong connection with changes in Ca and P, the main components of bioapatite. The variability in the organic matter has the same strong and positive characteristics and is also coupled with changes in Mg contents. Amelogenins in organic matter, which synthesize enamel rods, likely have a role in adjusting the amount of Mg, thus establishing the amount of organic matter and water in the whole enamel; this adjustment occurs through an unknown mechanism. Ca, P, Mg, and Cl ions, as well as organic matter and water, participate in the main circulation cycle of bioapatites. The selection of variations in the composition of bioapatite occurs only along particular trajectories, where the energy of transformation linearly depends on the following factors: changes in the crystallographic d parameter; the increase in the volume, V, of the crystallographic cell; the momentum transfer, which is indirectly expressed by ΔsinΘ value. To our knowledge, these findings are novel in the literature. The obtained results indicate the different chemical and crystallographic affinities of the enamels of selected animals to the human ones. This is essential when animal bioapatites are transformed into dentistic or medical substitutes for the hard tissues. Moreover, the role of Mg is shown to control the amount of water in the apatite and in detecting organic matter in the enamels.

Effect of dental composite dust on human gingival keratinocytes

OBJECTIVE

The aim was to investigate the effect of particles released during grinding of dental composites on human gingival keratinocytes (HGK).

METHODS

Specimens from Filtek™ Supreme XTE and ceram.x® universal were prepared and ground to dust. The dust was filtered (≤ 5 µm) and the particle size distribution was examined using NANO-flex®-180° dynamic light scattering (DLS). Suspensions at five concentrations (3, 10, 30, 100 and 300 µg/mL) were prepared using keratinocyte growth medium (KGM). These suspensions, as well as a positive (CuO) and a negative control (KGM) were added to HGK. The cells treated with Filtek™ Supreme XTE suspensions were analyzed by real-time monitoring using RTCA iCELLigence™. In addition, light and scanning electron microscopic images of the exposed cells were taken. Indirect immunofluorescence staining was performed to detect the extracellular matrix protein fibronectin.

RESULTS

In distilled water, DLS showed similar particles' range (171.9 nm- 2.7 µm) for both composites. In saliva, larger particles were detected (Filtek™ Supreme XTE: 243 nm-6,5 µm; ceram.x® universal: 204 nm- 4,6 µm). iCELLigence™ revealed similar results of cell growth parameters for HGK incubated with composite dust (≤ 5 µm) at different concentrations. The microscopic images indicated unaltered cell structures and formation of large agglomerates with high particle concentration (> 100 µg/mL). Exposure to composite dust resulted in upregulation of fibronectin expression.

SIGNIFICANCE

Grinding of dental composite materials generates dust particles of different sizes. The particle size distribution seems to be more influenced by the suspending medium than the material itself. While cell growth of HGK seem not to be affected by the particles, an upregulation of fibronectin in the intercellular space concomitant by increasing particle concentration may indicate an increase of cell migration/mobility.

Nanotechnology Innovations Transforming Oral Health Care and Dentistry: A Review

Nanotechnology has revolutionized dentistry by transforming how oral health care is conceptualized, delivered, and maintained. Harnessing nanomaterials and advanced clinical instruments has opened new avenues for precision and innovation across various aspects of dental care. Nanotechnology offers the potential for precise pain management, tooth restoration, and alleviating dental hypersensitivity. Nanomaterials can occlude exposed dentinal tubules, enhancing patient comfort and overall oral well-being. Orthodontic therapy is also revolutionized by nanomaterials with shape memory properties, enabling rapid and more efficient tooth movement. The development of groundbreaking products and therapeutic alternatives is supported by ongoing research efforts, enabling the formation of dental implants, fillings, and prosthetic devices that closely mimic natural tooth characteristics. Nano-delivery systems are being devised for precise drug delivery within the oral cavity, ensuring optimal therapeutic outcomes with minimal side effects. The integration of nanotechnology in dentistry represents a groundbreaking evolution beyond the conventional boundaries of oral health care, enabling the development of innovative diagnostic techniques and improved oral well-being.

Agglomeration effect on biomechanical performance of CNT-reinforced dental implant using micromechanics-based approach

Dental implants have long played an important role in restoring lost teeth, but there are still concerns about their durability and long-term success. Commercial dental implants have traditionally been made of metallic and ceramic materials like titanium and zirconia; however, each kind of material has restrictions regarding osseointegration and mechanical characteristics that differ between native bone and the implant material, limiting the implant's longevity and reliability. To address these concerns, this research explores the use of carbon nanotubes (CNTs) in restorative dentistry, their excellent properties make them an ideal candidate for promoting bone growth around implanted device and ensuring long-lasting success. The objective of this study was to understand how CNT properties when incorporated into the titanium matrix may be able to better adapt to the oral environment taking into consideration the CNT agglomeration effects when designing reinforced nanocomposite materials for dental implant. A mathematical formulation of the micromechanics model was developed and improved to extend its application for the case of CNT-based composite materials for dental implants. A three dimensional (3D) model of bone structure around the osseointegrated dental implant was established considering different compositions of implant material. Finite Element Analysis (FEA) were conducted to assess the aggregation effect of implant incorporating CNTs into the titanium matrix, considering CNTs with both spherical inclusions (CNT clusters), and randomly dispersive ones (CNTs) in the titanium matrix, on osseointegration and bone remodeling around the dental implant and supporting bone system over a period of 48 months. Firstly, the effects of CNT-Ti implantation on time-dependent performance are evaluated in a computational remodeling framework. Then, Von Mises equivalent stresses are investigated to evaluate the stress distributions and micromotions in jaw bones of loaded implant with different composition of prosthetic material. Three agglomeration patterns are considered, particularly without agglomeration (ζ = ξ), partial and complete agglomeration (ζ < ξ, ξ = 1). Further, the influence of CNTs volume fraction variation is taken into account to predict the mechanical response of the bony system after CNT-reinforced dental implantation. It can be inferred that the agglomeration of CNTs reduces the elastic stiffness of the matrix. This is due to the fact that when CNTs are agglomerated, the inter-tube contacts are reduced and the effective stiffness of the matrix is decreased.

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

Aim

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

Materials and methods

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

Result

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

Conclusion

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

Clinical significance

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

How to cite this article

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

Development of Light-Polymerized Dental Composite Resin Reinforced with Electrospun Polyamide Layers

As the mechanical properties of resin-based dental composite materials are highly relevant in clinical practice, diverse strategies for their potential enhancement have been proposed in the extant literature, aiming to facilitate their reliable use in dental medicine. In this context, the focus is primarily given to the mechanical properties with the greatest influence on clinical success, i.e., the longevity of the filling in the patient's mouth and its ability to withstand very strong masticatory forces. Guided by these objectives, the goal of the present study was to ascertain whether the reinforcement of dental composite resins with electrospun polyamide (PA) nanofibers would improve the mechanical strength of dental restoration materials. For this purpose, light-cure dental composite resins were interspersed with one and two layers comprising PA nanofibers in order to investigate the influence of such reinforcement on the mechanical properties of the resulting hybrid resins. One set of the obtained samples was investigated as prepared, while another set was immersed in artificial saliva for 14 days and was subsequently subjected to the same set of analyses, namely Fourier-transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and differential scanning calorimetry (DSC). Findings yielded by the FTIR analysis confirmed the structure of the produced dental composite resin material. They also provided evidence that, while the presence of PA nanofibers did not influence the curing process, it strengthened the dental composite resin. Moreover, flexural strength measurements revealed that the inclusion of a 16 μm-thick PA nanolayer enabled the dental composite resin to withstand a load of 3.2 MPa. These findings were supported by the SEM results, which further indicated that immersing the resin in saline solution resulted in a more compact composite material structure. Finally, DSC results indicated that as-prepared as well as saline-treated reinforced samples had a lower glass transition temperature (Tg) compared to pure resin. Specifically, while pure resin had a Tg of 61.6 °C, each additional PA nanolayer decreased the Tg by about 2 °C, while the further reduction was obtained when samples were immersed in saline for 14 days. These results show that electrospinning is a facile method for producing different nanofibers that can be incorporated into resin-based dental composite materials to modify their mechanical properties. Moreover, while their inclusion strengthens the resin-based dental composite materials, it does not affect the course and outcome of the polymerization reaction, which is an important factor for their use in clinical practice.

Silver Nanoparticles in Dental Applications: A Descriptive Review

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

Application of Nanomaterials in Restorative Dentistry

Dental composite resins are widely popular restoratives, as, when using these tools to restore the tooth, only the infected and affected carious structures are removed. This allows the patient to retain a greater quantity of their natural tooth structure than they would have using conventional principles of cavity preparation. Nanomaterials are a new concept concerning the manipulation of materials on an atomic or molecular level. However, on a nanoscale, the chemical, biological, and physical properties of an atom vary compared to the properties of its naturally occurring compound form. The main idea of shifting focus to the inclusion of nanomaterials is to aid in the detection, treatment, and prevention of the recurrence of a pathology (secondary caries). The primary aim of using nanomaterials in composites is to augment their strength, wear resistance, and microhardness. This usage also reduces polymerization shrinkage. Nanomaterials are capable of enhancing mechanical properties, life, and bond strength between dentin and restoration. This review aims to highlight different research studies and experiments that have been conducted on the use of nanomaterials in restorative dentistry in order to understand the versatility of these materials and their viability in practice.

Medical and Dental Applications of Titania Nanoparticles: An Overview

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

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

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

Biological and Physicochemical Characterization of Self-Adhesive Protective Coating Dental Restorative Material after Incorporation of Antibacterial Nanoparticles

This study evaluated the physicochemical and antibacterial properties of EQUIATM coat liquid (E) after incorporation of zinc oxide (ZnO) and titanium dioxide (TiO2) nanoparticles. ZnO and TiO2 (1 wt.% and 2 wt.%) were dispersed in EQUIA coat. Principal component analysis (PCA) and cluster analysis were performed to visualize systemic variation. Antibacterial activity was evaluated by colony-forming units and crystal violet staining using Streptococcusmutans and Lactobacillusacidophilus after 24 h, 48 h, and 72 h, and the microstructure was studied by scanning electron microscopy. The weight change was analyzed at 1 and 21 days. The PCA for TiO2- and ZnO-based groups showed 100% variance at all spectral ranges at 600−800/cm and 800−1200/cm, whereas 1200−1800/cm and 2700−3800/cm spectral regions demonstrated 99% variance. The absorbance values were significant (p < 0.05) for both nanoparticles-based adhesives, and the specimens with 2 wt.% ZnO showed the maximum response by minimum bacterial attachment, and the control group showed the least response by maximum attachment. The weight change percentage was reduced after the incorporation of antibacterial nanoparticles. It is suggested that EQUIATM coat containing nanoparticles exhibits promising results, and it may be recommended to clinically use as an improved coating material.

Physicochemical Properties and Surface Characteristics of Ground Human Teeth

Enamel, dentin and cementum apatite has a complex composition. The lack of complete reports on the chemical composition of all tooth tissues together and the need to create a modern biomaterial that reproduces the correct ratio of individual tooth mineral components prompted the authors to undertake the research. A detailed evaluation of the micro- and macro-elements of tooth powder, using various methods of chemical analysis was conducted. All four groups of human sound teeth were crushed using the grinder. A fine powder was implemented for the FTIR (Fourier Transform Infrared Spectroscopy), ICP (Inductively Coupled Plasma Optical Emission Spectometry) and for the potentiometric titration, SEM and mercury porosimetry analyses. The obtained studies indicate that there is no significant correlation in chemical composition between the different teeth types. This proves that every removed, crushed tooth free of microorganisms can be a suitable material for alveolar augmentation. It is essential to know the chemical profiles of different elements in teeth to develop a new class of biomaterials for clinical applications.

Comparison of physical and mechanical properties of three different restorative materials in primary teeth: an in vitro study

OBJECTIVE

Physical and mechanical properties of three different (Ketac Molar Easymix, Dyract XP, Cention N (CN)) restoratives with different ingredients were evaluated.

MATERIALS AND METHODS

Four groups were obtained; Group 1: CN LightCure, Group 2: CN SelfCure, Group 3: Ketac Molar Easymix and Group 4: Dyract XP. Disk-shaped samples (n = 10) were prepared and evaluated for the surface roughness test using a profilometer. For the flexure strength test, 2 × 2 × 25 mm bar-shaped samples (n = 10) were prepared, and a three-point bending test was applied to the samples. After preparing cavities for microleakage tests, teeth were restored with restoratives, immersed in dye, and microleakage was assessed. For the microtensile bond strength (µTBS) test, ten sticks were obtained for each group and were stressed under tension.

RESULTS

According to surface roughness tests, CN SelfCure showed the lowest value (0.13 μm), while Ketac Molar Easymix showed the highest value (0.28 μm), and significant differences were found between the groups. In flexural strength tests, the highest values were seen in CN SelfCure (82.94 MPa), with statistically significant differences between the groups. When CN SelfCure was applied with an adhesive, the teeth showed statistically decreased leakage than other groups on the gingival side. Higher leakage values were seen on the gingival side than the occlusal side in most groups, and the SelfCure groups showed decreased leakage than the LightCure groups. According to µTBS tests, the highest value was obtained in CN SelfCure-Adhesive group, while the lowest was in CN LightCure-Non-adhesive group. When µTBS was evaluated regardless of adhesive use, the SelfCure groups showed higher µTBS values than the LightCure groups. As a result of the µTBS and microleakage test, the difference between the use of CN with and without adhesive, regardless of the polymerization type, was found to be significant (p  < 0.05).

CONCLUSION

Cention N showed better properties in SelfCure mode, compared to the rest materials tested, but further in vitro and in vivo studies are needed to investigate the effect of different polymerization modes and the oral environmental conditions.

Analytical Methods for Determination of BPA Released from Dental Resin Composites and Related Materials: A Systematic Review

Knowing the impacts of bisphenol A (BPA) on human health, this systematic review aimed to gather the analytical methods for the quantification of BPA release of BPA in dental materials in in vitro and in vivo (biological fluids) studies. A brief critical discussion of the impacts of BPA on human health and the possible association with BPA in dental materials was also presented. The research was carried out by three independent researchers, (according to PRISMA guidelines) in PUBMED and SCOPUS databases, by searching for specific keywords and articles published between January 2011 and February 2022. Seventeen articles met the eligibility criteria and were included in this systematic review: 10 in vitro and 7 in vivo. In in vitro studies, the highest amounts of BPA released were from flowable to conventional resins, followed by resin-modified glass ionomer. In contrast, the smallest amount was released from "BPA-free" composites and CAD-CAM blocks. Regarding in vivo studies, a higher concentration of BPA were found in saliva than urine or blood. The best analytical method for trace quantifying BPA is LC-MS/MS (Liquid Chromatography with Tandem Mass Spectrometry) due to its selectivity, low quantification limits, and the unequivocal identification. However, further studies are required to develop faster and more sensitive methods, in order to obtain more reliable results.

Effect of the Addition of Varying Concentrations of Silver Nanoparticles on the Fluoride Uptake and Recharge of Glass Ionomer Cement

This study aimed to compare the amount of fluoride uptake and the recharge and release characteristics of conventional glass ionomer cement (GIC) without any additives in comparison to conventional glass ionomer cement supplemented with silver nanoparticles (AgNPs) at two concentrations: 0.1% and 0.2% (w/w). A total of 60 specimens were used in this in vitro study. The sample was divided into six groups—including three groups without fluoride charge: Group 1 (conventional GIC), Group 2 (GIC with 0.1% silver nanoparticles), and Group 3 (GIC with 0.2% silver nanoparticles; and three groups with fluoride charge: Group 4 (conventional GIC with fluoride); Group 5 (GIC with 0.1% silver nanoparticles with fluoride); Group 6 (GIC with 0.2% silver nanoparticles with fluoride), where Group 1 is considered the control group and the other five groups are used as the test groups. The amount of fluoride released was measured on days 1, 2, 7, 15, and 30. The comparisons were made between the groups with and without fluoride and among all the groups. A significant difference in the amount of fluoride released was observed between the groups, with the highest amount occurring in Group 1, followed by Group 2; the lowest amount of fluoride released was observed in Group 3 (p < 0.05). The groups with fluoride recharge (Groups 4, 5, and 6) exhibited a higher amount of fluoride release than the groups with no recharge (Groups 1, 2, and 3); however, Group 1 has more fluoride release compared to all other groups on days 1, 2, 7, 15, and 30 (p < 0.05). The amount of released fluoride decreased from day 1 to day 30 in all of the groups in the study. Despite the antimicrobial and anticariogenic benefits of adding silver nanoparticles to GIC, it seems that fluoride release characteristics are significantly affected by the addition of this material. This may force the clinician to a compromise between the antimicrobial benefit of silver nanoparticles and the remineralizing advantage of fluoride.

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

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

Exploiting Nanomaterials for Optical Coherence Tomography and Photoacoustic Imaging in Nanodentistry

There is already a societal awareness of the growing impact of nanoscience and nanotechnology, with nanomaterials (with at least one dimension less than 100 nm) now incorporated in items as diverse as mobile phones, clothes or dentifrices. In the healthcare area, nanoparticles of biocompatible materials have already been used for cancer treatment or bioimaging enhancement. Nanotechnology in dentistry, or nanodentistry, has already found some developments in dental nanomaterials for caries management, restorative dentistry and orthodontic adhesives. In this review, we present state-of-the-art scientific development in nanodentistry with an emphasis on two imaging techniques exploiting nanomaterials: optical coherence tomography (OCT) and photoacoustic imaging (PAI). Examples will be given using OCT with nanomaterials to enhance the acquired imaging, acting as optical clearing agents for OCT. A novel application of gold nanoparticles and nanorods for imaging enhancement of incipient occlusal caries using OCT will be described. Additionally, we will highlight how the OCT technique can be properly managed to provide imaging with spatial resolution down to 10's-100's nm resolution. For PAI, we will describe how new nanoparticles, namely TiN, prepared by femtosecond laser ablation, can be used in nanodentistry and will show photoacoustic microscopy and tomography images for such exogenous agents.

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.

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.

In Vitro Studies concerning Selected Properties of a Composite Material Blended with Nanofluoroapatite Crystals

The aim of the paper was to determine the potential for fluorine release from an original composite material blended with nanofluoroapatite (FAp). The level of fluoride ion emission into deionized water and saline was studied over a period of 12 weeks. Values were recorded after 1, 3, 24, 48, 72, and 96 h and then weekly for a period of 12 weeks. There were statistically significant differences in the periods of fluoride ion release from 5%FAp and 2%FAp materials into saline solution as well as into deionized water. The highest fluorine release from 5%FAp + polymer was observed in the 10th and 11th week of incubation (for saline solution) and in the 9th, 10th, and 11th week (for deionized water). The highest fluorine release from 2%FAp + polymer was observed in the 9th, 11th, and 12th week of incubation for both environments. Total fluoride ion release from 5%FAp + polymer and mean fluoride release levels were similar in 5%FAp and 2%FAp in both environments. Both tested materials (5%FAp and 2%FAp) show the ability to release fluoride ions over a long time in the experimental environment.

The evaluation of healing effect of triclosan and flurbiprofen-loaded nanogels in experimental periodontitis in rats by morphometric analysis

Purpose

To evaluate therapeutic effectiveness of antibacterial triclosan (TCS) and anti-inflammatory flurbiprofen (FLB)-loaded nanogels system in ligature-induced experimental periodontitis in rats.

Methodology

A total of 72 Sprague-Dawley rats were used in this study. Four groups (n = 18 each) were randomly created: Group 1 - neither subjected to experimental periodontitis nor to any treatment; Group 2 - subjected to experimental periodontitis but not treated; Group 3 - subjected to experimental periodontitis and then treated with the developed nanogels; Group 4 - subjected to experimental periodontitis and then placed on a mixture of pure TCS and FLB treatment. The experimental periodontitis was induced on the lower incisors by applying a ligature which was kept for 14 days. Treatment was done for 7 days, and sampling was done at 7, 14, and 28 day of the post-induction experimental period. Morphometric analysis was conducted to assess the clinical outcomes and healing effect.

Results

The morphometric findings showed that the group treated with the developed TCS and FLB-loaded nanogels recovered better and faster than a mixture of pure TCS and FLB. At 28 day of the experimental period, there was no significant difference (p > 0.05) between the baseline control group and the nanogels treated group.

Conclusions

The developed TCS and FLB-loaded nanogels was found to be effective in the treatment of experimental periodontitis in rats. The used experimental periodontitis model was found to be simple and easily reproducible.

Investigation of the structure and compressive strength of a bioceramic root canal sealer reinforced with nanomaterials

OBJECTIVES

A root canal sealer that can increase the resistance of endodontically treated teeth to compressive strength would be of great advantage. The purpose of this study is to use three different nanoparticles: multi-walled carbon nanotubes (MWCNTs), Titanium carbides (TC), and Boron nitrides (BN) into a bioceramic adhesive root canal sealer; BioRoot™ RCS, in an attempt to improve its structural and compressive strength properties.

METHODS

Three composites of two weight fractions (1- and 2-wt.%) were produced by mixing each nanomaterial separately with a pre-weighed mass of Bioroot powder. The microstructural properties and compressive strength of the different hardened composites obtained were investigated. The composites have been characterized by X-ray Diffraction, Fourier transform infrared spectroscopy, and scanning electron microscopy. Compression testing was performed.

RESULTS

The 1-wt.% composites, Bioroot/MWCNTs, and Bioroot/TC, except for the one reinforced with BN, displayed a significant improvement in the compressive strength compared to pristine BioRoot™ RCS. The 2-wt.% composites showed no significant improvement in the compressive strength.

CONCLUSION

The addition of 1-wt.% MWCNTs and TC nanomaterials can be considered in the future for enhancing the microstructure and compressive strength properties of pristine BioRoot™ RCS.

Physical and mechanical evaluation of dental resin composite after modification with two different types of Montmorillonite nanoclay

OBJECTIVES

Evaluation of degree of conversion (DC), flexural properties, micro-hardness and color change (ΔE₀₀) of dental resin composite after modification with two types of organo-modified Montmorillonite (MMT) nanoclay; an experimentally synthesized polymethyl-methacrylate modified MMT nanoclay (PMMA/MMT), and a commercially available one (Cloisite20A).

METHODS

MMT was synthesized by sol-gel technique, organo-modified with polymethyl-methacrylate and characterized using EDX, XRD and FTIR. PMMA/MMT and Cloisite20A nanoclay were added to flowable resin composite in 0.5, 1 and 1.5 wt% concentrations. Unmodified resin composite was used as control group. DC was assessed by FTIR, flexural properties were tested by three-point bending test using a universal testing machine, micro-hardness was analyzed by Vickers micro-hardness tester and color change (ΔE₀₀) was evaluated using a reflective spectrophotometer. SEM and elemental mapping assessment were performed to evaluate nanoclay distribution in resin composite. Data were analyzed using One-way ANOVA followed by Tukey's post hoc test, in addition to Two-way ANOVA (p ≤ 0.05). Weibull analysis was used to analyze flexural strength results.

RESULTS

Characterization results revealed successful preparation of PMMA/MMT. DC results showed insignificant difference up to 1 wt% of nanoclay concentration. Addition of 0.5 wt% of PMMA/MMT significantly increased flexural properties, while addition of 1.5 wt% of PMMA/MMT significantly decreased flexural properties. Micro-hardness results revealed a significant increase in PMMA/MMT groups in all tested concentrations. ΔE₀₀ results showed that color change was clinically acceptable on adding 0.5 wt% nanoclay.

CONCLUSION

PMMA/MMT in 0.5 wt% is a promising nanofiller for resin composite that significantly enhanced flexural strength and micro-hardness without compromising DC and color.

Cytotoxicity of Different Composite Resins on Human Gingival Fibroblast Cell Lines

The aim of the present study was to evaluate and compare the cytotoxic effects of eight composite resins on immortalized human gingival fibroblasts. Composite resins were eluted in cell culture medium for 48 or 72 h at 37 °C. Immortalized human gingival fibroblast-1 (HGF-1) cell lines were seeded in 96-well (1 × 10⁴) plates and incubated for 24 h at 37 °C with the obtained extraction medium. The percentage of viable cells in each well (MTT test) was calculated relative to control cells, which were set to 100%. Data observed were not normally distributed, and nonparametric statistical methods were used for statistical analysis. The Wilcoxon test was used for intragroup comparison, and the Kruskal–Wallis test was used for intergroup multiple comparisons. Significance value was set as p < 0.05. All materials tested showed cytotoxic effects on gingival fibroblasts, recordable as noncytotoxic, mildly cytotoxic or severely cytotoxic, depending on the percentage of cell viability. The Wilcoxon test for intragroup comparison showed that the percentage of viable cells decreased significantly for extracts, for all composite resins tested. The composite resins contained monomers that displayed cytotoxic properties. BisGMA, TEGDMA and UDMA had inhibitory effects and induced apoptotic proteins in pulp fibroblast. Composite resins that contained lower percentages of unbound free monomers—and that released less ions—possessed superior biocompatibility in vitro.

Physicochemical and Mechanical Properties of Bis-GMA/TEGDMA Dental Composite Resins Enriched with Quaternary Ammonium Polyethylenimine Nanoparticles

Modification of dental monomer compositions with antimicrobial agents must not cause deterioration of the structure, physicochemical, or mechanical properties of the resulting polymers. In this study, 0.5, 1, and 2 wt.% quaternary ammonium polyethylenimine nanoparticles (QA-PEI-NPs) were obtained and admixed with a Bis-GMA/TEGDMA (60:40) composition. Formulations were then photocured and tested for their degree of conversion (DC), polymerization shrinkage (S), glass transition temperature (T_g), water sorption (WS), solubility (SL), water contact angle (WCA), flexural modulus (E), flexural strength (σ), hardness (HB), and impact resistance (a_n). We found that the DC, S, Tg, WS, E, and HB were not negatively affected by the addition of QA-PEI-NPs. Changes in these values rarely reached statistical significance. On the other hand, the SL increased upon increasing the QA-PEI-NPs concentration, whereas σ and a_n decreased. These results were usually statistically significant. The WCA values increased slightly, but they remained within the range corresponding to hydrophilic surfaces. To conclude, the addition of 1 wt.% QA-PEI-NPs is suitable for applications in dental materials, as it ensures sufficient physicochemical and mechanical properties.

3D printing of PEEK and its composite to increase biointerfaces as a biomedical material- A review

Poly ether-ether-ketone (PEEK) is a polymer with better lignin biocompatibility than other polymers. It is good for biomedical engineering applications. This research summarises the outcomes of an evaluation conducted on PEEK material composites, such as cellular calcium hydroxyapatite (CHAp) for medical applications. Prospects of PEEK for medical implant are highlighted. Critical analysis and review on 3D printing of PEEK, CHAp and their biological macromolecular behaviours are presented. An electronic search was carried out on Scupos database, Google search and peer-reviewed papers published in the last ten years. Because of the extraordinary strength and biological behaviours of PEEK and its composite of CHAp, 3D-printed PEEK has several biomedical applications, and its biological macromolecular behaviour leads to health sustainability. This work highlights its biological macromolecular behaviours as a bone implant material and the optimum 3D printing process for PEEK and CHAp for medical applications. The current problems with printing PEEK and CHAp are investigated along with their possible uses. Possible solutions to improve the 3D printability of PEEK and CHAp are explained based on scientific mechanisms. This detailed report stands to benefit both scientific community and medical industry to enhance 3D printing concepts for PEEK and CHAp.

Effect of Low Hydroxyapatite Loading Fraction on the Mechanical and Tribological Characteristics of Poly(Methyl Methacrylate) Nanocomposites for Dentures

Denture base materials need appropriate mechanical and tribological characteristics to endure different stresses inside the mouth. This study investigates the properties of poly(methyl methacrylate) (PMMA) reinforced with different low loading fractions (0, 0.2, 0.4, 0.6, and 0.8 wt.%) of hydroxyapatite (HA) nanoparticles. HA nanoparticles with different loading fractions are homogenously dispersed in the PMMA matrix through mechanical mixing. The resulting density, Compressive Young's modulus, compressive yield strength, ductility, fracture toughness, and hardness were evaluated experimentally; the friction coefficient and wear were estimated by rubbing the PMMA/HA nanocomposites against stainless steel and PMMA counterparts. A finite element model was built to determine the wear layer thickness and the stress distribution along the nanocomposite surfaces during the friction process. In addition, the wear mechanisms were elucidated via scanning electron microscopy. The results indicate that increasing the concentration of HA nanoparticles increases the stiffness, compressive yield strength, toughness, ductility, and hardness of the PMMA nanocomposite. Moreover, tribological tests show that increasing the nanoparticle weight fraction considerably decreases the friction coefficient and wear loss.

Surface degradation effects of carbonated soft drink on a resin based dental compound

Dental compounds and restorative materials undergo surface degradation and erosion from exposure to a variety of dietary substances. In this study we investigated changes in the surface properties of Rebaron, a hard denture reline material (HDRM), following timed immersion in carbonated soft drinks to determine its durability in a common acidic environment. Samples were prepared and immersed in a carbonated soft drink (or its components) for 6, 12, or 24 h. Surface structure and mechanical properties were characterized using Atomic Force Microscopy (AFM). Raman spectroscopy was used to identify changes in the HDRM surface chemistry following exposure to the test solutions. AFM revealed that prolonged exposure led to pit formation and a subsequent increase in surface roughness, from 302.02 ± 30.20 to 430.59 ± 15.07 nm Ra, following a 24 h exposure. Young's modulus values decreased from 9.3 ± 7.0 to 0.53 ± 0.26 GPa under the same conditions, demonstrating a softening and embrittlement of the HDRM sample. Raman results revealed that immersion in the carbonated soft drink or acidic solution changed the nature of the HDRM structure, converting the HDRM surface chemistry from primarily hydrophobic to hydrophilic. Our study indicates that sustainability and durability of Rebaron HDRM are significantly reduced by prolonged exposure to carbonated (acidic) soft drink, resulting in deformation and degradation of the material surface.

The Benefits of Smart Nanoparticles in Dental Applications

Dentistry, as a branch of medicine, has undergone continuous evolution over time. The scientific world has focused its attention on the development of new methods and materials with improved properties that meet the needs of patients. For this purpose, the replacement of so-called "passive" dental materials that do not interact with the oral environment with "smart/intelligent" materials that have the capability to change their shape, color, or size in response to an externally stimulus, such as the temperature, pH, light, moisture, stress, electric or magnetic fields, and chemical compounds, has received much attention in recent years. A strong trend in dental applications is to apply nanotechnology and smart nanomaterials such as nanoclays, nanofibers, nanocomposites, nanobubbles, nanocapsules, solid-lipid nanoparticles, nanospheres, metallic nanoparticles, nanotubes, and nanocrystals. Among the nanomaterials, the smart nanoparticles present several advantages compared to other materials, creating the possibility to use them in various dental applications, including preventive dentistry, endodontics, restoration, and periodontal diseases. This review is focused on the recent developments and dental applications (drug delivery systems and restoration materials) of smart nanoparticles.

Surface roughness of enamel and root surface after scaling, root planning and polishing procedures: An in-vitro study

Objectives

The aim of this study was to evaluate enamel and root surface roughness on exracted human teeth by using different tecniques (ultrasonic scaler, hand instruments, polishing paste, pumice and air powder system).

Materials and methods

A total of 200 samples were divided into two groups (enamel and root) randomly with 100 samples for each enamel and root groups. The groups were divided into 5 subgroups: Group I: ultrasonic scaler, group II: hand instruments, group III: polishing paste, group IV: pumice, group V: air-powder. Surface roughness (Ra) was assessed with Mitutoyo SJ-410 device. The one-way analysis of variance (ANOVA) test along with the Tukey test was used for statistical analysis. P values less than 0.05 were considered statistically significant.

Results

The use of ultrasonic scalers caused the highest roughness increase on the enamel surface (0.935 ​± ​0.010), whereas the use of pumice was the least (0.896 ​± ​0.018) (p ​< ​0.05). There was a significant difference between ultrasonic scalers and all the groups (hand instruments, polishing paste, pumice and air powder system) on enamel surface (p ​< ​0.05). Maximum surface roughness increase was observed in the ultrasonic scalers on root surface. There was a significant difference between ultrasonic scalers and polishing paste, pumice and air powder on root surface, respectively (p ​< ​0.05).

Conclusion

The use of ultrasonic scalers cause more rough enamel and root surfaces than hand instrumentation and polishing tecniques.

Clinical relevance

Uneven surfaces adversely affect the intended periodontal healing by creating a retention area of microbial dental plaque.

Therapeutic Role of Nystatin Added to Tissue Conditioners for Treating Denture-Induced Stomatitis: A Systematic Review

Denture-induced stomatitis (DIS) represents a pathological condition caused by ill-fitting dentures trauma, manifested as inflammation of the palatal tissue beneath the denture. The fungal infections are the principal contributory factors to DIS. Although the aetiology of DIS is multifactorial, the Candida albicans fungal infection remains the main cause. The objective of the present systematic review was to evaluate the latest literature on the addition of nystatin into the tissue conditioners (TCs) in the management of DIS. To search the published literature about “the addition of nystatin in TCs for treating DIS”, electronic databases (PubMed (National library of medicine) and Cochrane Library (Wiley)) were searched (from 1975 until December 2020) using different keywords. Various studies described the effectiveness and efficacy of incorporating nystatin into several TCs. The present systematic review reported that the addition of nystatin is beneficial, with slight or no consequences on both the mechanical and physical features of TCs. Adding nystatin to various TCs for treating DIS can be suggested.

Biomineralization process in hard tissues: The interaction complexity within protein and inorganic counterparts

Biomineralization can be considered as nature's strategy to produce and sustain biominerals, primarily via creation of hard tissues for protection and support. This review examines the biomineralization process within the hard tissues of the human body with special emphasis on the mechanisms and principles of bone and teeth mineralization. We describe the detailed role of proteins and inorganic ions in mediating the mineralization process. Furthermore, we highlight the various available models for studying bone physiology and mineralization starting from the historical static cell line-based methods to the most advanced 3D culture systems, elucidating the pros and cons of each one of these methods. With respect to the mineralization process in teeth, enamel and dentin mineralization is discussed in detail. The key role of intrinsically disordered proteins in modulating the process of mineralization in enamel and dentine is given attention. Finally, nanotechnological interventions in the area of bone and teeth mineralization, diseases and tissue regeneration is also discussed. STATEMENT OF SIGNIFICANCE: This article provides an overview of the biomineralization process within hard tissues of the human body, which encompasses the detailed mechanism innvolved in the formation of structures like teeth and bone. Moreover, we have discussed various available models used for studying biomineralization and also explored the nanotechnological applications in the field of bone regeneration and dentistry.

Managing the phase-down of amalgam amongst Nigerian dental professionals and students: A national survey

BACKGROUND

Amalgam is one of the most reliable dental restorative materials. Health and environmental concerns associated with the mercury content of amalgam have necessitated an amalgam phase-down in clinical practice.

OBJECTIVES

This study investigated the level of awareness and preparedness for the planned amalgam phase-down recommended by the Minamata Convention amongst Nigerian dental students and dentists.

METHODS

This cross-sectional national survey was performed across all geopolitical zones of Nigeria. Data regarding awareness, practice and level of preparedness for amalgam phase-down were obtained using a questionnaire that was distributed amongst clinical dental students and dentists of different cadres, who routinely place dental restorations, in public and private practice. The questionnaires were administered online or were hand delivered. Data were analysed using the chi-square test and Spearman's rank correlation coefficient. A p value ≤ 0.05 was considered statistically significant.

RESULTS

Notably, 845 dental students and dentists participated in the survey. Mean age (±standard deviation) of participants was 30.15 ± 7.67 years, 33.8% were students, and 66.2% were dentists (most dentists [77.1%] were employed at public hospitals). A significant percentage of respondents had poor knowledge of the Minamata Convention (87.7%) and lacked training in the use of alternatives to amalgam (72.0%). Amalgam continues to be commonly used by 39.1% and 31.3% of dental students and dentists, respectively. Only 4.7% of the respondents admitted to following good amalgam phase-down practices. Awareness (P = 0.013) and amalgam phase-down practices (P = 0.011) were significantly higher amongst dentists than amongst dental students.

CONCLUSION

We observed low levels of awareness regarding the Minamata Convention, amalgam phase-down, mercury hygiene practices and training in alternatives to amalgam use amongst Nigerian dental professionals and students.

Nanoparticles of Quaternary Ammonium Polyethylenimine Derivatives for Application in Dental Materials

Various quaternary ammonium polyethylenimine (QA-PEI) derivatives have been synthesized in order to obtain nanoparticles. Due to their antibacterial activity and non-toxicity towards mammalian cells, the QA-PEI nanoparticles have been tested extensively regarding potential applications as biocidal additives in various dental composite materials. Their impact has been examined mostly for dimethacrylate-based restorative materials; however, dental cements, root canal pastes, and orthodontic adhesives have also been tested. Results of those studies showed that the addition of small quantities of QA-PEI nanoparticles, from 0.5 to 2 wt.%, led to efficient and long-lasting antibacterial effects. However, it was also discovered that the intensity of the biocidal activity strongly depended on several chemical factors, including the degree of crosslinking, length of alkyl telomeric chains, degree of N-alkylation, degree of N-methylation, counterion type, and pH. Importantly, the presence of QA-PEI nanoparticles in the studied dental composites did not negatively impact the degree of conversion in the composite matrix, nor its mechanical properties. In this review, we summarized these features and functions in order to present QA-PEI nanoparticles as modern and promising additives for dental materials that can impart unique antibacterial characteristics without deteriorating the products' structures or mechanical properties.

Prosthodontic Applications of Polymethyl Methacrylate (PMMA): An Update

A wide range of polymers are commonly used for various applications in prosthodontics. Polymethyl methacrylate (PMMA) is commonly used for prosthetic dental applications, including the fabrication of artificial teeth, denture bases, dentures, obturators, orthodontic retainers, temporary or provisional crowns, and for the repair of dental prostheses. Additional dental applications of PMMA include occlusal splints, printed or milled casts, dies for treatment planning, and the embedding of tooth specimens for research purposes. The unique properties of PMMA, such as its low density, aesthetics, cost-effectiveness, ease of manipulation, and tailorable physical and mechanical properties, make it a suitable and popular biomaterial for these dental applications. To further improve the properties (thermal properties, water sorption, solubility, impact strength, flexural strength) of PMMA, several chemical modifications and mechanical reinforcement techniques using various types of fibers, nanoparticles, and nanotubes have been reported recently. The present article comprehensively reviews various aspects and properties of PMMA biomaterials, mainly for prosthodontic applications. In addition, recent updates and modifications to enhance the physical and mechanical properties of PMMA are also discussed.

Mineral Trioxide Aggregate Applications in Endodontics: A Review

A current topic in dentistry concerns the biocompatibility of the materials, and in particular, conservative dentistry and endodontics ones. The mineral trioxide aggregate (MTA) is a dental material with biocompatibility properties to oral and dental tissues. MTA was developed for dental root repair in endodontic treatment and it is formulated from commercial Portland cement, combined with bismuth oxide powder for radiopacity. MTA is used for creating apical plugs during apexification, repairing root perforations during root canal therapy, treating internal root resorption, and pulp capping. The objective of this article is to investigate MTA features from a clinical point of view, even compared with other biomaterials. All the clinical data regarding this dental material will be evaluated in this review article. Data obtained from the analysis of the past 10 years' literature highlighted 19 articles in which the MTA clinical aspects could be recorded. The results obtained in this article are an important step to demonstrate the safety and predictability of oral rehabilitations with these biomaterials and to promote a line to improve their properties in the future.

Influences of Successive Exposure to Bleaching and Fluoride Preparations on the Surface Hardness and Roughness of the Aged Resin Composite Restoratives

Background and Objectives: Surfaces of composite restorations are adversely affected upon bleaching and topical fluoride application. Such a procedure is normally carried out in the presence of restorations already serving in a different oral environment, although previous in vitro studies only considered the freshly-prepared composite specimens for assessment. The current study accordingly aimed to evaluate both the surface hardness and roughness of aged composite restoratives following their successive exposure to bleaching and topical fluoride preparations. Materials and Methods: Disc specimens were prepared from micro-hybrid, nano-filled, flowable and bulk-fill resin composites (groups 1-4, n = 60 each). All specimens were subjected to artificial aging before their intermittent exposure to surface treatment with: none (control), bleach or topical fluoride (subgroups 1-3, n = 20). All surface treatments were interrupted with two periods of 5000 thermal cycles. Specimens' surfaces were then tested for both surface hardness (Vickers hardness number (VHN), n = 10) and roughness (Ra, n = 10). The collected VHNs and Ras were statistically analyzed using two-way ANOVA and Tukey's comparisons at α = 0.05 to confirm the significance of differences between subgroups. Results: None of the tested composites showed differences in surface hardness and roughness between the bleached and the non-treated specimens (p > 0.05), but the bleached flowable composite specimens only were rougher than their control (p < 0.000126). In comparison to the control, fluoride treatment not only reduced the surface hardness of both micro-hybrid (p = 0.000129) and flowable (p = 0.0029) composites, but also increased the surface roughness of all tested composites (p < 0.05). Conclusion: Aged composite restoratives provide minimal surface alterations on successive bleaching and fluoride applications. Flowable resin composite is the most affected by such procedures. Although bleaching seems safe for other types of composites, the successive fluoride application could deteriorate the aged surfaces of the tested resin composites.

Current aspects and prospects of glass ionomer cements for clinical dentistry

Glass ionomer cement (GIC) is a tailor-made material that is used as a filling material in dentistry. GIC is cured by an acid-base reaction consisting of a glass filler and ionic polymers. When the glass filler and ionic polymers are mixed, ionic bonds of the material itself are formed. In addition, the extra polymer anion reacts with calcium in enamel or dentin to increase adhesion to the tooth tissue. GICs are widely used as adhesives for artificial crowns or orthodontic brackets, and are also used as tooth repair material, cavity liner, and filling materials. In this review, the current status of GIC research and development and its prospects for the future have been discussed in detail.

Comparison of Shear Bond Strength of Three Types of Glass Ionomer Cements Containing Hydroxyapatite Nanoparticles to Deep and Superficial Dentin

Statement of the Problem

The clinical success of glass ionomer cement (GIC) restorations depends on the strength of its bonding to dentin, yet the bond strength of nanohydroxyapatite (nHAp) added GIC to dentin needs to be investigated.

Purpose

This study aimed to assess if the type of GIC containing nHAp and dentin depth could affect the shear bond strength (SBS).

Materials and Method

In this experimental study, 60 freshly extracted intact third molars were randomly divided into two main groups of flat occlusal dentin with different cuts as superficial (S); just below the dentinoenamel junction (DEJ) and deep (D); 2mm below DEJ. After conditioning with 20% polyacrylic acid, each group were randomly assigned to the tested GIC (n=10) subgroups as (1) Fuji IX Extra+nHAp, (2) Fuji II LC+nHAp and (3) Zirconomer+nHAp. Plastic tubes were placed on the pre-treated surfaces and filled with one of the GIC, then stored in an incubator at 37 oC and 100% humidity for 24hr. The specimens were thermocycled at5/55 oC for 500 cycles and subjected to SBS test using a universal testing machine (1 mm/min). The data analyzed by Mann-Whitney and Kruskal-Wallis test (p< 0.05).

Results

The means of SBS of Fuji II LC+nHAp was significantly higher than Fuji IX+nHAp and Zirconomer+nHAp both in superficial and deep dentin (p< 0.05). The means of SBS of Fuji IX Extra+nHAp and Zirconomer+nHAp subgroups in superficial dentin were higher than deep dentin, this differences was statistically significant (p= 0.0001 and p= 0.009, respectively).

Conclusion

It can conclude that SBS was influenced by type of GIC and depth of dentin.

Biofunctionalization of Microgroove Surfaces with Antibacterial Nanocoatings

Objectives

To investigate the physical properties of the modified microgroove (MG) and antibacterial nanocoated surfaces. In addition, the biological interactions of the modified surfaces with human gingival fibroblasts (HGFs) and the antibacterial activity of the surfaces against Porphyromonas gingivalis were studied.

Methods

The titanium nitride (TiN) and silver (Ag) coatings were deposited onto the smooth and MG surfaces using magnetron sputtering. A smooth titanium surface (Ti-S) was used as the control. The physicochemical properties including surface morphology, roughness, and hydrophilicity were characterized using scanning electron microscopy, atomic force microscopy, and an optical contact angle analyzer. The "contact guidance" morphology was assessed using confocal laser scanning microscopy. Cell proliferation was analyzed using the Cell Counting Kit-8 assay. The expression level of the main focal adhesion-related structural protein vinculin was compared using quantitative reverse transcription PCR and Western blotting. The antibacterial activity against P. gingivalis was evaluated using the LIVE/DEAD BacLight™ Bacterial Viability Kit.

Results

The Ag and TiN antibacterial nanocoatings were successfully deposited onto the smooth and MG surfaces using magnetron sputtering technology. TiN coating on a grooved surface (TiN-MG) resulted in less nanoroughness and greater surface hydrophilicity than Ag coating on a smooth surface (Ag-S), which was more hydrophobic. Cell proliferation and expression of vinculin were higher on the TiN-MG surface than on the Ag-coated surfaces. Ag-coated surfaces showed the strongest antibacterial activity, followed by TiN-coated surfaces.

Conclusion

Nano-Ag coating resulted in good antimicrobial activity; however, the biocompatibility was questionable. TiN nanocoating on an MG surface showed antibacterial properties with an optimal biocompatibility and maintained the "contact guidance" effects for HGFs.