Glass-ceramic Flexural Strength after Hydrofluoric Acid and Unfilled Resin Treatment

poster abstractThe use of hydrofluoric (HF) acid is considered one of the most effective methods for achieving durable resin bond to glass-ceramics. Nonetheless, HF acid etching effect on glass-based ceramics strength remains uncertain and only a few contradictory studies have reported the influence of an unfilled resin (UR) application on the ceramic strength. Objectives: To investigate the effect of HF acid etching followed by silane and UR applications on the biaxial flexural strength of a nanofluorapatite glass-ceramic. Methods: 144 disc-shaped (15±1mm in diameter and 0.8±0.1mm in thickness) nanofluorapatite ceramic specimens were allocated into 12 groups: G1-control (no etching), G2-30s, G3-60s, G4-90s, G5-120s, G6-60s+60s. Meanwhile, G7-G12 were treated in the same fashion as G1-G6, but followed by silane and UR applications. Surface morphology of G1-G12 was assessed by scanning electron microscopy/SEM. The flexural strength was determined by biaxial testing per ISO 6872. Statistical analyses were two-way ANOVA and the Sidak multiple comparisons procedure (α=0.05). Additionally, Weibull statistics and finite element analysis (FEA) were carried out. Results: A significant effect of etching time (p=0.0290) on flexural strength was observed. G4 led to a significantly (p=0.0392) higher flexural strength than G1. Correspondingly, G10 revealed a considerably higher flexural strength than G7 (p=0.0392). Furthermore, flexural strength was significantly higher for G7-G12 than for G1-G6 (p<0.0001). For G1-G6, G4 showed the highest Weibull characteristic strength and G10 also presented the highest Weibull characteristic strength among G7-G12. FEA showed lower stress concentration in G7-G12 with the gradient stress supporting the fracture types of the biaxial test. Finally, the SEM data revealed that the HF acid etching affected the surface of ceramic specimens by generating pores and irregularities and more importantly that the UR was able to penetrate into the ceramic microstructure. Conclusions: HF acid etching followed by silane and UR applications enhanced the ceramic biaxial flexural strength

Recent Advances in Adhesive Bonding - The Role of Biomolecules, Nanocompounds, and Bonding Strategies in Enhancing Resin Bonding to Dental Substrates

Purpose of review: To present an overview on the main agents (i.e., biomolecules and nanocompounds) and/or strategies currently available to amplify or stabilize resin-dentin bonding. Recent findings: According to studies retrieved for full text reading (2014-2017), there are currently six major strategies available to overcome resin-dentin bond degradation: (i) use of collagen crosslinking agents, which may form stable covalent bonds with collagen fibrils, thus strengthening the hybrid layer; (ii) use of antioxidants, which may allow further polymerization reactions over time; (iii) use of protease inhibitors, which may inhibit or inactivate metalloproteinases; (iv) modification of the bonding procedure, which may be performed by using the ethanol wet-bonding technique or by applying an additional adhesive (hydrophobic) coating, thereby strengthening the hybrid layer; (v) laser treatment of the substrate prior to bonding, which may cause specific topographic changes in the surface of dental substrates, increasing bonding efficacy; and (vi) reinforcement of the resin matrix with inorganic fillers and/or remineralizing agents, which may positively enhance physico-mechanical properties of the hybrid layer. Summary: With the present review, we contributed to the better understanding of adhesion concepts and mechanisms of resin-dentin bond degradation, showing the current prospects available to solve that problematic. Also, adhesively-bonded restorations may be benefited by the use of some biomolecules, nanocompounds or alternative bonding strategies in order to minimize bond strength degradation

Effects of ciprofloxacin-containing antimicrobial scaffolds on dental pulp stem cell viability-In vitro studies

OBJECTIVE: A combination of antibiotics, including but not limited to metronidazole (MET) and ciprofloxacin (CIP), has been indicated to eradicate bacteria in necrotic immature permanent teeth prior to regenerative procedures. It has been shown clinically that antibiotic pastes may lead to substantial stem cell death. The aim of this study was to synthesise scaffolds containing various concentrations of CIP to enhance cell viability while preserving antimicrobial properties. DESIGN: Polydioxanone (PDS)-based electrospun scaffolds were processed with decreasing CIP concentrations (25-1 wt.%) and morphologically evaluated using scanning electron microscopy (SEM). Cytotoxicity assays were performed to determine whether the amount of CIP released from the scaffolds would lead to human dental pulp stem cell (hDPSC) toxicity. Similarly, WST-1 assays were performed to evaluate the impact of CIP release on hDPSC proliferation. Pure PDS scaffolds and saturated double antibiotic solution MET/CIP (DAP) served as both positive and negative controls, respectively. Antibacterial efficacy against E. faecalis (Ef) was tested. RESULTS: A significant decrease in hDPSC' viability at concentrations 5-25 wt.% was observed. However, concentrations below 5wt.% did not impair cell viability. Data from the WST-1 assays indicated no detrimental impact on cell proliferation for scaffolds containing 2.5 wt.% CIP or less. Significant antimicrobial properties were seen for CIP-scaffolds at lower concentrations (i.e., 1 and 2.5 wt.%). CONCLUSION: The obtained data demonstrated that a reduced concentration of CIP incorporated into PDS-based scaffolds maintains its antimicrobial properties while enhancing viability and proliferation of dental pulp stem cells

Antimicrobial Efficacy of Triple Antibiotic-Eluting Polymer Nanofibers against Multispecies Biofilm

The elimination of microbial flora in cases of immature permanent teeth with necrotic pulp is both key and a challenging goal for the long-term success of regenerative therapy. Recent research has focused on the development of cell-friendly intracanal drug delivery systems. This in vitro study aimed to investigate the antimicrobial action of 3-dimensional (3D) tubular-shaped triple antibiotic-eluting nanofibrous constructs against a multispecies biofilm on human dentin. Polydioxanone polymer solutions, antibiotic-free or incorporated with metronidazole, ciprofloxacin, and minocycline, were electrospun into 3D tubular-shaped constructs. A multispecies biofilm consisting of Actinomyces naeslundii, Streptococcus sanguinis, and Enterococcus faecalis was forced inside the dentinal tubules via centrifugation in a dentin slice in vitro model. The infected specimens were exposed to 2 experimental groups (ie, 3D tubular-shaped triple antibiotic-eluting constructs and triple antibiotic paste [TAP]) and 2 control groups (7-day biofilm untreated and antibiotic-free 3D tubular-shaped constructs). Biofilm elimination was quantitatively analyzed with confocal laser scanning microscopy. Confocal laser scanning microscopic (CLSM) analysis showed a dense population of viable (green) bacteria adhered to dentin and penetrated into the dentinal tubules. Upon 3D tubular-shaped triple antibiotic-eluting nanofibrous construct exposure, nearly complete elimination of viable bacteria on the dentin surface and inside the dentinal tubules was shown in the CLSM images, which was similar (P < .05) to the bacterial death promoted by the TAP group but significantly greater when compared with both the antibiotic-free 3D tubular-shaped constructs and the control (saline). The proposed 3D tubular-shaped antibiotic-eluting construct showed pronounced antimicrobial effects against the multispecies biofilm tested and therefore holds significant clinical potential as a disinfection strategy before regenerative endodontics

Advanced Scaffolds for Dental Pulp and Periodontal Regeneration

No current therapy promotes root canal disinfection and regeneration of the pulp-dentin complex in cases of pulp necrosis. Antibiotic pastes used to eradicate canal infection negatively affect stem cell survival. Three-dimensional easy-to-fit antibiotic-eluting nanofibers, combined with injectable scaffolds, enriched or not with stem cells and/or growth factors, may increase the likelihood of achieving predictable dental pulp regeneration. Periodontitis is an aggressive disease that impairs the integrity of tooth-supporting structures and may lead to tooth loss. The latest advances in membrane biomodification to endow needed functionalities and technologies to engineer patient-specific membranes/constructs to amplify periodontal regeneration are presented

Hygrothermal performance of historic massive wall: when is 2D simulation necessary?

Hygrothermal analysis of historical building envelopes is crucial in ensuring their durability and enhancing their performances. The use of hygrothermal dynamic simulation is the most effective approach to predict moisture related damages or risk of mould growth on ancient masonry envelopes. However, simulating the hygrothermal behaviour of a historic wall composed by stones or bricks and mortar joints, with a detailed two-dimensional (2D) model, is typically a complex and time-consuming process. For this reason, in numerical models, composite walls are often simplified with a one-dimensional (1D) layer, neglecting the mortar joints. An oversimplified numerical model could affect the evaluation of a retrofit intervention and lead to inadequate design choices. This study evaluates when the description of a historic wall as a 1D homogenous layer leads to an acceptable level of accuracy and when it is necessary the use of a more precise 2D model. We quantified the error by comparing 1D and 2D simulations of different massive walls in three Italian climate conditions. We examined a possible retrofit intervention with different internal insulation systems considering vapor tight, vapor retardant and capillary active solutions. Although simplified 1D models are reliable for thermal parameters, we have identified a different behavior regarding the hygric parameters. Whereas for a capillary active insulation system the 1D and 2D simulations show a reasonable agreement, the 1D approximation is no longer acceptable in the case of vapour closed insulation systems as it leads to large deviations. Knowing when it is possible to implement a simplified 1D model and quantifying the introduced error will support architects and energy consultants in the design process. It will guide them in the choice of the most suitable model depending on their specific requirements

The Effect of Polymerization Methods and Fiber Types on the Mechanical Behavior of Fiber-Reinforced Resin-Based Composites

Purpose Glass fibers were introduced to increase the fracture resistance of resin-based composites restorations; however, the poor polymerization between fibers and resin-based composite were sometimes noted and can cause debonding and failure. The purpose of this study was to investigate the effects of different polymerization methods as well as fiber types on the mechanical behavior of fiber-reinforced resin-based composites. Materials and Methods Seventy-five specimens were fabricated and divided into one control group and four experimental groups (n = 15), according to the type of glass fiber (strip or mesh) and polymerization methods (one- or two-step). A 0.2-mm-thick fiber layer was fabricated with different polymerization methods, on top of which a 1.8 mm resin-based composite layer was added to make a bar-shape specimen, followed by a final polymerization. Specimens were tested for flexural strength and flexural modulus. The failure modes of specimens were observed by scanning electron microscopy. Results The fiber types showed significant effect on the flexural strength of test specimens (F = 469.48, p < 0.05), but the polymerization methods had no significant effect (F = 0.05, p = 0.82). The interaction between these two variables was not significant (F = 1.73, p = 0.19). In addition, both fiber type (F = 9.71, p < 0.05) and polymerization method (F = 12.17, p < 0.05) affected the flexural modulus of test specimens; however, the interaction between these two variables was not significant (F = 0.40, p = 0.53). Conclusions The strip fibers showed better mechanical behavior than mesh fibers and were suggested for resin-based composites restorations reinforcement; however, different polymerization methods did not have a significant effect on the strength and failure mode of fiber-reinforced resin-based composites

Hemoglobin A1C Percentage in Nonhuman Primates: A Useful Tool to Monitor Diabetes before and after Porcine Pancreatic Islet Xenotransplantation

Non-human primates (NHPs) are a very valuable experimental model for diabetes research studies including experimental pancreatic islet transplantation. In particular NHPs are the recipients of choice to validate pigs as possible source of pancreatic islets. The aim of this study was to quantify glycated hemoglobin percentage in NHPs and to assess whether changes in values reflect the metabolic trends after diabetes induction and islet transplantation. Sera from 15 NHPs were analyzed. 9 NHPs were rendered diabetic with streptozotocin (STZ), and 3 of them received porcine islet transplants. Hemoglobin A1c (HbA1c) percentage was measured with an assay based on a latex immunoagglutination inhibition methodology. Whereas diabetes and its duration were associated with increasing HbA1c levels, postislet transplantation blood glucose normalization was paralleled by a decrease in the HbA1c percentage. Our data provide evidence that HbA1c is a useful tool to monitor glucose metabolism in NHPs

Bonding to densely sintered alumina- and glass infiltrated aluminum / zirconium-based ceramics.

The objective of this study was to test two hypotheses: (1) silica coating affects the bond strength between ceramics and a resin cement; (2) bond strength is affected by the type of ceramic. Twelve blocks 5 x 6 x 8 mm of In-Ceram Zirconia (ZR) and twelve Procera AllCeram (PR) ceramics were made and duplicated in composite. Five blocks of each ceramic were treated as follows: (1) ZR + GB (laboratorial airborne particles abrasion with Al2O3 particles) + silane; (2) ZR + SC (chairside tribochemical silica coating system, Cojet); (3) PR + GB; (4) PR + SC. Two treated samples of ceramic were analyzed under SEM. The ceramic-composite blocks were cemented with Panavia F and stored in 37ºC distilled water for 7 days. They were then cut to produce bar specimens (n=30) with a bonding area of 0.6±0.1mm². Specimens were loaded to failure under tension in a universal testing machine (1 mm/min). Bond strength (sigma) values were statistically analyzed using ANOVA (Two-way) and Tukey (alpha = 0.05). Mean sigma (MPa) and standard deviation were as follows: 1) 15.1 ± 5.3; 2) 26.8 ± 7.4; 3) 12.7 ± 2.6; 4) 18.5 ± 4.7. Silica coated surfaces showed statistically higher sigma than the same substrate treated with GB only. In addition, ZR (with vitreous phase) showed higher ó than PR (without vitreous phase)