Fracture rate of monolithic zirconia restorations up to 5 years: A dental laboratory survey

AbstractStatement of problemThe demand for ceramic restorations has increased over the past years because of their esthetic properties and the high cost of noble metals. However, the lack of long-term clinical studies and the difficulty of interpreting in vitro studies have placed the durability of ceramic restorations in doubt.PurposeThe purpose of this study was to determine the failure rate of monolithic zirconia restorations due to fracture up to 5 years of clinical performance.Material and methodsData were collected over 5 years from 2 commercial dental laboratories. Restorations that were returned to the laboratory for remake because of catastrophic failure (fracture) were identified and included. Restorations were categorized as anterior or posterior. Each category was further divided into complete-coverage single crowns (SCs) and multiple-unit fixed dental prostheses (FDPs). Fracture rates were compared and analyzed using a chi-square test (α=.05).ResultsA total of 39827 restoration records were reviewed and included 3731 anterior restorations (1952 SC; 1799 FDP) and 36096 posterior restorations (29808 SC; 6288 FDP). The overall fracture rate of up to 5 years for all restorations (anterior and posterior) was 1.09%. Fracture rates were 2.06% for all anterior restorations and 0.99% for all posterior restorations. Fracture rates were 0.97% for anterior SCs and 0.69% for posterior SCs, and the combined fracture rate (anterior and posterior) was 0.71%. For FDPs, 3.26% restorations fractured anteriorly and 2.42% fractured posteriorly, and the combined fracture rate (anterior and posterior) was 2.60%.ConclusionWithin the relative short-term evaluation of 5 years, restorations fabricated from monolithic zirconia material displayed relatively low fracture rates. Anterior restorations fractured at a slightly higher rate than posterior restorations, and FDPs fractured at a rate double that of SCs

Proliferation of preosteoblasts on TiO 2 nanotubes is FAK/RhoA related

Model for FAK/RhoA modulation of topography-regulated proliferation

RhoA-Mediated Functions in C3H10T1/2 Osteoprogenitors Are Substrate Topography Dependent: TOPOGRAPHY-DEPENDENT RhoA MEDIATED FUNCTIONS

Surface topography broadly influences cellular responses. Adherent cell activities are regulated, in part, by RhoA, a member of the Rho-family of GTPases. In this study, we evaluated the influence of surface topography on RhoA activity and associated cellular functions. The murine mesenchymal stem cell line C3H10T1/2 cells (osteoprogenitor cells) were cultured on titanium substrates with smooth topography (S), microtopography (M), and nanotopography (N) to evaluate the effect of surface topography on RhoA-mediated functions (cell spreading, adhesion, migration, and osteogenic differentiation). The influence of RhoA activity in the context of surface topography was also elucidated using RhoA pharmacologic inhibitor. Following adhesion, M and N adherent cells developed multiple projections, while S adherent cells had flattened and widespread morphology. RhoA inhibitor induced remarkable longer and thinner cytoplasmic projections on all surfaces. Cell adhesion and osteogenic differentiation was topography dependent with S < M and N surfaces. RhoA inhibition increased adhesion on S and M surfaces, but not N surfaces. Cell migration in a wound healing assay was greater on S versus M versus N surfaces and RhoA inhibitor increased S adherent cell migration, but not N adherent cell migration. RhoA inhibitor enhanced osteogenic differentiation in S adherent cells, but not M or N adherent cells. RhoA activity was surface topography roughness dependent (S < M, N). RhoA activity and -mediated functions are influenced by surface topography. Smooth surface adherent cells appear highly sensitive to RhoA function, while nano-scale topography adherent cell may utilize alternative cellular signaling pathway(s) to influence adherent cellular functions regardless of RhoA activity

Characteristics and Detection Rate of SARS-CoV-2 in Alternative Sites and Specimens Pertaining to Dental Practice: An Evidence Summary

Knowledge about the detection potential and detection rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in various body fluids and sites is important for dentists since they, directly or indirectly, deal with many of these fluids/sites in their daily practices. In this study, we attempt to review the latest evidence and meta-analysis studies regarding the detection rate of SARS-CoV-2 in different body specimens and sites as well as the characteristics of these sample. The presence/detection of SARS-CoV-2 viral biomolecules (nucleic acid, antigens, antibody) in different clinical specimens depends greatly on the specimen type and timing of collection. These specimens/sites include nasopharynx, oropharynx, nose, saliva, sputum, bronchoalveolar lavage, stool, urine, ocular fluid, serum, plasma and whole blood. The relative detection rate of SARS-CoV-2 viral biomolecules in each of these specimens/sites is reviewed in detail within the text. The infectious potential of these specimens depends mainly on the time of specimen collection and the presence of live replicating viral particles

Biomaterials and Extracellular Vesicle Delivery: Current Status, Applications and Challenges

In this review, we will discuss the current status of extracellular vesicle (EV) delivery via biopolymeric scaffolds for therapeutic applications and the challenges associated with the development of these functionalized scaffolds. EVs are cell-derived membranous structures and are involved in many physiological processes. Na&iuml;ve and engineered EVs have much therapeutic potential, but proper delivery systems are required to prevent non-specific and off-target effects. Targeted and site-specific delivery using polymeric scaffolds can address these limitations. EV delivery with scaffolds has shown improvements in tissue remodeling, wound healing, bone healing, immunomodulation, and vascular performance. Thus, EV delivery via biopolymeric scaffolds is becoming an increasingly popular approach to tissue engineering. Although there are many types of natural and synthetic biopolymers, the overarching goal for many tissue engineers is to utilize biopolymers to restore defects and function as well as support host regeneration. Functionalizing biopolymers by incorporating EVs works toward this goal. Throughout this review, we will characterize extracellular vesicles, examine various biopolymers as a vehicle for EV delivery for therapeutic purposes, potential mechanisms by which EVs exert their effects, EV delivery for tissue repair and immunomodulation, and the challenges associated with the use of EVs in scaffolds

Transcriptional Coactivation of Bone-Specific Transcription Factor Cbfa1 by TAZ

Core-binding factor 1 (Cbfa1; also called Runx2) is a transcription factor belonging to the Runt family of transcription factors that binds to an osteoblast-specific cis-acting element (OSE2) activating the expression of osteocalcin, an osteoblast-specific gene. Using the yeast two-hybrid system, we identified a transcriptional coactivator, TAZ (transcriptional coactivator with PDZ-binding motif), that binds to Cbfa1. A functional relationship between Cbfa1 and TAZ is demonstrated by the coimmunoprecipitation of TAZ by Cbfa1 and by the fact that TAZ induces a dose-dependent increase in the activity of osteocalcin promoter-luciferase constructs by Cbfa1. A dominant-negative construct of TAZ in which the coactivation domains have been deleted reduces osteocalcin gene expression down to basal levels. NIH 3T3, MC 3T3, and ROS 17/2.8 cells showed the expected nuclear localization of Cbfa1, whereas TAZ was distributed throughout the cytoplasm with some nuclear localization when transfected with either Cbfa1 or TAZ. Upon cotransfection by both Cbfa1 and TAZ, the transfected TAZ shows predominant nuclear localization. The dominant-negative construct of TAZ shows minimal nuclear localization upon cotransfection with Cbfa1. These data indicate that TAZ is a transcription coactivator for Cbfa1 and may be involved in the regulation of osteoblast differentiation

A case-control study assessing oral-health-related quality of life after immediately loaded single implants in healed alveolar ridges or extraction sockets

Introduction: Tooth loss reduces oral-health-related quality of life (OHRQoL) as assessed with the 14-item Oral Health Impact Profile questionnaire (OHIP-14). Objectives: This prospective multicenter case-control study sought to (i) establish OHRQoL in patients requiring a single implant in the anterior maxilla and to (ii) compare these changes following implant placement and immediate provisionalization in extraction sockets with healed alveolar ridges up to 1 year. Material and methods: Ninety-six patients were enrolled in the study with 102 single implants (OsseoSpeedt AstraTech) provisionalized immediately after placement in sockets or after placement in healed ridges. A final crown was cemented after 12 weeks. OHIP-14 was registered before surgery (baseline), after 1 (provisional crown), 6 and 12 months (final crown). Repeated measures ANOVA was performed for the seven conceptual OHIP Domains, the treatment group (extraction site socket vs. healed alveolar ridge) and time as within subjects variables. Results: Two implants failed, 1/48 (2.1%) in the extraction group (n¼46 patients) and 1/54 (1.8%) in the healed ridge group (n¼50 patients). From 82 patients (87.5%), OHIP-14 was available at all time points. The overall OHIP-14 based on the mean of the seven domains increases between baseline and 6 months and remained stable afterward for the total study group and both treatment groups. Comparison between extraction and healed groups revealed no significant difference at baseline but the healed group showed a significantly higher improvement for functional limitation, physical disability, physical pain and psychological discomfort (Po0.05). Between baseline and 1 year in the healed bone group, all seven domains improved significantly compared with only three domains in the extraction group. However, the overall OHIP-14 score between groups was not substantially different. Hence, both treatment modalities lead to similar OHRQoL improvement. Conclusion: Patients in need of a single-tooth replacement have limited OHRQoL problems as reflected by the OHIP-14 score but improvements in several domains related to oral health were evaluated when implants were placed and provisionalized in healed bone and extraction sites

Effects of Delta12-prostaglandin J2 on bone regeneration and growth factor expression in rats

OBJECTIVES: Cyclopentenone prostaglandins have been shown to promote osteoblast differentiation in vitro. The aim of this study was to examine in a rat model the effects of local delivery of Delta(12)-prostaglandin J(2) (Delta(12)-PGJ(2)) on new bone formation and growth factor expression in (i) cortical defects and (ii) around titanium implants. MATERIAL AND METHODS: Standardized transcortical defects were prepared bilaterally in the femur of 28 male Wistar rats. Ten microliters of Delta(12)-PGJ(2) at 4 concentrations (10(-9), 10(-7), 10(-5) and 10(-3) mol/l) in a collagen vehicle were delivered inside a half-cylindrical titanium chamber fixed over the defect. Contralateral defects served as vehicle controls. Ten days after surgery, the amount of new bone formation in the cortical defect area was determined by histomorphometry and expression of platelet-derived growth factor (PDGF)-A and -B, insulin-like growth factor (IGF)-I/II, bone morphogenetic protein (BMP)-2 and -6 was examined by immunohistochemistry. In an additional six rats, 24 titanium implants were inserted into the femur. Five microliters of carboxymethylcellulose alone (control) or with Delta(12)-PGJ(2) (10(-5) and 10(-3) mol/l) were delivered into surgically prepared beds prior to implant installation. RESULTS: Delta(12)-PGJ(2) (10(-5) and 10(-3) mol/l) significantly enhanced new bone formation (33%, P<0.05) compared with control cortical defects. Delivery of Delta(12)-PGJ(2) at 10(-3) mol/l significantly increased PDGF-A and -B and BMP-2 and -6 protein expression (P<0.05) compared with control defects. No significant difference was found in IGF-I/II expression compared with controls. Administration of Delta(12)-PGJ(2) also significantly increased endosteal new bone formation around implants compared with controls. CONCLUSION: Local delivery of Delta(12)-PGJ(2) promoted new bone formation in the cortical defect area and around titanium implants. Enhanced expression of BMP-2 and -6 as well as PDGF-A and -B may be involved in Delta(12)-PGJ(2)-induced new bone formation

Marginal Fit Evaluation of CAD/CAM All Ceramic Crowns Obtained by Two Digital Workflows: An In Vitro Study Using Micro‐CT Technology

PurposeTo evaluate the marginal fit of CAD/CAM all ceramic crowns made from lithium disilicate and zirconia using two different fabrication protocols (model and model‐less).Materials and MethodsForty anterior all ceramic restorations (20 lithium disilicate, 20 zirconia) were fabricated from digital impressions using a CEREC Bluecam scanner. Two different digital workflows were used: a fully digital model‐less approach and a printed model digital approach. The crowns were cemented on the respective prepared typodont teeth and marginal gap was evaluated using Micro‐CT. Each specimen was analyzed in sagittal and trans‐axial orientations, allowing evaluation of the marginal fit (vertical and horizontal) on each surface. Logarithmic transformation was used with a significance of 0.05. After that a reliability analysis was performed by re‐measuring four randomized selected images for each specimen and performing intraclass correlations to determine any systematic bias in the measurements.ResultsVertical measurements in the lingual, distal and mesial views had an estimated marginal gap ranging from 101.9 to 133.9 µm for lithium disilicate crowns and 126.4 to 165.4 µm for zirconia. No significant differences were found between model and model‐less techniques.ConclusionsBoth workflows are valid protocols for the fabrication of monolithic ceramic restorations. The use of a printed model did not improve the marginal fit of lithium disilicate or zirconia crowns.Both materials are also clinically acceptable, no matter which workflow was used to obtain the restoration.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152707/1/jopr13115_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/152707/2/jopr13115.pd