Functionalization of zirconia ceramic with fibronectin proteins enhanced bioactivity and osteogenic response of osteoblast-like cells

Introduction: To overcome the genuine bioinert properties of zirconia ceramic, functionalization of the surface with the bioactive protein fibronectin was conducted.Methods: Glow discharge plasma (GDP)-Argon was first used to clean the zirconia surface. Then allylamine was treated at three different powers of 50 W, 75 W, and 85 W and immersed into 2 different fibronectin concentrations (5 µg/ml and 10 µg/ml).Results and Discussion: After surface treatment, irregularly folded protein-like substances were attached on the fibronectin coated disks, and a granular pattern was observed for allylamine grafted samples. Infrared spectroscopy detected C-O, N-O, N-H, C-H, and O-H functional groups for fibronectin treated samples. Surface roughness rose and hydrophilicity improved after the surface modification, with MTT assay showing the highest level of cell viability for the A50F10 group. Cell differentiation markers also showed that fibronectin grafted disks with A50F10 and A85F10 were the most active, which in turn encouraged late-stage mineralization activity on 21d. Up-regulation of osteogenic related mRNA expression from 1d to 10d can be observed in RT-qPCR data for ALP, OC, DLX5, SP7, OPG and RANK biomarkers. These physical and biological properties clearly indicate that an allylamine and fibronectin composite grafted surface significantly stimulated the bioactivity of osteoblast-like cells, and can be utilized for future dental implant applications

Rehardening and the Protective Effect of Gamma-Polyglutamic Acid/Nano-Hydroxyapatite Paste on Surface-Etched Enamel

Many revolutionary approaches are on the way pertaining to the high occurrence of tooth decay, which is an enduring challenge in the field of preventive dentistry. However, an ideal dental care material has yet to be fully developed. With this aim, this research reports a dramatic enhancement in the rehardening potential of surface-etched enamels through a plausible synergistic effect of the novel combination of γ-polyglutamic acid (γ-PGA) and nano-hydroxyapatite (nano-HAp) paste, within the limitations of the study. The percentage of recovery of the surface microhardness (SMHR%) and the surface parameters for 9 wt% γ-PGA/nano-HAp paste on acid-etched enamel were investigated with a Vickers microhardness tester and an atomic force microscope, respectively. This in vitro study demonstrates that γ-PGA/nano-HAp treatment could increase the SMHR% of etched enamel to 39.59 ± 6.69% in 30 min. To test the hypothesis of the rehardening mechanism and the preventive effect of the γ-PGA/nano-HAp paste, the surface parameters of mean peak spacing (Rsm) and mean arithmetic surface roughness (Ra) were both measured and compared to the specimens subjected to demineralization and/or remineralization. After the treatment of γ-PGA/nano-HAp on the etched surface, the reduction in Rsm from 999 ± 120 nm to 700 ± 80 nm suggests the possible mechanism of void-filling within a short treatment time of 10 min. Furthermore, ΔRa-I, the roughness change due to etching before remineralization, was 23.15 ± 3.23 nm, while ΔRa-II, the roughness change after remineralization, was 11.99 ± 3.90 nm. This statistically significant reduction in roughness change (p < 0.05) implies a protective effect against the demineralization process. The as-developed novel γ-PGA/nano-HAp paste possesses a high efficacy towards tooth microhardness rehardening, and a protective effect against acid etching

Calcium Phosphate Nanoclusters for the Repair of Tooth Enamel Erosion

The artificial repair of tooth enamel is still an urgent requirement because it has a complicated and well-arranged structure. Herein, calcium phosphate nanoclusters (CaP NCs) were synthesized, via a facile approach, for application in the repair of tooth enamel erosion. Structural and optical characterizations validated the successful preparation of spherical CaP NCs, with an average size of 2.1 ± 0.11 nm. By evaporating the ethanol and triethylamine (TEA) solvents, pure CaP was produced, which was further used to repair the tooth enamel. Simulated caries lesions were achieved via phosphoric acid etching to cause damage to enamel rods. After repair, the damaged enamel rods were directly covered with CaP. According to microhardness testing, after repair with CaP NCs, the hardness value of the tooth enamel with acid etching increased to a similar level to that of normal tooth enamel. The results of the microhardness test indicated that CaP NCs revealed great potential for repairing tooth enamel erosion. Our work demonstrates a promising potential for treating the early stage of tooth erosion with CaP NCs. Based on these findings, we believe that stable CaP NCs can be employed as a precursor for the tunable, effective repair of tooth enamel in the near future

Early Childhood Caries-Related Knowledge, Attitude, and Practice: Discordance between Pediatricians and Dentists toward Medical Office-Based Prevention in Taiwan

The aim of this study was to assess the knowledge, attitude, and practice regarding early childhood caries (ECC) prevention and implementation of medical setting-based caries prevention among pediatricians and dentists in Taiwan. Data were collected from currently practicing pediatricians and general and pediatric dentists using self-administered questionnaires. A total of 301 questionnaires were completed by the pediatricians (n = 105), general dentists (n = 117), and pediatric dentists (n = 79). The pediatric dentists obtained significantly higher knowledge and practice scores than the general dentists and pediatricians (p < 0.0001). The pediatricians’ attitude score related to engaging physicians in medical office-based caries prevention was significantly higher than the attitude scores of the general and pediatric dentists (p < 0.05). A Spearman rank correlation analysis indicated a significant positive correlation between knowledge and practice among the general dentists (rs = 0.271, p < 0.01) and pediatricians (rs = 0.262, p < 0.01). The correlation between knowledge and attitude among the pediatricians was significantly positive (rs = 0.242, p < 0.05). Attitude and practice among the pediatricians were significantly positively correlated (rs = 0.271, p < 0.01). Pediatricians lacked ECC-related knowledge; however, they had a more positive attitude toward medical office-based prevention when they had a higher level of knowledge. Oral health-related education for pediatricians is necessary if such medical office-based caries prevention programs are to be implemented in Taiwan

Effect of Comorbidity on Lung Cancer Diagnosis Timing and Mortality: A Nationwide Population-Based Cohort Study in Taiwan

The effect of comorbidity on lung cancer patients’ survival has been widely reported. The aim of this study was to investigate the effects of comorbidity on the establishment of the diagnosis of lung cancer and survival in lung cancer patients in Taiwan by using a nationwide population-based study design. This study collected various comorbidity patients and analyzed data regarding the lung cancer diagnosis and survival during a 16-year follow-up period (1995–2010). In total, 101,776 lung cancer patients were included, comprising 44,770 with and 57,006 without comorbidity. The Kaplan–Meier analyses were used to compare overall survival between lung cancer patients with and without comorbidity. In our cohort, chronic bronchitis patients who developed lung cancer had the lowest overall survival in one (45%), five (28.6%), and ten years (26.2%) since lung cancer diagnosis. Among lung cancer patients with nonpulmonary comorbidities, patients with hypertension had the lowest overall survival in one (47.9%), five (30.5%), and ten (28.2%) years since lung cancer diagnosis. In 2010, patients with and without comorbidity had 14.86 and 9.31 clinical visits, respectively. Lung cancer patients with preexisting comorbidity had higher frequency of physician visits. The presence of comorbid conditions was associated with early diagnosis of lung cancer

Effects of At-Home and In-Office Bleaching Agents on the Color Recovery of Esthetic CAD-CAM Restorations after Red Wine Immersion

The aim of this study was to evaluate the effects of at-home and in-office bleaching agents on esthetic CAD-CAM materials after red wine immersion by measuring their optical properties. Sixty specimens were prepared out of three esthetic CAD-CAM materials: Vita Enamic, Celtra Duo, and Ceresmart (n = 20). All specimens were immersed in a red wine solution, and color measurements were performed. Specimens were randomly divided (n = 10) according to the bleaching procedure (in office, at home), bleaching durations were set to 3 time points, and color measurements were performed. According to the Commission Internationale de l’Eclairage (CIE) L* a* b* parameters, CIEDE2000 color differences (ΔE00), translucency parameters (TP00), and whiteness index values (ΔWID) after wine staining and after bleaching were calculated. Data were analyzed using the Mann–Whitney U-test, the Kruskal–Wallis test, and a two-way analysis of variance (ANOVA) (α = 0.05). ΔE00, ΔTP00, and ΔWID decreased with an increase in bleaching treatment. ΔE00 after the final bleaching treatment of in-office bleaching ranged from 1.7 to 2.0, whereas those of in-office treatment ranged from 0.4 to 1.1. All ΔTP00 and ΔWID after the final treatment were below the 50:50% perceptibility thresholds (ΔTP00 < 0.6, and ΔWID < 0.7). Significant differences in ΔE00, ΔTP00, and ΔWID among esthetic CAD-CAM materials were found between CD and CE. In the present study, color recovery after at-home and in-office bleaching appeared to be material-dependent. In-office bleaching showed more effective recovery comparing to at-home bleaching

In Vitro and In Vivo Studies of Hydrophilic Electrospun PLA95/β-TCP Membranes for Guided Tissue Regeneration (GTR) Applications

The guided tissue regeneration (GTR) membrane is a barrier intended to maintain a space for alveolar bone and periodontal ligament tissue regeneration but prevent the migration of fast-growing soft tissue into the defect sites. This study evaluated the physical properties, in vivo animal study, and clinical efficacy of hydrophilic PLA95/β-TCP GTR membranes prepared by electrospinning (ES). The morphology and cytotoxicity of ES PLA95/β-TCP membranes were evaluated by SEM and 3-(4,5-cimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) respectively. The cementum and bone height were measured by an animal study at 8 and 16 weeks after surgery. Fifteen periodontal patients were selected for the clinical trial by using a commercial product and the ES PLA95/β-TCP membrane. Radiographs and various indexes were measured six months before and after surgery. The average fiber diameter for this ES PLA95/β-TCP membrane was 2.37 ± 0.86 µm. The MTT result for the ES PLA95/β-TCP membrane showed negative for cytotoxicity. The significant differences in the cementum and bone height were observed between empty control and the ES PLA95/β-TCP membrane in the animal model (p < 0.05). Clinical trial results showed clinical attachment level (CAL) of both control and ES PLA95/β-TCP groups, with a significant difference from the pre-surgery results after six months. This study demonstrated that the ES PLA95/β-TCP membrane can be used as an alternative GTR membrane for clinical applications

Argon Plasma Surface Modified Porcine Bone Substitute Improved Osteoblast-Like Cell Behavior

Low-temperature plasma-treated porcine grafts (PGPT) may be an effective means for treating demanding osseous defects and enhance our understanding of plasma-tissue engineering. We chemically characterized porcine grafts under low-temperature Argon plasma treatment (CAP) and evaluated their biocompatibility in-vitro. Our results showed that PGPT did not differ in roughness, dominant crystalline phases, absorption peaks corresponding to phosphate band peaks, or micro-meso pore size, compared to non-treated porcine grafts. The PGPT Ca/P ratio was 2.16; whereas the porcine control ratio was 2.04 (p < 0.05). PGPT’s [C 1s], [P 2p] and [Ca 2p] values were 24.3%, 5.6% and 11.0%, respectively, indicating that PGPT was an apatite without another crystalline phase. Cell viability and alkaline phosphatase assays revealed enhanced proliferation and osteoblastic differentiation for the cells cultivated in the PGPT media after 5 days (p < 0.05). The cells cultured in PGPT medium had higher bone sialoprotein and osteocalcin relative mRNA expression compared to cells cultured in non-treated porcine grafts (p < 0.05). CAP treatment of porcine particles did not modify the biomaterial’s surface and improved the proliferation and differentiation of osteoblast-like cells

Decision Tree Approach to the Impact of Parents’ Oral Health on Dental Caries Experience in Children: A Cross-Sectional Study

Decision tree (DT) analysis was applied in this cross-sectional study to investigate caries experience in children by using clinical and microbiological data obtained from parent–child pairs. Thirty pairs of parents and children were recruited from periodontal and pediatric dental clinics. All participants were clinically examined for caries and periodontitis by a calibrated examiner. Cariogenic and periodontopathic bacteria examinations were conducted. The Kendall rank correlation coefficient was used to measure the association between data variables obtained through clinical and microbiological examinations. A classificatory inductive decision tree was generated using the C4.5 algorithm with the top-down approach. The C4.5 DT analysis was applied to classify major influential factors for children dental caries experience. The DT identified parents’ periodontal health classification, decayed, missing, filled permanent teeth (DMFT) index, periodontopathic test (PerioCheck) result, and periodontal pocket depth as the classification factors for children caries experience. 13.3% of children were identified with a low decayed, missing, filled primary teeth (dmft) index (dmft < 3) whose parents had a periodontal pocket depth ≤3.7, PerioCheck score >1, DMFT index <13.5, and periodontal classification >2. The DT model for this study sample had an accuracy of 93.33%. Here, parental periodontal status and parents’ DMFT were the factors forming the DT for children’s caries experience