Current perspectives on dental adhesion: (3) Adhesion to intraradicular dentin: Concepts and applications

Adhesion science is one of the greatest contributions to restorative dentistry. Adhesion not only established the current principles of tissue preservation, but also allowed for the production of more hermetic and long-lasting restorations. Although adhesive strategies are routinely used in most clinical situations, adhesion to root dentin is still a major challenge. The presence of humidity together with less intertubular dentin are factors that limit the adhesive potential of root dentin. This situation is more unfavorable in endodontically treated teeth prepared for prefabricated or custom-made intraradicular posts; these procedures may alter the mechanical properties of teeth by modifying the viable dentin surface for adhesion. Also, contaminants deposited on the dentin surface are difficult to remove through conventional techniques. Moreover, root canal morphology has a very unfavorable C-factor, bringing undesirable effects resulting from polymerization contraction of resin-based materials. However, the differences between coronal and root dentin are not a barrier for dentin adhesion. Standardization of procedures and care during clinical steps are fundamental to the success of adhesion to coronal or intraradicular dentin. Thus, it is essential to know the anatomy of the root structure, the factors that interfere with intraradicular adhesion, as well as the current adhesive materials and techniques

Graphene for zirconia and titanium composites in dental implants: Significance and predictions

Purpose of Review: Graphene is introduced in dentistry as a material to be used in the fabrication or coating of dental implants due to its biocompatibility, ability to physically interact with biomolecules and very high surface area. This review highlights the current knowledge on the general properties of graphene, potential benefits especially when used in zirconia-based implants, as composite materials and coatings. Recent Findings: The literature reviewed showed a growing body of evidence supporting the use of graphene-based material, associated with titanium or zirconia as a coating or composite material that helps in cell viability, differentiation and proliferation, improving the bioactivity, osseointegration, physical, chemical and mechanical properties particularly zirconia. Graphene-based materials present great potential for biomedical applications especially when used in the form of nanostructured biological coatings that can be obtained through reproducible and economical processes. Summary: The use of graphene as a composite implant material or coating may have great potential for osseointegration and bone regeneration, providing that, features including hydrophilicity, protein adsorption capacity, oxygen content and effect of external parameters such as temperature, pH and ionic strength need further elucidations before they can be implemented as a coating or composite material for dental implants.Institute for Empirical Research in Economics, University of Zurich ; Neuroscience Center Zurich, University of Zuric

Dental and composite resin discoloration induced by different hydraulic calcium silicate-based cements: two-year in vitro assessment

Few long-term studies assess the discoloration induced by hydraulic calcium silicate-based cement on dental structures. In addition, as far as we know, no long-term study has assessed the discoloration induced by these cement on composite resin. Objective: This in vitro study aimed to assess, during a period of two years, the discoloration potential of different hydraulic calcium silicate-based cements (hCSCs) on the enamel/dentin structure and composite resin restoration. Methodology: A total of 40 enamel/dentin discs were obtained from bovine incisors, and 40 composite resin discs (10 mm in diameter × 2 mm thick) were fabricated. A 0.8 mm-deep cavity was made in the center of each disc and filled with the following hCSCs (n=10): Original MTA (Angelus); MTA Repair HP (Angelus); NeoMTA Plus (Avalon); and Biodentine (Septodont). An initial color measurement was performed (T0 - baseline). After 7, 15, 30, 45, 90, 300 days, and two years, new color measurements were performed to determine the color (ΔE00), lightness (ΔL’), chroma (ΔC’), hue differences (ΔH’), and whiteness index (WID). Results: For enamel/dentin, the ΔE00 was significant among groups and periods (p<0.05). NeoMTA Plus had the greatest ΔE00. The NeoMTA Plus group had the greatest ΔE00 after two years for composite resin. Significant reduction in lightness was observed for all groups after two years (p<0.05). The most significant WID values were observed after 30 days for Biodentine (enamel/dentin) and MTA Repair HP groups (composite resin) (p<0.05). Conclusions: The hCSCs changed the colorimetric behavior of both substrates, leading to greater darkening over time. The Bi2O3 in the Original MTA seems relevant in the short periods of color change assessment

Additive Manufacturing Technologies for Fabrication of Biomaterials for Surgical Procedures in Dentistry: A Narrative Review

PURPOSE: To screen and critically appraise available literature regarding additive manufacturing technologies for bone graft material fabrication in dentistry. MATERIAL AND METHODS: PubMed and Scopus were searched up to May 2021. Studies reporting the additive manufacturing techniques to manufacture scaffolds for intraoral bone defect reconstruction were considered eligible. A narrative review was synthesized to discuss the techniques for bone graft material fabrication in dentistry and the biomaterials used. RESULTS: The databases search resulted in 933 articles. After removing duplicate articles (128 articles), the titles and abstracts of the remaining articles (805 articles) were evaluated. A total of 89 articles were included in this review. Reading these articles, 5 categories of additive manufacturing techniques were identified: material jetting, powder bed fusion, vat photopolymerization, binder jetting, and material extrusion. CONCLUSIONS: Additive manufacturing technologies for bone graft material fabrication in dentistry, especially 3D bioprinting approaches, have been successfully used to fabricate bone graft material with distinct compositions

Verblendungsfraktur - direkte und indirekte Reparaturmethoden.

Die Fraktur oder Abplatzung von Verblendkeramik bei metall- bzw. vollkeramischen Gerüsten ist eine der häufigsten klinischen Misserfolge in der Zahnmedizin. Da die Bruchsprödigkeit des Keramikmaterials leicht zu ästhetischen und funktionellen Problemen für den Patienten führen kann, ist schnelles klinisches Handeln erforderlich. Direkte und indirekte Reparaturen, welche die Funktion, die Ästhetik und den Tragekomfort von frakturierten, aber gut passenden und ästhetischen Rekonstruktionen wiederherstellen, sind indiziert. Der Beitrag stellt die verschiedenen Techniken der direkten und der indirekten Reparatur vor, diskutiert sowohl die Vor- als auch die Nachteile und weist darauf hin, wie wichtig die adhäsiven Verfahren für den Erfolg dieses restaurativen Vorgehens sind

Bioactive Materials for Direct and Indirect Restorations: Concepts and Applications

Currently, minimally invasive restorations could be made in dentistry applying adhesive materials and adhesion principles to the dental structures. Following this philosophy, endodontic interventions have been avoided largely, preserving hard tissues, and maintaining dental vitality. Advances in biologically favorable bioactive materials enabled clinicans to induce repair and regeneration of dental tissues. Such materials are primarily used for pulp protection and cementation of indirect restorations. This review highlights current bioactive materials available, principles of bioactivity and their mechanisms of action

Esthetic and functional rehabilitation of bilateral congenital absence of maxillary lateral incisors: Minimally invasive surgical and prosthetic approach

Congenital absence of maxillary lateral incisors is a frequent clinical challenge which must be solved by a multidisciplinary approach in order to obtain an esthetic and functional restorative treatment. Noninvasive treatments, that are in accordance with the patients' expectations, should be the first therapeutic alternative. If the deciduous tooth is present, minimally invasive dental extraction followed by immediate dental implant placement and provisional restoration is indicated. In this restorative treatment, an adequate emergency profile can be achieved by peri‐implant soft‐tissue‐conditioning techniques. Moreover, the association of restorative materials, such as composite resins and dental ceramics, provides more predictable esthetic results. Clinical Considerations The present case report presents a rehabilitation of bilateral congenital absence of maxillary lateral incisors through a multidisciplinary approach. Dental implants, long‐term provisional restoration, tooth bleaching, minimally veneered high‐translucent monolithic zirconia crowns, feldspathic veneers, and composite restorations were used by the dental team to achieve the expected functional and esthetic outcomes. Conclusions Different treatment modalities are available for the rehabilitation of congenital absence of teeth. However, it is important that a dental team consider performing minimally invasive treatments, as many of these treatments are done on young patients. Clinical Significance Patient‐centered treatments involving minimally invasive approaches in a multidisciplinary environment would be appropriate in order to achieve predictable results

Materials and Manufacturing Techniques for Polymeric and Ceramic Scaffolds Used in Implant Dentistry

Preventive and regenerative techniques have been suggested to minimize the aesthetic and functional effects caused by intraoral bone defects, enabling the installation of dental implants. Among them, porous three-dimensional structures (scaffolds) composed mainly of bioabsorbable ceramics, such as hydroxyapatite (HAp) and β-tricalcium phosphate (β-TCP) stand out for reducing the use of autogenous, homogeneous, and xenogenous bone grafts and their unwanted effects. In order to stimulate bone formation, biodegradable polymers such as cellulose, collagen, glycosaminoglycans, polylactic acid (PLA), polyvinyl alcohol (PVA), poly-ε-caprolactone (PCL), polyglycolic acid (PGA), polyhydroxylbutyrate (PHB), polypropylenofumarate (PPF), polylactic-co-glycolic acid (PLGA), and poly L-co-D, L lactic acid (PLDLA) have also been studied. More recently, hybrid scaffolds can combine the tunable macro/microporosity and osteoinductive properties of ceramic materials with the chemical/physical properties of biodegradable polymers. Various methods are suggested for the manufacture of scaffolds with adequate porosity, such as conventional and additive manufacturing techniques and, more recently, 3D and 4D printing. The purpose of this manuscript is to review features concerning biomaterials, scaffolds macro and microstructure, fabrication techniques, as well as the potential interaction of the scaffolds with the human body