3D Printing of Teeth from X-Ray Microtomography for the Purpose of Research and Training

Within dental education, there is a distinct need for hands-on pre-clinical training before a patient’s treatment is carried out for the first time. A combination of extracted teeth and artificial teeth (typodonts) are widely used. However, the availability of extracted teeth is low, and there is a dissatisfaction amongst undergraduate dental students that these artificial teeth do not look and feel like extracted teeth. This project aimed to produce an artificial tooth that looks and feels like an extracted tooth, utilising images collected from X-ray microtomography (XMT) and manufacturing techniques of three-dimensional (3D) printing. As well as to establish differences between extracted and artificial teeth from a haptic point of view. Extracted human teeth were imaged using high-contrast XMT. A method was developed to convert reconstructed XMT images into a 3D printing file format (STL). A technique was also developed to measure the forces imposed on the tooth from a dental handpiece, with forces being measured during the cutting process. Models were 3D printed to high accuracy from the original reconstructed XMT images. From the simulated ‘haptic’ feedback experiment, it was shown that commercially available artificial teeth required more force to cut compared to extracted teeth. The composites that were designed and printed closely resembled this force needed to cut, compared to artificial teeth. These teeth were provided to qualified dentists and undergraduate dental students. Feedback from them showed a promising basis for future development. To conclude, this project has investigated the consensus that dental students are unhappy with current commercially available teeth and has developed a force measuring technique to quantify this difficulty in cutting. Through material development, materials that required a similar cutting force were produced. This project provides the basis for future development in producing more accurate dental simulants for teaching and training

Composite 3D printing of biomimetic human teeth

Human teeth are mechanically robust through a complex structural composite organisation of materials and morphology. Efforts to replicate mechanical function in artificial teeth (typodont teeth), such as in dental training applications, attempt to replicate the structure and morphology of real teeth but lack tactile similarities during mechanical cutting of the teeth. In this study, biomimetic typodont teeth, with morphology derived from X-ray microtomography scans of extracted teeth, were 3D printed using an approach to develop novel composites. These composites with a range of glass, hydroxyapatite and porcelain reinforcements within a methacrylate-based photopolymer resin were compared to six commercial artificial typodont teeth. Mechanical performance of the extracted human teeth and 3D printed typodont teeth were evaluated using a haptic approach of measuring applied cutting forces. Results indicate 3D printed typodont teeth replicating enamel and dentine can be mechanically comparable to extracted human teeth despite the material compositions differing from the materials found in human teeth. A multiple parameter variable of material elastic modulus and hardness is shown to describe the haptic response when cutting through both human and biomimetic, highlighting a critical dependence between the ratio of material mechanical properties and not absolute material properties in determining tooth mechanical performance under the action of cutting forces

Approaches to 3D printing teeth from X-ray microtomography.

Artificial teeth have several advantages in preclinical training. The aim of this study is to three-dimensionally (3D) print accurate artificial teeth using scans from X-ray microtomography (XMT). Extracted and artificial teeth were imaged at 90 kV and 40 kV, respectively, to create detailed high contrast scans. The dataset was visualised to produce internal and external meshes subsequently exported to 3D modelling software for modification before finally sending to a slicing program for printing. After appropriate parameter setting, the printer deposited material in specific locations layer by layer, to create a 3D physical model. Scans were manipulated to ensure a clean model was imported into the slicing software, where layer height replicated the high spatial resolution that was observed in the XMT scans. The model was then printed in two different materials (polylactic acid and thermoplastic elastomer). A multimaterial print was created to show the different physical characteristics between enamel and dentine

Herbal medicine as an auspicious therapeutic approach for the eradication of Helicobacter pylori infection: A concise review

Helicobacter pylori (H. pylori) causes gastric mucosa inflammation and gastric cancer mostly via several virulence factors. Induction of proinflammatory pathways plays a crucial role in chronic inflammation, gastric carcinoma, and H. pylori pathogenesis. Herbal medicines (HMs) are nontoxic, inexpensive, and mostly anti-inflammatory reminding meticulous emphasis on the elimination of H. pylori and gastric cancer. Several HM has exerted paramount anti-H. pylori traits. In addition, they exert anti-inflammatory effects through several cellular circuits such as inhibition of 5'-adenosine monophosphate-activated protein kinase, nuclear factor-κB, and activator protein-1 pathway activation leading to the inhibition of proinflammatory cytokines (interleukin 1α [IL-1α], IL-1β, IL-6, IL-8, IL-12, interferon γ, and tumor necrosis factor-α) expression. Furthermore, they inhibit nitrous oxide release and COX-2 and iNOS activity. The apoptosis induction in Th1 and Th17-polarized lymphocytes and M2-macrophagic polarization and STAT6 activation has also been exhibited. Thus, their exact consumable amount has not been revealed, and clinical trials are needed to achieve optimal concentration and their pharmacokinetics. In the aspect of bioavailability, solubility, absorption, and metabolism of herbal compounds, nanocarriers such as poly lactideco-glycolide-based loading and related formulations are helpful. Noticeably, combined therapies accompanied by probiotics can also be examined for better clearance of gastric mucosa. In addition, downregulation of inflammatory microRNAs (miRNAs) by HMs and upregulation of those anti-inflammatory miRNAs is proposed to protect the gastric mucosa. Thus there is anticipation that in near future HM-based formulations and proper delivery systems are possibly applicable against gastric cancer or other ailments because of H. pylori

L2 Bone Quality in Osteoporosis: Biomed 1 Revisited.

publicationstatus: acceptedL2 Bone Quality in Osteoporosis: Biomed 1 Revisited. A.J. Cresswell-Boyes, D. Mills, G.R. Davis, A. Boyde Dental Physical Sciences, Oral BioEngineering, Bart’s and The London School of Medicine and Dentistry, Queen Mary University of London, Mile End campus, London E1 4NS, UK A Boyde, [email protected] As a part of the European Union BIOMED I study “Assessment of Bone Quality in Osteoporosis,” Sixty-nine second lumbar vertebral body specimens (L2) were obtained post mortem from 32 women and 37 men (age 24–92 years). Our initial remit was to study variations in density of the calcified tissues by quantitative backscattered electron imaging (BSE-SEM). To this end, the para-sagittal bone slices were embedded in PMMA and block surfaces micro-milled and carbon coated. Many samples were re-polished to remove the carbon coat and stained with iodine vapour to permit simultaneous BSE imaging of non-mineralised tissues - especially disc, annulus, cartilage and ligament - uncoated, at 50Pa chamber pressure. We have now studied most of these samples by 30-μm resolution high contrast resolution X-ray microtomography (XMT), typically 72 hours scanning time, thus giving exact correlation between high resolution BSE-SEM and XMT. The 3D XMT data sets were rendered using Drishti software to produce static and movie images for visualisation and edification. We have now selected a set of the female samples for reconstruction by 3D printing, taking as examples the youngest, post-menopausal, oldest, best, worst, and anterior and central compression fractures and anterior collapse with fusion to L3 - which will be attached to the poster display. The most porotic cases were also the most difficult to reconstruct. A surprising proportion of elderly samples showed excellent bone architecture, though with retention of fewer, but more massive, load-bearing trabeculae. Accepted for poster and oral presentation, EORS 26th Annual meeting, Galway 26-28th Sept 201

An assessment of mineral concentration of dental enamel neighbouring hypothetical orthodontic brackets using X-ray microtomography.

OBJECTIVES: Differences in the mineral concentration (MC) level of dental enamel may represent a precursor of white spot lesions adjacent to fixed orthodontic brackets. The aim of the current in vitro study was to compare the MC level central, occlusal and cervical to orthodontic attachments. METHODS AND MATERIALS: A total of 16 enamel blocks were obtained from sound human premolar samples extracted for orthodontic reasons. The buccal portion of the dental enamel blocks was divided into central, occlusal, and cervical regions and then imaged and measured to calculate the level of MC using quantitative X-ray microtomography methods (XMT) at each site. RESULTS: There was a substantial variation in the mineral concentration with the lowest level being detected in the cervical region when compared with other regions. The MC of the gingival zone was significantly lower than that of the middle zone (P<0.05) and was insignificantly lower than that of the occlusal zone. CONCLUSION: Within the limitations of the current study, it can be concluded that the cervical region of the permanent enamel had the lowest mineral concentration using XMT. The cervical region may therefore be more vulnerable to the development of white spot lesions (WSLs) adjacent to a fixed orthodontic appliance during orthodontic treatment. CLINICAL SIGNIFICANCE: Using X-ray microtomography lower mineral concentration in the cervical region of the enamel was observed. This may make these areas particularly susceptible to demineralisation during fixed appliance-based orthodontic treatment and may influence the bond strength of fixed orthodontic attachments