The use of a single metal for all restorations would be necessary because it protects against metal corrosion caused by the contact of different metals. For this “one-metal rehabilitation” concept, non-alloyed commercially pure (CP) titanium should be used for all restorations. Titanium frameworks have been cast and used for the long term without catastrophic failure, whereas they have been fabricated recently using computer-aided design/computer-aided manufacturing (CAD/CAM). However, the milling process for the frameworks of removable partial dentures (RPDs) is not easy because they have very complicated shapes and consist of many components. Currently, the fabrication of RPD frameworks has been challenged by one-process molding using repeated laser sintering and high-speed milling. Laser welding has also been used typically for repairing and rebuilding titanium frameworks. Although laboratory and clinical problems still remain, the one-metal rehabilitation concept using CP titanium as a bioinert metal can be recommended for all restorations.

To develop dental restorative materials with “bio-active” functions, addition of the capability to release active agents is an effective approach. However, such functionality needs to be attained without compromising the basic properties of the restorative materials. We have developed novel non-biodegradable polymer particles for drug delivery, aimed for application in dental resins. The particles are made using 2-hydroxyethyl methacrylate (HEMA) and a cross-linking monomer trimethylolpropane trimethacrylate (TMPT), with a hydrophilic nature to adsorb proteins or water-soluble antimicrobials. The polyHEMA/TMPT particles work as a reservoir to release fibroblast growth factor-2 (FGF-2) or cetylpyridinium chloride (CPC) in an effective manner. Application of the polyHEMA/TMPT particles loaded with FGF-2 to adhesives, or those loaded with CPC to resin-based endodontic sealers or denture bases/crowns is a promising approach to increase the success of the treatments by conferring “bio-active” properties to these materials to induce tissue regeneration or to inhibit bacterial infection.

To add biocompatibility or biofunction to metal surface, an intelligent interface between metals and tissues must be acquired. Tremendous surface modification techniques are currently studied to create the intelligent interface. In particular, bone formation or bone bonding is major purpose of the surface modifications. Time transient of surface modification techniques are summarized and the importance of roughened or porous surface to combine materials with bone tissue is demonstrated. As an example of surface modification, electrodeposition of poly(ethylene glycol) to inhibit biofilm formation is introduced. A dual-functional surface is formed on titanium by micro arc oxidation. In addition, the effect of topography on the elongation and differentiation of human mesenchymal stem cells was confirmed on the hybrid micrometer-level and nanometer-level grooves of titanium surface. Metal surface is possibly biofunctionalized by various surface modification techniques.

Silane is a dominant coupler that is widely used in dentistry to promote adhesion among the components of dental composites. Silica-based fillers can be easily silanized because of their similarly ordered structure. However, silane is hydrolytically degraded in the aqueous oral environment and inefficiently bonds to non-silica fillers. Thus, the development of hydrolytically stable dental composites is an important objective in the research on dental materials. Titanate coupling agents (TCAs) exhibit satisfactory interfacial bonding, enhanced homogeneous filler dispersion, and improved mechanical properties of the composites. Titanates also provide superior hydrolytic stability in wet environments, which should be considered in fabricating dental composites. The addition of a small amount of titanates can improve the resistance of the composites to moisture. This paper reviews the effects of the instability of silanes in moisture on the performance of dental composites and presents TCAs as alternative couplers to silanes for fabricating dental composites.

The aim of this study was to evaluate the influence of infiltrating 3D printed (TCP) scaffolds with different biodegradable polymers on their mechanical and biological properties. 3D printed TCP scaffolds with interconnecting channels measuring 450±50 µm were infiltrated with four different biodegradable copolymers. To determine the average compressive strength, a uniaxial testing system was used. Additionally, scaffolds were seeded with MC3T3 cells and cell viability was assessed by live/dead-assay. Uninfiltrated TCP had an average compression strength of 1.92±0.38 MPa. Mechanical stability was considerably increased in all infiltrated scaffolds up to a maximum of 7.36±0.57 MPa. All scaffolds demonstrated high cell survival rates with a maximum of 94±10 % living cells. In conclusion, infiltration of 3D printed tricalcium phosphate scaffolds with biodegradable polymers significantly improved mechanical properties and biological properties were comparable to those of uninfiltrated TCP scaffolds.

The aim of the study was to evaluate the effect of modifying polymethyl methacrylate (PMMA) denture base material with polyimide (PI) on its flexural property and biocompatibility. Low molecular weight (1,500 g/mol) PI was synthesized and small amount of PI (0.4, 0.6, 0.8 and 1 wt%) was dispersed into the PMMA matrix. Three-point bending tests, scanning electron microscopy and thermal cycling were used to measure the mechanical properties, while MTT assay was used to evaluate the biocompatibility of the denture base material. The results showed that 0.6% addition of PI significantly increased flexural strength of PMMA denture base material by 13.5%, compared with the control group (p<0.05). Even after 5,000 hydrothermal cycling the reinforce effect still existed. However, when the PI content further increased, flexural strength of the denture base material decreased due to particle agglomeration. The MTT assay confirmed that the addition of PI did not change the biocompatibility of the PMMA denture base material. The present study suggested that blending polyimide in the proper proportion can be a potential method to strengthen the PMMA-based denture base material.

The aim of this study was to evaluate the intrapulpal temperature changes during the curing of different bulk-fill restorative materials. Ten mandibular molar teeth were selected and occlusal surfaces were removed to obtain a standard 0.5 mm occlusal dentin thickness. Five bulk-fill restorative materials and a conventional resin composite (control) were applied. The intrapulpal temperature changes during the curing of these materials were determined by a device simulating pulpal blood microcirculation. The difference between the initial and maximum temperature values (Δt), was recorded. The data were statistically analyzed with one-way ANOVA and Tukey’s HSD test (p<0.05). There were statistically significant differences between materials (p<0.001). The light-curing bulkfill restoratives exhibited the highest Δt values. Equia Forte showed the lowest Δt values among all the groups (p<0.05). Bulk-fill restorative materials causes significantly different temperature changes in the pulp chamber according to curing type. Therefore, clinicians should be considered when using these materials.

Three-dimensional collagen scaffolds coated with beta-tricalcium phosphate (β-TCP) nanoparticles reportedly exhibit good bioactivity and biodegradability. Dose effects of β-TCP nanoparticles on biocompatibility and bone forming ability were then examined. Collagen scaffold was applied with 1, 5, 10, and 25 wt% β-TCP nanoparticle dispersion and designated TCP1, TCP5, TCP10, and TCP25, respectively. Compressive strength, calcium ion release and enzyme resistance of scaffolds with β-TCP nanoparticles applied increased with β-TCP dose. TCP5 showed excellent cell-ingrowth behavior in rat subcutaneous tissue. When TCP10 was applied, osteoblastic cell proliferation and rat cranial bone augmentation were greater than for any other scaffold. The bone area of TCP10 was 7.7-fold greater than that of non-treated scaffold. In contrast, TCP25 consistently exhibited adverse biological effects. These results suggest that the application dose of β-TCP nanoparticles affects the scaffold bioproperties; consequently, the bone conductive ability of TCP10 was remarkable.

Aim of this study was to investigate the effect of long-time immersion of soft denture liners in 37°C water on viscoelastic properties. Six silicone-based and two acrylic resin-based soft denture liners were selected. Cylindrical specimens were stored in distilled water at 37°C for 6 months. Viscoelastic properties, which were instantaneous and delayed elastic displacements, viscous flow, and residual displacement, were determined using a creep meter, and analyzed with 2-way analysis of variance and Tukey’s comparison (α=0.05). Viscoelastic properties and their time-dependent changes were varied among materials examined. The observed viscoelastic properties of three from six silicone-based liners did not significantly change after 6-month immersion, but those of two acrylic resin-based liners significantly changed with the increase of immersion time. However, the sum of initial instantaneous elastic displacement and delayed elastic displacement of two acrylic resin-based liners during 6-month immersion changed less than 10%, which might indicate clinically sufficient elastic performance.

The authors have developed a β-tricalcium-phosphate (β-TCP) powder modified mechano-chemically through the application of a ball-milling process (mβ-TCP). The resulting powder can be used in a calcium-phosphate-cement (CPC). In this study, the effects of the powder-to-liquid ratio (P/L ratio) on the properties of the CPCs were investigated, and an appropriate P/L ratio that would simultaneously improve injectability and strength was clarified. The mβ-TCP cement mixed at a P/L ratio of 2.5 and set in air exhibited sufficient injectability until 20 min after mixing, and strength similar to or higher than that mixed at a P/L ratio of 2.0 and 2.78. Although the mβ-TCP cements set in vivo and in SBF were found to exhibit a lower strength than those set in air, it did have an appropriate setting time and strength for clinical applications. In conclusion, P/L ratio optimization successfully improved the strength of injectable mβ-TCP cement.

Resin bonding to zirconia ceramics is difficult to achieve using the standard methods for conventional silica-based dental ceramics, which employ silane coupling monomers as primers. The hypothesis in this study was that a silane coupling oligomer —a condensed product of silane coupling monomers— would be a more suitable primer for zirconia. To prove this hypothesis, the shear bond strengths between a composite resin and zirconia were compared after applying either a silane coupling monomer or oligomer. The shear bond strength increased after applying a non-activated ethanol solution of the silane coupling oligomer compared with that achieved when applying the monomer. Thermal treatment of the zirconia at 110°C after application of the silane coupling agents was essential to improve the shear bond strength between the composite resin cement and zirconia.

The aim of this investigation was to compare the cleaning and shaping efficiency of Self-adjusting file and Protaper, and to assess the correlation between root canal curvature and working time in mandibular molars using micro-computed tomography. Twenty extracted mandibular molars instrumented with Protaper and Self-adjusting file and the total working time was measured in mesial canals. The changes in canal volume, surface area and structure model index, transportation, uninstrumented area and the correlation between working-time and the curvature were analyzed. Although no statistically significant difference was observed between two systems in distal canals (p>0.05), a significantly higher amount of removed dentin volume and lower uninstrumented area were provided by Protaper in mesial canals (p<0.0001). A correlation between working-time and the canal-curvature was also observed in mesial canals for both groups (SAFr² =0.792, p<0.0004, PTUr²=0.9098, p<0.0001)

The purpose of this study was to evaluate the flexural properties and surface topography of fiber posts surface-treated with various etching protocols. Seventy each of three types of fiber posts: RelyX Fiber Post, Tenax Fiber Trans, and D.T. Light-Post Illusion X-Ro, were randomly divided into 7 groups: no surface treatment, surface treated with hydrofluoric acid (HF) 4.5% for 60 s, HF 4.5% for 120 s, HF 9.6% for 15 s, HF 9.6% for 60 s, HF 9.6% for 120 s, and treated with H₂O₂ 24% for 10 min. The specimens were then subjected to a three-point bending test. Surface topographies of the posts were observed using a SEM. The results indicate that fiber post surface pretreatments had no adverse effects on the flexural properties. However, the fiber posts treated with high HF concentrations or long etching times seemed to have more surface irregularities.

This study assessed the effect of bur or Er:YAG laser preparation on marginal and internal adaptation of conventional and extended fissure sealing (FS) with a 3-component etch-and-rinse (Optibond FL; OFL) and a 1-component self-etch (Scotchbond Universal; SB) adhesive system. Scanning electron microscope analysis was performed before and after thermocycling/occlusal load and additional optical coherence tomography evaluation was carried out for internal marginal assessment. Significant differences were observed between the groups (ANOVA, p<0.05). Laser-prepared and non-etched FS suffered from marginal degradation after fatigue. When enamel was etched with H₃PO₄ and independently of the adhesive system, laser technique was equally effective to bur-preparation with percentages of continuous margins ranging from 96 to 99%, being laser less invasive than bur preparation. This is clinically relevant in paediatric dentistry as minimally invasive FS can be performed with laser and adhesive systems used as fissure sealants. Nevertheless, enamel etch with phosphoric acid is still necessary.

The aim of this study was to determine the effects of calcium hydroxide (Ca(OH)₂) treatment on bond strength of resin cements to root dentin and retention force of fiber-reinforced composite (FRC) posts. Bovine root dentin was endodontically prepared and treated with Ca(OH)₂ for 7 days. Root dentin for bond strength test was adhered to resin-composite with resin cements. For pull-out test, posts consisting of FRC posts and resin-composites were fabricated and cemented to root. Shear bond and pull-out tests were performed using a universal testing machine. No significant differences in bond strength and post retention force were found between Ca(OH)₂ treated and untreated groups. Significant differences were found among the cements. A positive correlation was indicated between bond strength of cements and retention force of FRC posts. In conclusion, Ca(OH)₂ treatment on root dentin did not affect bond strength of resin cements and retention force of FRC posts.

Released (co)monomers from dental composite components can induce DNA damage of which DNA double-strand breaks (DSBs) threaten genome integrity. Here, we tested whether the administration of the antioxidant N-acetylcysteine (NAC) is able to reduce the dental composite-induced DSBs in primary human gingiva fibroblasts. The dental composites Bis-GMA (bisphenol-A-glycerolate dimethacrylate), GMA (glycidyl methacrylate), HEMA (2-hydroxyethyl methacrylate) and TEGDMA (triethyleneglycol dimethacrylate) were found to induce co-localizing microscopic nuclear foci numbers of the DSB markers γ-H2AX and 53BP1 per cell in the order: GMA>Bis-GMA>TEGDMA>HEMA. Supplementation of (co)monomer-containing culture medium with NAC led to a significant reduction of resin-induced DSBs as well as to an amelioration of dental monomer-induced nuclear chromatin condensation in gingival fibroblasts. Thus, antioxidant treatment can reduce radical-induced chromatin and DNA damage and open avenues to mitigate genotoxic effects of dental composite compounds.

The aim of this study was to evaluate the stability of implant/interconnected porous calcium hydroxyapatite complex (implant/IPCHA-complex) under functional loading. Implant/IP-CHA-complexes were placed into the mandibles of four Beagle-Labrador hybrid dogs (complex-group). On the other side, an implant was placed directly (control-group). To subject the loading, the animals were fed a hard diet throughout the loading phase of 5 months. The implant stability quotients (ISQs) and bone implant contact (BIC), and histological evaluations were performed. The ISQs of implant/IP-CHA-complex was significantly lower at placement than that of the control-implant. On the other hand, there was no significant difference between in the groups during loading. The BIC measurements, there was no significantly difference between in both groups. Histologically, newly formed bone was observed in contact with most of the implant surface in the complex-group. An IP-CHA/implant-complex would be able to achieve both bone reconstruction and implant stability under functional loading conditions.

The objective of this study was to compare the retention and caries-preventive effect of glass ionomer (Fuji Triage) and resin-based (Clinpro) sealants among 6–9-year-old children. This split-mouth, randomized clinical trial covered 35 children/140 fully erupted permanent first molars. Evaluation was conducted by two independent examiners after 6, 12, and 18 months and the data were compared in relation to the children’s caries risk and age groups. The Kaplan-Meier survival method and chi-square test were used for analysis. There were no statistically significant differences in the survival of partial and fully retained sealants or in the survival of caries-free pits and fissures between glass-ionomer and resin-based sealants. In terms of retention, both sealants performed better in the younger age group at the end of the study, and showed better caries prevention in moderate caries risk children. After 18 months, both sealants had comparable retention and caries-preventive effects in 6–9-year old children.

Antimicrobial cetylpyridinium chloride (CPC) has low miscibility with acrylic resin monomer but can be homogeneously mixed using ethanol as a cosolvent. This study investigated the effects of ethanol addition on the properties of a cold-cure acrylic resin. Ethanol was an excellent cosolvent for CPC and methyl methacrylate monomer (MMA), but the cured resin exhibited a strong change in coloration to yellow (ΔE*_ab>8) and a drastically reduced bending strength (from 97 to 25 MPa) and elastic modulus (from 2.7 to 0.6 GPa) when equal volumes of ethanol and monomer were used together, possibly due to the solvation and deactivation of radicals by ethanol. However, these unfavorable effects diminished when the ethanol/MMA ratio was reduced to 0.25, and became smaller when each specimen was depressurized and excess ethanol was removed. Thus, it may be possible to develop a molecularly uniform antibacterial acrylic resin with acceptable color and strength using this simple technique.

Orthodontic treatments increase the incidence of white spot lesions. The objectives of this study were to develop an antibacterial orthodontic cement to inhibit demineralization, and to evaluate its enamel shear bond strength and anti-biofilm properties. Novel antibacterial monomer dimethylaminohexadecyl methacrylate (DMAHDM) was synthesized and incorporated into Transbond XT at 0, 1.5 and 3% by mass. Anti-biofilm activity was assessed using a human dental plaque microcosm biofilm model. Shear bond strength and adhesive remnant index were also tested. Biofilm activity precipitously dropped when contacting orthodontic cement with DMAHDM. Orthodontic cement containing 3% DMAHDM significantly reduced biofilm metabolic activity and lactic acid production (p<0.05), and decreased biofilm colony-forming unit (CFU) by two log. Water-aging for 90 days had no adverse influence on enamel shear bond strength (p>0.1). By incorporating DMAHDM into Transbond XT for the first time, the modified orthodontic cement obtained a strong antibacterial capability without compromising the enamel bond strength.

To fabricate a sustained-release delivery system of bone morphogenetic protein (BMP-2) on titanium surface, explore the effect of BMP-2 concentration on the loading/release behavior of BMP-2 and evaluate the cell compatibility of the system in vitro, pure titanium specimens were immersed into supersaturated calcium phosphate solutions (SCP) containing 4 different concentrations of BMP-2: 0, 50, 100, 200 and 400 ng/mL. Biomimetic calcium phosphate coating was formed on titanium surface and BMP-2 was incorporated into the coating through co-deposition. The release profile of BMP-2 suggested that BMP-2 were delivered sustainably up to 20 days. CCK-8 and ALP assay showed that 200 group and 400 ng/mL BMP-2 group have significant effect on promoting MC3T3-E1 cell proliferation and differentiation. The BMP-2 incorporated into the hybrid coating released in a sustained manner and significantly promoted the proliferation and differentiation of MC3T3-E1 on the titanium surface.