The use of monolithic [yttria (Y2O3)-stabilized tetragonal zirconia (ZrO2) polycrystalline] (Y-TZP) ceramics to restore teeth is expanding in dentistry. However, there are still some problems about color matching and the translucency of these ceramics. The employment of Y-TZP ceramics in aesthetically critical regions is questionable due to the insufficient translucency and opacity of the restorations. The objective of this review was to assess the factors affecting the translucency of monolithic Y-TZP ceramics for a better understanding the relevant parameters in restorations. The translucency of polycrystalline ceramics is a complex phenomenon. Apprehending the translucency regarding ceramics requires their knowledge of physical, chemical and microstructural characteristics with the light interactions among them.
The demand for titanium and titanium alloys in dentistry is high. A surveillance survey regarding the clinical and laboratory uses of titanium/titanium alloys in Japan was conducted in this study. The alloys used for casting demonstrated a decreasing tendency in quantity, whereas the use of non-casting titanium alloys increase in the market. This increasing trend is reflected the popularity of CAD/CAM devices. In Japan, the processing technologies of titanium alloys have been improved; therefore, the application of titanium and titanium alloys to dental procedures covered by the insurance is clearly worth considering.
This review describes low temperature degradation (LTD), discoloration, and erosion of high translucent dental zirconia and discusses its chemical durability in comparison with other CAD/CAM materials. The LTD of zirconia strongly depended on the firing temperature, yttria content, surface treatment, and heat treatment. Glass ceramics for CAD/CAM were remarkably etched in a lactic acid at 60°C, KOH solution at 60°C, and saline solution at 90°C, whereas zirconia showed no changes in these solutions. Glass ceramics and hybrid resins for CAD/CAM showed significant discoloration in a red wine and rhodamine B solution at 37°C, whereas zirconia showed no discolorations in either solution. It was concluded that high translucent dental zirconia has the highest chemical durability among dental CAD/CAM materials.
This review scientifically compares the properties of zirconia and titanium, but does not identify the best among them as an implant material. Surface treatment and modification to improve tissue bonding and inhibit bacterial adhesion are not considered in this review. The mechanical properties of titanium are superior to those of zirconia; some studies have shown that zirconia can be used as a dental implant, especially as an abutment. Extensive surface treatment research is ongoing to inhibit bacterial adhesion and improve osseointegration and soft tissue adhesion phenomena which make it difficult to evaluate properties of the materials themselves without surface treatment. Osseointegration of titanium is superior to that of zirconia itself without surface treatment; after surface treatment, both materials show comparable osseointegration. The surface morphology is more important for osseointegration than the surface composition. To inhibit bacterial adhesion, zirconia is superior to titanium, and hence, more suitable for abutments. Both materials show similar capability for soft tissue adhesion.
Zirconia have been applied to dental implants as well as fixed dental prostheses due to their mechanical, esthetic and biocompatible performance. Moreover, they offer an advantage over titanium (Ti) implants, in that there is no risk of discoloration or hypersensitive reaction with allergy. In this review, the durability and tissue-compatibility of zirconia for the oral implants was mainly discussed. Hot isostatic pressing of Y-TZP had higher cyclic fatigue strength than Cp-Ti (Grade-2), leading the sufficient durability. Tissue-compatibility of zirconia; 1) Blast and acid-etching was effective for bone formation with synergetic effect of micro- and nano-topography. 2) Super-hydrophilic treatment, cold plasma in particular, enhanced initial attachment of osteoblast-like cells and oral keratinocytes. 3) Adherence of the periodontopathic bacteria on zirconia was similar to that on Cp-Ti, leading the necessity of surface modification.
The rationale leading to the present generation of resin composites is surveyed. There are many sub-classes such as flowable materials with specialized clinical indications. But a simplistic categorization of resin-composite materials is inappropriate. It is better to appreciate the factors that have driven recent developments. These include the search for low shrinkage composites and for greater depth of cure. Other necessary features are good handling behavior and sufficient strength for load-bearing situations. The esthetic challenge is for materials with superior and life-like optical properties and it is important to identify products that are good in every critical property. Nanotechnology has led to certain improvements, but the possibilities and limitations of nanoparticles must be appreciated. In all these developments, the structure and properties of the host tissues are a challenge and inspiration. Thus materials that can emulate the features of enamel and dentin are the goal of biomimetic design.
An optical-impression by an intraoral scanner (IOS) involves optically measuring the surface shape of the target teeth or gums directly in the patient’s mouth. IOSs have many advantages, such as reduce patients pain and discomfort, the operator’s burden and the risk on infection, real-time impression scanning and visualization, simple replication and selective scanning, reduction of cost and waste of materials and detection of dental caries and crack . IOSs have become one of the most valuable dental-treatment devices for patients, dentists, dental technicians, and dental hygienists. The IOS accuracy matches or supersedes the accuracy of the conventional-impression and indirect method with working models. IOS is clinically applicable in restoration up to four units. IOS’s high reproducibility, information-processing ability, multimedia capability, and simplicity and speed in communication can apply to group examination and identification of disaster victims or dementia patients.
Optical technology has provided a paradigm shift in implant dentistry. However, there is little information about the use of optical technology in implant dentistry, since this technology is relatively new and has been evolving under the current conditions. In the present narrative literature review, the effects of intraoral scanners (IOSs) use on accuracy and the operating time, as well as safety and patient perception, in implant dentistry were evaluated from the clinical perspective. The accuracy of digital scans with IOSs was comparable to the conventional impression techniques for single or partial prostheses, and the digital scans with IOSs are time efficient when taking impressions for single- or double-abutments. However, the accuracy and time efficiency are decreased for multiple implant scans or large-area scans with IOSs use. Patient satisfaction with and preference for IOSs scans are generally superior to those with conventional impression procedures.
Protecting resin-dentin interfaces from hydrolytic and enzymatic degradation is critical for the longevity of adhesive restorations. In recent years, several strategies have been tested in vitro to induce apatite precipitation within interfibrillar and intrafibrillar collagen spaces, as well as in resin-sparse regions where the adhesive infiltration was incomplete. Also, the presence of calcium ions and other metallic ions has shown an inhibitory effect on enzymatic activity. Ion-releasing particles and biomimetic analogs have been studied for hybrid layer remineralization. Overall, remineralization strategy is dependent on the remaining mineral content. In partially demineralized dentin, residual apatite crystallites serve as nucleation sites for calcium and phosphate ions precipitation and crystal growth (“top-down” remineralization). In completely demineralized dentin where crystallites are absent (e.g., acid etched dentin) the use of mineral nano-precursors assisted by non-collagenous proteins analogs are necessary (“bottom-up” remineralization). This article reviews the approaches for hybrid layer remineralization and resin-dentin interface preservation.
Advancements in materials used for restorative and preventive treatment is being directed toward “bio-active” functionality. Incorporation of filler particles that release active components is a popular method to create bio-active materials, and many approaches are available to develop fillers with the ability to release components that provide “bio-protective” or “bio-promoting” properties; e.g. metal/calcium phosphate nanoparticles, multiple ion-releasing glass fillers, and non-biodegradable polymer particles. In this review paper, recent developments in cutting-edge filler technologies to release bio-active components are addressed and summarized according to their usefulness and functions, including control of bacterial infection, tooth strengthening, and promotion of tissue regeneration.
The purpose of this study was to investigate the influence of cellulose nanofibers (CNF) solution on the mechanical and biological properties of denture base resins (DBR). Two types of CNFs obtained from bamboo (BB) and needle-leaved (NB) trees were used in this study. We prepared 18 different CNF solutions based on their fibrillation (A-low, B-middle, and C-high) and concentration (0.05, 0.10, and 0.20 wt%). A heat-polymerized acrylic resin was used as DBR. The contact angles for each specimen were measured after immersion. The flexural properties of the immersed specimens, and the biological properties of the CNF solutions were examined. Specimens immersed in CNF-NB-C-0.05 wt% solution presented with the lowest contact angles. Specimens in CNF-NB-C and CNF-BB-A groups showed higher flexural modulus values. No cytotoxic or antimicrobial effects were observed for the CNF solutions. This study suggest that CNF solution may improve the surface wettability of the DBR without affecting its flexural property.
The purpose of this study was to investigate the influence of retainers and major connector designs on the stabilization of remaining mobile teeth using removable partial dentures (RPDs). We prepared experimental RPDs with several retainer designs and major connectors for lower Kennedy class I models. The simulated RPD insertion and removal test was conducted and retentive force and mobility of mobile remaining teeth with and without RPD placement were measured throughout a simulation test. Regardless of reduction of retentive force, the placement of RPDs using cast clasps and/or lingual plates resulted in reduced mobility of the remaining teeth than use of wrought wire clasps and/or lingual bars. The results suggested that cast clasps and lingual plates are effective for the stabilization of mobile, remaining teeth. Additionally, the stabilizing effect of RPD on abutment teeth was not diminished, despite decreases in retentive force.
The aim of this study was to evaluate the cytotoxicity of contemporary flowable and paste-like bulk-fill dental composites by using a real-time cell analysis. In the present paper, cytotoxicity levels of five flowable, five paste-like bulk-fill composite materials and one conventional flowable, one conventional paste-like resin composite were examined on L929 mouse fibroblast cell line. After seeding 25,000 cells/300 μL/well cell suspensions into the wells of an E-plate, test materials were added and observed at every 30 min intervals for 72 h. Kruskal Wallis H and Mann Whitney U multiple comparison tests were used to analyze the results. Pre-reacted glass-ionomer (PRG) containing bulk-fill composites were severely toxic at all time points (24, 48 and 72 h, p<0.05). None of the tested composites demonstrated high cell viability (>70%) at 48 and 72 h. Flowable and paste-like composites of the same brand exhibited similar cytotoxic properties (p>0.05).
This study evaluated roughness parameters and phase transformation of monolithic zirconia ceramics after various mechanical and laser thermal treatments. Fully sintered monolithic zirconia cylinder specimens were divided to five groups, according to the applied surface treatment: CL: control, GB: grit-blasted with glass particles. AL50: grit-blasted with 50 μm alumina particles, AL90: grit-blasted with 90 μm dyed-alumina particles and FEML: subjected to femto laser thermal treatment. Six roughness parameters (Sa, Sq, Sz, Sci, Svi and Sdr) were measured by optical profilometry. Phase transformation in zirconia was determined by micro-Raman spectroscopy. The highest roughness values were recorded in AL90 and FEML groups, followed by AL50. AL90 presented statistically higher monoclinic phase content compared to all other groups. Control and GB groups presented similar roughness without phase transformation. Laser thermal treatment causes minimal destruction of the zirconia surface, and can be suggested as an alternative to other roughening treratments, for enhancing the adhesive potential to dentin.
To explore the effects of infiltration resin, casein phosphate polypeptide-amorphous calcium phosphate (CPP-ACP) and fluoride on microhardness and micromorphology of irradiated enamel. Sixty human permanent teeth were mesiodistally sectioned, yielding 120 enamel samples, which randomly divided into 8 groups: G1: blank control; G2: irradiation control; G3: irradiation+fluoride; G4: irradiation+CPP-ACP; G5: irradiation+CPP-ACP+fluoride; G6: irradiation+infiltration resin; G7: irradiation+infiltration resin+fluoride; G8: irradiation+infiltration resin+CPP-ACP. A progressive improvement was observed on the superficial morphology of enamel treated with different anti-caries procedures. The order of microhardness values after irradiation from the highest to the lowest was as follows: G1>G8~G7>G6>G5>G4~G3>G2. CPP-ACP, infiltration resin and fluoride can effectively restore the direct destruction of enamel caused by irradiation and promote the occurrence of remineralization. Infiltration resin and its combined effects with fluoride or CPP-ACP have the most potential anti-caries agent to resist radiation-caries.
The purpose of the study was to test new method for in vitro evaluation of dental material wear with 3D digitization procedure. Thirty dental crowns, made of polyetheretherketone and veneered with composite material, were subjected to wear test. The crown surface was digitized using coordinate measuring machine before and after the performed wear test. Mesh 3D models were reconstructed and average and maximum depth of lost material and volume loss was calculated (GOM Inspect 2016 software). Mean average depth value amounted 12±7 µm, maximum depth value was 42 µm, while mean volume loss was 0.0024 mm3. The smallest measured values were 4 µm for depth value and 0.0003 mm3 for volume loss. Coefficient of variation was very high for all tested parameters (>50%) as a result of data inconsistency. Within the limitations of applied methodology, the possibility of using coordinate measuring machine in measurement of dental material wear was confirmed.
The aim of the present study was to evaluate the effects of build conditions and angle acuteness on edge reproducibility of the casting patterns fabricated using a digital light process. The prism-shaped patterns with various vertex angles were fabricated in three build orientations. The height from the base to the vertex angle point of the fabricated pattern was measured and the incomplete height was calculated as the discrepancy between the original and measured heights. Two-way ANOVA revealed that the vertex angle and build orientation and their interaction were significant (p<0.05). The incomplete height significantly decreased with an increase of the vertex angle. When the vertex angle was 20° and the build-up direction was parallel to the edge of vertex angle and perpendicular to the triangular base, the incomplete height was the smallest. Therefore, build orientation and angle acuteness influenced the edge reproducibility of the casting patterns fabricated using a digital light process.
The key of the root canal therapy is to eliminate the micro-organism infection, fill the root canal tightly and reduce the stimulation to the periapical tissues. However, it is quite difficult to meet all the conditions due to the defect of the material. Here we develop a novel root canal sealer (MZOE), in which zinc oxide eugenol (ZOE) were fabricated with polyhexamethylene guanidine (PHMG), and the PHMG’s concentration is 0.8, 1.0, 1.2 and 1.4%. Our investigation tested its physical properties, antibacterial effect to E. faecalis, C. albicans, E. coli, S. aureus and cytotoxicity to human periodontal ligament fibroblasts (HPDLFs). The physical properties of the MZOE conformed to the ISO 6876:2001, and its antibacterial effect was stronger than ZOE (p<0.05), the RGR of HPDLFs was tested between 1 to 24%, belonging to moderate cytotoxicity. It was suggested that MZOE had good physical properties, high antibacterial effect, and moderate cytotoxicity.
Many β-Ti alloys have been developed for, and used in, medical devices because of the corrosion resistance, biocompatibility, and exceptionally low Young’s modulus. The aim of the present study was to investigate the histomorphometric aspects of peri-implant bone around Ti-Nb-Sn alloy implants and compare them with those in the case of commercially pure Ti (Ti). Fluorescent morphological observations of ST-2 cells on the substrate were performed and bone morphogenesis around implants in rat femur was evaluated. There was no difference between the cell morphology on Ti and those on the Ti-Nb-Sn alloy during observation for 24 h. A comparison of the Ti-Nb-Sn alloy implant and the Ti implant showed no significant differences between the bone-to-implant contact ratios or the bone fractions. These results suggest that the biological adaptations with Ti-Nb-Sn implants during a healing period are similar to those with Ti. Ti-Nb-Sn is therefore suitable for use in dental implants.
This study investigated the effects of different silica-based layer coatings on shear bond strength (SBS) between Y-TZP and bovine dentin. Three different silica-based layer coatings were applied to the Y-TZP surface: tribochemical silica coating, vitrification (glaze coating), and composite resin sintering. A silane coupling agent (SIL) was applied to the silica-coated Y-TZP surface in the presence or absence of hydrofluoric acid (HF) treatment. A one-step adhesive was then applied to the silica-coated Y-TZP and cemented to bovine dentin using MDP-free resin cement. The SBS value of the tribochemical silica coating group was lowest among the experimental groups, while the HF+SIL subgroup showed the highest SBS value after vitrification (p<0.05). While hydrofluoric acid etching did not affect the SBS value of the tribochemical silica coating group, it affected the SBS value in the vitrification and composite resin sintering groups (p<0.05).