Current evidence of tissue engineering for dentine regeneration in animal models: a systematic review.

Aim: The aim of this study is to verify the type of scaffold effect on tissue engineering for dentine regeneration in animal models. Materials & methods: Strategic searches were conducted through MEDLINE/PubMed, Web of Science and Scopus databases. The studies were included with the following eligibility criteria: studies evaluating dentine regeneration, and being an in vivo study. Results: From 1392 identified potentially relevant studies, 15 fulfilled the eligibility criteria. All studies described characteristics of neoformed dentine, being that the most reported reparative dentine formation. Most of included studies presented moderate risk of bias. Conclusion: Up to date scientific evidence shows a positive trend to dentine regeneration when considering tissue engineering in animal models, regardless the type of scaffolds used.

Chipping of veneering ceramic on a lithium disilicate anterior single crown: Description of repair method and a fractographic failure analysis.

OBJECTIVE: This article presents a retrospective analysis of an anterior single crown that showed chipping of the veneering ceramic, the clinical stages of intraoral repair made in composite resin, and fractographic analysis of the causes of failure. CLINICAL CONSIDERATIONS: The ceramic chipping occurred in the incisal and labial surfaces of the crown, 1 year after installation. Clinical examination revealed the presence of occlusal interference, which was probably responsible for chipping. Vinyl-polysiloxane impression was made from the patient, and epoxy replica was produced. The replica was gold coated and inspected under the optical microscopy and scanning electron microscope (SEM) for descriptive fractography. Optical microscopy and SEM images showed that chipping initiated at the incisal edge, where it is possible to note an area of damage accumulation. At the labial surface, multiple arrest lines with their convex sides facing the incisal edge were observed. The fractured area was repaired intraorally with composite resin, and the patient's occlusion was checked and monitored. CONCLUSION: According to the fractographic analysis, occlusal interference was related to ceramic chipping in the incisal edge. Intraoral repair technique with composite resin was indicated for this moderate chipping. CLINICAL SIGNIFICANCE: Retrieval analysis of chipping ceramic delivers better understanding of the failure origin and could prevent future failures. Intraoral repair is a practical and conservative technique and may be performed in a single clinical session without requiring the removal of prosthesis.

Does Acid Challenge Affect the Properties and Bond Stability of Restorative Materials on Primary Teeth?

PURPOSE: To evaluate the effect of acidic challenge (AC) on the properties and bond stability of restorative materials to primary enamel and dentin. MATERIALS AND METHODS: One hundred twenty primary molars were assigned to 12 groups according to substrate (enamel or dentin), restorative material (composite, high-viscosity glass ionomer cement [HV-GIC] or resin-modified glass-ionomer cement [RM-GIC]), and immersion after restoration (control [saline solution/7 days] or AC [cola-based drink/5 min/3x per day/7 days]). Twenty-four hours after the restorative procedure, specimens were submitted to one of the proposed challenges. Half of the specimens were immediately subjected to the microshear bond strength test, and the other half after 12 months. To determine flexural strength flexural strength and superficial roughness (SR), 30 specimens were built up. After 24 h, the first measurement of SR from 10 specimens was performed. Specimens were then immersed in one of proposed challenges and SR was measured again. Subsequently, flexural strength testing was performed. Bond strength, surface roughness, and flexural strength data were subjected to ANOVA and Tukey's test. RESULTS: Composite showed the highest bond strengths compared to the others materials on both substrates. The storage period negatively influenced the bond strength only for composite groups in dentin. AC after restoration negatively influenced bond strength when the materials were evaluated in eroded dentin. AC affected the second SR measurement, showing increased SR for all restorative materials. AC did not affect flexural strength. CONCLUSION: The acidic challenge jeopardizes the surface roughness and bond strength of restorations to eroded dentin.

Effect of different aging methods on the mechanical behavior of multi-layered ceramic structures.

OBJECTIVE: To evaluate the effect of two aging methods (mechanical cycling and autoclave) on the mechanical behavior of veneer and framework ceramic specimens with different configurations (monolithic, two and three-layers). METHODS: Three ceramics used as framework for fixed dental prostheses (YZ-Vita In-Ceram YZ; IZ-Vita In-Ceram Zirconia; AL-Vita In-Ceram AL) and two veneering porcelains (VM7 and VM9) were studied. Bar-shaped specimens were produced in three different designs: monolithic, two layers (porcelain-framework) and three layers (porcelain-framework-porcelain). Specimens were tested for three-point flexural strength at 1MPa/s in 37°C artificial saliva. Three different experimental conditions were evaluated (n=10): control; mechanical cycling (2Hz, 37°C artificial saliva); and autoclave aging (134°C, 2 bars, 5h). Bi-layered specimens were tested in both conditions: with porcelain or framework ceramic under tension. Fracture surfaces were analyzed using stereomicroscope and scanning electron microscopy. Results were statistically analyzed using Kruskal-Wallis and Student-Newman-Keuls tests. RESULTS: Only for AL group, mechanical cycling and autoclave aging significantly decreased the flexural strength values in comparison to the control (p<0.01). YZ, AL, VM7 and VM9 monolithic groups showed no strength degradation. For multi-layered specimens, when the porcelain layer was tested in tension (bi and tri-layers), the aging methods evaluated also had no effect on strength (p≥0.05). Total and partial failure modes were identified. SIGNIFICANCE: Mechanical cycling and autoclave aging protocols had no effect on the flexural strength values and failure behavior of YZ and IZ ceramic structures. Yet, AL monolithic structures showed a significant decrease in flexural strength with any of the aging methods.

Effect of the microstructure on the lifetime of dental ceramics.

OBJECTIVES: To evaluate the effect of the microstructure on the Weibull and slow crack growth (SCG) parameters and on the lifetime of three ceramics used as framework materials for fixed partial dentures (FPDs) (YZ - Vita In-Ceram YZ; IZ - Vita In-Ceram Zirconia; AL - Vita In-Ceram AL) and of two veneering porcelains (VM7 and VM9). METHODS: Bar-shaped specimens were fabricated according to the manufacturer's instructions. Specimens were tested in three-point flexure in 37°C artificial saliva. Weibull analysis (n=30) and a constant stress-rate test (n=10) were used to determine the Weibull modulus (m) and SCG coefficient (n), respectively. Microstructural and fractographic analyzes were performed using SEM. ANOVA and Tukey's test (α=0.05) were used to statistically analyze data obtained with both microstructural and fractographic analyzes. RESULTS: YZ and AL presented high crystalline content and low porosity (0.1-0.2%). YZ had the highest characteristic strength (σ(0)) value (911MPa) followed by AL (488MPa) and IZ (423MPa). Lower σ(0) values were observed for the porcelains (68-75MPa). Except for IZ and VM7, m values were similar among the ceramic materials. Higher n values were found for YZ (76) and AL (72), followed by IZ (54) and the veneering materials (36-44). Lifetime predictions showed that YZ was the material with the best mechanical performance. The size of the critical flaw was similar among the framework materials (34-48µm) and among the porcelains (75-86µm). SIGNIFICANCE: The microstructure influenced the mechanical and SCG behavior of the studied materials and, consequently, the lifetime predictions.