Antimicrobial efficacy of self-locomotive manganese oxide nanozyme-doped diatom microbubbler on orthodontic brackets in vitro.

BACKGROUND: Orthodontic brackets provide a favorable environment for Streptococcus mutans biofilm formation, increasing the risk of white spots and dental caries. Manganese oxide (MnO2) nanozyme-doped diatom microbubbler (DM) is a recently developed material for biofilm removal. DM can generate oxygen by catalase-mimicking activity in Hydrogen peroxide (H2O2) solution and move with ejecting oxygen microbubbles to produce a mechanical self-cleansing effect. This study aimed to evaluate the feasibility of DM as a novel bracket cleaner. METHODS: DM was prepared according to the protocol and analyzed using a scanning electron microscope (SEM). We treated S. mutans biofilms grown over bracket with phosphate-buffered saline (PBS group), 0.12% chlorhexidine (CHX group), 3% H2O2 (H2O2 group), and co-treatment with 3 mg/mL of DM and 3% H2O2 (DM group). The biofilm removal effect was analyzed using crystal violet assay, and the results were observed using SEM. The viability of S. mutans in remaining biofilms was evaluated using confocal laser scanning microscopy (CLSM). Finally, we examined the effect of all materials on mature multispecies biofilms formed on debonded brackets. RESULTS: Crystal violet assay results revealed that the CHX group removed more biofilms than the control group, and the DM group removed biofilms more effectively than the CHX group (p < 0.0001). SEM and CLSM images showed that CHX killed S. mutans but failed to remove most biofilms on brackets. However, DM effectively removed biofilms and mature multispecies biofilms on debonded brackets (p < 0.0001). CONCLUSIONS: Co-treatment with DM and H2O2 is effective in removing biofilms on orthodontic brackets compared to conventional antibacterial agents.

Improving wear resistance of acrylic resin denture teeth by using zirconia complete crowns fabricated with a CAD-CAM double-scanning method: A clinical report.

Acrylic resin denture teeth can wear and chip when opposed by zirconia prostheses. This clinical report describes the use of zirconia complete crowns to prevent these problems. The predictability of treatment was improved by using the computer-aided design and computer-aided manufacturing (CAD-CAM) double-scanning method.

Clinical and radiographic outcomes of dental implant after maxillary sinus floor augmentation with rhBMP-2/hydroxyapatite compared to deproteinized bovine bone.

OBJECTIVES: This study aimed to evaluate the clinical and radiographic outcomes of early implant placement and functional loading in maxillary sinus floor augmentation (MSFA) using recombinant human bone morphogenetic protein 2/hydroxyapatite (rhBMP-2/HA) and to compare these outcomes with those of the conventional protocol in MSFA using deproteinized bovine bone (DBB). MATERIALS AND METHODS: The rhBMP-2/HA and DBB groups consisted of 14 and 13 patients who underwent MSFA with BMP and DBB, respectively. After placement of 22 implants and 21 implants in the rhBMP-2/HA and DBB groups, respectively, abutment connections were performed 3 months after implant placement for the rhBMP-2/HA group and 6 months after implant placement for the DBB group. Changes in grafted sinus height (GSH), marginal bone loss (MBL), and implant stability were evaluated up to one year after functional loading. RESULTS: Survival rates for the rhBMP-2/HA and DBB groups after one year of functional loading were 90.9% and 90.5%, respectively. Both groups exhibited no significant time-course changes in GSH until one year of functional loading (rhBMP-2/HA, p = 0.124; DBB, p = 0.075). Although significant MBL occurred after one year of functional loading for both groups (rhBMP-2/HA, p < 0.001; DBB, p < 0.001), there were no significant differences in time-course changes in MBL between the two groups (p = 0.450). The mean implant stability quotient values in the rhBMP-2/HA and DBB groups were 75.3 and 75.4 after one year of functional loading, respectively, and there were no significant differences between the two groups (p = 0.557). CONCLUSIONS: MSFA using rhBMP-2/HA allowed implant rehabilitation with early implant placement and functional loading and led to a comparable survival rate and implant stability after 1 year of functional loading with acceptable MBL and stable maintenance of GSH compared to the MSFA using DBB with 6 months of healing after implant placement.

Manganese Oxide Nanozyme-Doped Diatom for Safe and Efficient Treatment of Peri-Implantitis.

Peri-implantitis is a major cause of dental implant failure. Bacterial biofilm contamination on the implant induces surrounding bone resorption and soft tissue inflammation, leading to severe deterioration of oral health. However, conventional biofilm removal procedures, such as mechanical decontamination and antiseptic application, are not effective enough to induce reosseointegration on decontaminated implant surfaces. This is due to (1) incomplete decontamination of the biofilm from inaccessible areas and (2) physicochemical alteration of implant surfaces caused by decontamination procedures. Herein, a safe and effective therapeutic approach for peri-implantitis is developed, which involves decontamination of implant-bound biofilms using the kinetic energy of microsized oxygen bubbles generated from the catalytic reaction between hydrogen peroxide (H2O2) and manganese oxide (MnO2) nanozyme sheet-doped silica diatom microparticles (Diatom Microbubbler, DM). Rapidly moving microsized DM particles are able to penetrate narrow spaces between implant screws, exerting just the right amount of force to entirely destroy biofilms without harming the surrounding mucosa or implant surfaces, as opposed to conventional antiseptics such as chlorhexidine or 3% H2O2 when used alone. Consequently, decontamination with DM facilitates successful reosseointegration on the peri-implantitis-affected implant surface. In summary, our new DM-based therapeutic approach will become a promising alternative to resolve clinically challenging aspects of peri-implantitis.

Effect of layer thickness and printing orientation on the color stability and stainability of a 3D-printed resin material.

STATEMENT OF PROBLEM: Although 3-dimensional (3D)-printed resin prostheses are widely used, studies on the effects of the manufacturing parameters of 3D printing on the color stability and stainability of these prostheses are lacking. PURPOSE: The purpose of this in vitro study was to investigate the effects of layer thickness and printing orientation on the color stability and stainability of a 3D-printed resin. In addition, the influence of roughness and water contact angle was evaluated. MATERIAL AND METHODS: Color changes (ΔE00) in tooth-colored resin specimens produced by 3D printing with 2 different layer thicknesses and 3 different printing orientations and immersed in 3 types of aging media (distilled water, coffee solution, and wine) were evaluated (n=10). The CIELab color values were measured with a spectrophotometer at baseline and different time points (1, 3, 7, 15, and 30 days). The surface roughness (Ra) of resin specimens was measured at various time points (baseline, 7, 15, and 30 days) by confocal laser scanning microscopy after immersion in coffee solution (n=15). The water contact angle was determined by using the sessile drop method (n=10). The ΔE00 values were analyzed by using the 3-way repeated measures ANOVA followed by the Bonferroni test and Dunnett T3 test (α=.05). Ra values were analyzed by 3-way repeated measures ANOVA (α=.05). The water contact angle data were analyzed by 2-way ANOVA (α=.05). RESULTS: The 3-way repeated measures ANOVA showed that layer thickness, printing orientation, and storage time significantly influenced the ΔE00 values of the 3D-printed resin specimens in each aging medium (P<.001). The ΔE00 values in the 0-degree subgroups were significantly lower than those in the 45- and 90-degree subgroups (P<.05). The ΔE00 values in the 25-µm thick groups were significantly higher than those in the 100-µm thick groups (P<.05). The ΔE00 values demonstrated an increase up to 15 days in all aging media. In distilled water, the ΔE00 values of the specimens increased or decreased depending on the groups, whereas in the coffee solution, the values decreased after 15 days (P<.001); in red wine, the values demonstrated a continuous increase up to 30 days in all groups (P<.001). The 3-way repeated measures ANOVA showed that the Ra values did not change significantly with immersion time (P=.444). The 2-way ANOVA showed that the water contact angle was not significantly affected by layer thickness (P=.921) or printing orientation (P=.062). CONCLUSIONS: Layer thickness and printing orientation affected the color stability and stainability of the 3D-printed resin. The discoloration of the 3D-printed resin differed with time, depending on the type of aging media used.

Effect of post-curing time on the color stability and related properties of a tooth-colored 3D-printed resin material.

This study investigated the effect of post-curing time on the color stability and related properties, such as degree of conversion (DC), surface roughness, water contact angle, water sorption (Wsp), and water solubility (Wsl) of 3D-printed resin for dental restorations. The 3D-printed specimens were divided into four groups according to the post-curing time (0, 5, 10, and 20 min). Color changes (ΔE00) of the specimens immersed in aging media were measured using a spectrophotometer at different aging times. The DC of the resin was measured using a FTIR. The surface roughness (Ra) of the resin immersed in coffee was measured at different aging times. Water contact angle was evaluated using the sessile drop method, and Wsp and Wsl were tested according to the ISO 4049:2019. The ΔE00 values of the specimens immersed in coffee and red wine decreased with increasing post-curing time. As the post-curing time increased up to 10 min, the DC increased and water contact angle decreased. The Ra value of the group without post-curing (0 min) increased gradually for 30 days, except between 7 and 15 days. However, when the post-curing time increased to greater than 10 min, no apparent change in Ra value was detected. The Wsp and Wsl of the group without post-curing were significantly lower and larger than that of the other groups, respectively. The longer the post-curing time of the tooth-colored 3D-printed resin, the better the color stability. The post-curing time of the 3D-printed resin affected the DC, surface roughness after aging in the staining media, water contact angle, water sorption, and water solubility.

Removal effect of Candida albicans biofilms from the PMMA resin surface by using a manganese oxide nanozyme-doped diatom microbubbler.

To prevent oral candidiasis, removal of the Candida biofilms from dentures is important. However, common denture cleaners are insufficiently effective in removing biofilms. A manganese oxide (MnO2) nanozyme-doped diatom microbubbler (DM) can generate oxygen gas microbubbles by a catalase-mimicking activity in hydrogen peroxide (H2O2). DM can invade and destroy biofilms with the driving force of continuously generated microbubbles. In this study, the Candida biofilm removal efficiency by co-treatment of DM and H2O2 was investigated. Diatom particles were reacted with (3-aminopropyl)triethoxysilane to prepare amine-substituted diatom particles. These particles were reacted with potassium permanganate to fabricate DMs. The morphology and components of DM were analyzed by using a scanning electron microscope (SEM). Four types of denture base resin specimens on which biofilms of Candida albicans were formed were treated with phosphate-buffered saline (PBS group), Polident 5-Minute (Polident group), 0.12% chlorhexidine gluconate (CHX group), 3% H2O2 (H2O2 group), and co-treatment of 3 mg/mL of DM and 3% H2O2 (DM group). The biofilm removal effect of each group was quantitatively analyzed by crystal violet assay, and the results were visually confirmed by SEM images. After each treatment, the remaining C. albicans were stained with Hoechst 33342/propidium iodide, and observed with confocal laser scanning microscopy (CLSM) to evaluate the viability. MnO2 nanozyme sheets were successfully doped on the surface of the fabricated DM. Although biofilms were not effectively removed in the Polident and CHX groups, CLSM images showed that CHX was able to effectively kill C. albicans in the biofilms on all resin specimen types. According to the crystal violet analysis, the H2O2 groups removed the biofilms on heat-activated and 3D-printed resins (P < .01), but could not remove the biofilms on autopolymerizing and milled resins significantly (P = .1161 and P = .1401, respectively). The DM groups significantly removed C. albicans from all resin specimen types (P < .01).