The influence of the addition of titanium oxide nanotubes on the properties of 3D printed denture base materials.

INTRODUCTION: In this study, the effects of adding titanium dioxide nanotubes (TiO2) to 3D-printed denture base resin on the mechanical and physical properties of denture bases were examined for the first time. METHODS: The specimens were digitally created using 3D builder software from Microsoft Corporation through computer-aided design. In accordance with the test specifications for transverse strength, impact strength, hardness, surface roughness, and color stability, specimens were designed and printed with certain dimensions following relevant standards. TiO2 nanotubes (diameter: 15-30 nm and length: 2-3 µm) were added to the 3D-printed denture base resin (DentaBase, Asiga, Australia) at 1.0% and 1.5% by weight. Flexural strength, impact strength (Charpy impact), hardness, surface roughness, and color stability were evaluated, and the collected data were analyzed with ANOVA followed by Tukey's post hoc test (α = 0.05). Field emission scanning electron microscopy (FESEM) and energy dispersive x-ray spectroscopy (EDX) mapping were used to evaluate the dispersion of the nanotubes. RESULTS: Compared with those of the control group (0.0 wt.% TiO2 nanotubes), the average flexural, impact, and hardness values of the 1.0 and 1.5 wt.% TiO2 nanotube reinforcement groups increased significantly. Both nanocomposite groups showed significant color changes compared to that of the pure resin, and there was a considerable reduction in the surface roughness of the nanocomposites compared to that of the control group. CONCLUSION: Adding TiO2 nanotubes to 3D-printed denture base materials at 1.0 and 1.5 wt.% could enhance the mechanical and physical properties of the material, leading to better clinical performance. CLINICAL SIGNIFICANCE: In terms of clinical applications, 3D-printed denture base material has been shown to be a viable substitute for traditional heat-cured materials. By combining this with nanotechnology, existing dentures could be significantly enhanced, promoting extended service life and patient satisfaction while addressing the shortcomings of the current standard materials.

Impact of nano-cellulose fiber addition on physico-mechanical properties of room temperature vulcanized maxillofacial silicone material.

Objectives: Maxillofacial silicone is used to restore abnormalities due to congenital or acquired causes. However, the quality of silicone is far from ideal. This study was aimed at assessing the influence of the addition of cellulose nanofibers (CNFs; several nanometers in diameter and 2-5 µm long) on the physical and mechanical characteristics of maxillofacial silicone elastomers. Methods: Two CNF weight percentages (0.5% and 1%) were tested, and 180 specimens were divided into one control and two experimental groups. Each group was subdivided into six subgroups. In each subgroup, ten specimens subjected to each of the following tests: tearing strength, Shore-A hardness, tensile strength, elongation percentage, surface roughness, and color stability. The samples were additionally analyzed with Fourier transform infrared spectroscopy (FTIR) and field emission scanning electronic microscopy (FESEM). Results: The 0.5% CNF group, compared with the control group, exhibited highly significantly greater tearing strength, elongation percentage, hardness Shore-A, and surface roughness, and substantially greater tensile strength. However, color stability did not significantly differ between groups.The 1% CNF group showed significantly greater Shore-A hardness, tear strength, color stability, and surface roughness, and insignificantly lower tensile strength and percentage elongating values, than the control group. FESEM imaging revealed good CNF dispersion. The FTIR spectra indicated that CNFs interacted with silicone through surface functional hydroxyl groups. Conclusion: Addition of 0.5 wt. % CNF to silicone elastomers increased the material's mechanical tensile strength, tear strength, elongation percentage, and hardness as long as it stayed within the acceptable range for clinical use. Surface roughness increased in direct proportion to the amount of nanofibers added. Moreover, addition of 0.5 wt. % CNF to silicone polymers had insignificant effects on color stability.

Bio-hybrid dental implants prepared using stem cells with ß-TCP-coated titanium and zirconia.

PURPOSE: This study investigated periodontal ligament (PDL) restoration in osseointegrated implants using stem cells. METHODS: Commercial pure titanium and zirconium oxide (zirconia) were coated with beta-tricalcium phosphate (ß-TCP) using a long-pulse Nd:YAG laser (1,064 nm). Isolated bone marrow mesenchymal cells (BMMSCs) from rabbit tibia and femur, isolated PDL stem cells (PDLSCs) from the lower right incisor, and co-cultured BMMSCs and PDLSCs were tested for periostin markers using an immunofluorescent assay. Implants with 3D-engineered tissue were implanted into the lower right central incisors after extraction from rabbits. Forty implants (Ti or zirconia) were subdivided according to the duration of implantation (healing period: 45 or 90 days). Each subgroup (20 implants) was subdivided into 4 groups (without cells, PDLSC sheets, BMMSC sheets, and co-culture cell sheets). All groups underwent histological testing involving haematoxylin and eosin staining and immunohistochemistry, stereoscopic analysis to measure the PDL width, and field emission scanning electron microscopy (FESEM). The natural lower central incisors were used as controls. RESULTS: The BMMSCs co-cultured with PDLSCs generated a well-formed PDL tissue that exhibited positive periostin expression. Histological analysis showed that the implantation of coated (Ti and zirconia) dental implants without a cell sheet resulted in a well-osseointegrated implant at both healing intervals, which was confirmed with FESEM analysis and negative periostin expression. The mesenchymal tissue structured from PDLSCs only or co-cultured (BMMSCs and PDLSCs) could form a natural periodontal tissue with no significant difference between Ti and zirconia implants, consequently forming a biohybrid dental implant. Green fluorescence for periostin was clearly detected around the biohybrid implants after 45 and 90 days. FESEM showed the invasion of PDL-like fibres perpendicular to the cementum of the bio-hybrid implants. CONCLUSIONS: ß-TCP-coated (Ti and zirconia) implants generated periodontal tissue and formed biohybrid implants when mesenchymal-tissue-layered cell sheets were isolated from PDLSCs alone or co-cultured BMMSCs and PDLSCs.

Effects of Long Durations of RF-Magnetron Sputtering Deposition of Hydroxyapatite on Titanium Dental Implants.

OBJECTIVES: Dental implant is a revolution in dentistry; some shortages are still a focus of research. This study use long duration of radiofrequency (RF)-magnetron sputtering to coat titanium (Ti) implant with hydroxyapatite (HA) to obtain a uniform, strongly adhered in a few micrometers in thickness. MATERIALS AND METHODS: Two types of substrates, discs and root form cylinders were prepared using a grade 1 commercially pure (CP) Ti rod. A RF-magnetron sputtering device was used to coat specimens with HA. Magnetron sputtering was set at 150 W for 22 hours at 100°C under continuous argon gas flow and substrate rotation at 10 rpm. Coat properties were evaluated via field emission scanning electron microscopy (FESEM), scanning electron microscopy-energy dispersive X-ray (EDX) analysis, atomic force microscopy, and Vickers hardness (VH). Student's t-test was used. RESULTS: All FESEM images showed a homogeneous, continuous, and crack-free HA coat with a rough surface. EDX analysis revealed inclusion of HA particles within the substrate surface in a calcium (Ca)/phosphorus (P) ratio (16.58/11.31) close to that of HA. Elemental and EDX analyses showed Ca, Ti, P, and oxygen within Ti. The FESEM views at a cross-section of the substrate showed an average of 7 µm coat thickness. Moreover, these images revealed a dense, compact, and uniform continuous adhesion between the coat layer and the substrate. Roughness result indicated highly significant difference between uncoated Ti and HA coat (p-value < 0.05). A significant improvement in the VH value was observed when coat hardness was compared with the Ti substrate hardness (p-value < 0.05). CONCLUSION: Prolonged magnetron sputtering successfully coat Ti dental implants with HA in micrometers thickness which is well adhered essentially in excellent osseointegration.

In vitro periodontal ligament cell expansion by co-culture method and formation of multi-layered periodontal ligament-derived cell sheets.

OBJECTIVE: Per-implantitis is one of the implant treatment complications. Dentists have failed to restore damaged periodontium by using conventional therapies. Tissue engineering (stem cells, scaffold and growth factors) aims to reconstruct natural tissues. The paper aimed to isolate both periodontal ligament stem cells (PDLSCs) and bone marrow mesenchymal stem cells (BMMSCs) and use them in a co-culture method to create three-layered cell sheets for reconstructing natural periodontal ligament (PDL) tissue. MATERIALS AND METHODS: BMMSCs were isolated from rabbit tibia and femur, and PDLSC culture was established from the lower right incisor. The cells were co-cultured to induce BMMSC differentiation into PDL cells. Cell morphology, stem cells and PDL-specific markers (CD90, CD34, and periostin) were also detected using immunofluorescent assay. Co-cultured cell monolayers were detached using temperature-responsive tissue culture dishes and collagen graft to create the three-layer construct. The 3D-engineered tissue was examined histologically and by field emission scanning electron microscopy (FESEM). RESULTS: BMMSCs co-cultured with PDLSCs successfully induced more PDL cells. The newly induced PDL cells exhibited periostin and CD90 expression. Fluorescence green intensity was measured for the co-cultured cells that were stained with periostin, the mean fluorescence green intensity (periostin expression) was significantly higher for the newly induced PDL cells after 1, 2, and 3 weeks when compared with control (BM-MSCs), at 21 days non-significant difference was measured when compared with control (PDLSCs).The results showed the successful formation of 3D multilayer PDL tissue. Histological cross-section showed cell sheets and the stable adhesion between them. FESEM examination was conducted for the cross-section, showing three-layered cell sheets with stable adhesion between cells. CONCLUSIONS: The results of this paper report that the three layered-cell sheets were successfully constructed by the novel use of collagen graft as a scaffold to be used in treatment of periodontitis and to envelop the dental implants to create biohybrid implant.

Implementation and characterization of coating pure titanium dental implant with sintered ß-TCP by using Nd:YAG laser.

OBJECTIVES: This work presents laser coating of grade 1 pure titanium (Ti) dental implant surface with sintered biological apatite beta-tricalcium phosphate (ß-TCP), which has a chemical composition close to bone. MATERIALS AND METHODS: Pulsed Nd:YAG laser of single pulse capability up to 70 J/10 ms and pulse peak power of 8 kW was used to implement the task. Laser pulse peak power, pulse duration, repetition rate and scanning speed were modulated to achieve the most homogenous, cohesive and highly adherent coat layer. Scanning electron microscopy (SEM), energy dispersive X-ray microscopy (EDX), optical microscopy and nanoindentation analyses were conducted to characterise and evaluate the microstructure, phases, modulus of elasticity of the coating layer and calcium-to-phosphate ratio and composition.Results showed that the laser power and scanning speed influenced coating adherence. The cross-sectional field-emission scanning electron microscopy images at low power and high speed showed poor adherence and improved as the laser power increased to 2 kW. Decreasing the scanning speed to 0.2 mm/s at the same power of 2 kW increased adherence. EDX results of the substrate demonstrated that the chemical composition of the coat layer did not change after processing. Moreover, the maps revealed proper distribution of Ca and P with some agglomeration on the surface. The sharp peaks on the X-ray diffraction patterns indicated that ß-TCPs in the coat layer were mostly crystalline. The elastic modulus was low at the surface and increased gradually with depth to reach 19 GPa at 200 nm; this value was close to that of bone. The microhardness of the coated substrate increased by about 88%. The laser pulse energy of 8.3 J, pulse peak power of 2 kW, pulse duration of 4.3 min, repetition rate of 10 Hz and scanning speed of 0.2 ms-1 yielded the best results. CONCLUSION: Both processing and coating have potential use for dental implant applications.