A leptin-loaded poly-ϵ-caprolactone 3D printing scaffold for odontoblastic differentiation in human dental pulp cells.

This study investigated the effects on odontoblast differentiation of a 3D-printed poly-ϵ-caprolactone (PCL) scaffold that incorporated leptin. Material extrusion-type 3D printing with a 43 000-molecular weight PCL material was used to fabricate a PCL scaffold with a 6 mm diameter, 1 mm height, and 270-340 µm pore size. The experimental groups were PCL scaffolds (control group), PCL scaffolds with aminated surfaces (group A), and PCL scaffolds with leptin on the aminated surface (group L). The aminated surface was treated with 1,6-hexanediamine and verified by ninhydrin analysis. Leptin loading was performed using Traut's reagent and 4-(N-Maleimidomethyl)cyclohexane-1-carboxylic acid 3-sulfo-N-hydroxysuccinimide ester sodium salt (Sulfo-SMCC). Groups A and L showed significantly higher surface wettability, pulp cell adhesion, and proliferation than the control group. Group L exhibited increased alkaline phosphatase, calcification deposits, and mRNA and protein expression of dentin sialophosphoprotein and dentin matrix acidic phosphoprotein 1 compared with the control group. In this study, a 3D-printed PCL scaffold containing leptin was enhanced odontoblast differentiation and dental pulp cells adhesion and proliferation.

Fundamental Properties and Clinical Application of 3D-Printed Bioglass Porcelain Fused to Metal Dental Restoration.

The purpose of this study is to evaluate the mechanical properties and clinical fitness of 3D-printed bioglass porcelain fused to metal (PFM) dental crowns. To evaluate the mechanical properties, tensile strength, Vickers microhardness, shear bond strength, and surface roughness tests of the SLM printed Co-Cr alloy was conducted. A right mandibular 1st molar tooth was prepared for a single dental crown (n = 10). For a three-unit metal crown and bridge, the right mandibular first premolar and first molar were prepared. Bioglass porcelain was fired to fabricate PFM dental restorations. A clinical gap was observed and measured during each of the four times porcelain was fired. A statistical analysis was conducted. The SLM technique showed the largest statistically significant tensile strength and a 0.2% yield strength value. The milling technique had the lowest statistically significant compressive strength value. The shear bond strength and surface roughness showed no statistically significant difference between the fabricated method. There was a statistically significant change in marginal discrepancy according to the porcelain firing step. The casting technique showed the greatest statistically significant margin discrepancy value. The SLM method showed better fitness than the traditional casting method and showed better mechanical properties as a dental material.

The Impact of Particle Size and Surface Treatment of Zirconia Suspension for Photocuring Additive Manufacturing.

To prepare a photocurable ceramic suspension for use in commercialized additive manufacturing equipment, the effects of the rheological properties of zirconia particles added to a binder, and the presence or absence of a silane coupling agent on the particles was evaluated. To this end, three experimental groups (ZSs, ZMs, ZLs) and three control groups (ZS, ZM, ZL) were designed depending on the size of the underlying zirconia particles. The test-group zirconia suspensions were prepared through silanization, which was not applied to the control-group suspensions. Depending on the particle size, viscosity differences between the test and control groups were 16,842, 18,623, and 12,303 mPa·s, respectively. Compared to the other groups, the viscosity of the ZLs group suspension decreased by 70.98-88.04%. This confirmed that the viscosity of the suspensions was affected by the particle size and the presence of silane coating. The dispersion stability of the zirconia suspensions was evaluated over 20 days. A sedimentation test confirmed that the sedimentation rate of the ZLs group was slower than those of the other groups. This study aimed to optimize the suspension manufacturing method to effectively be utilized in further commercializing zirconia three-dimensional (3D) printing and could also help to develop various medical applications.

Integration of an intraoral scan and a conventional impression for fabricating complete dentures for a patient with flabby tissues.

Inflammatory movable tissues in the maxillary anterior region are the result of excessive stimulation of the anterior alveolar ridge, as the maxillary denture habitually rotates anteriorly and upward during mastication. The pressure required for a functional impression makes it difficult to obtain the accurate anatomy of the inflamed mucosal tissues. An intraoral scanner can be used to record the movable tissues in an immobile state. However, for removable dentures, the oral scanner is limited by the difficulty in evaluating the denture borders or the posterior palatal seal area accurately. The fabrication of a complete denture by combining the use of an oral scanner to capture an anatomic impression without exerting pressure on the maxilla, including the movable tissues, and a traditional functional impression using the closed-mouth technique is described.

Effects of UV Absorber on Zirconia Fabricated with Digital Light Processing Additive Manufacturing.

This study evaluated the effect of UV absorbers on the dimensional accuracy of zirconia specimens fabricated by additive manufacturing using a digital light process. Zirconia suspension for additive manufacturing was prepared by setting the volume fractions (0, 0.005, 0.05, and 0.1%) of various UV absorbers. The effect of UV absorber content was evaluated through curing thickness, geometric overgrowth model design, linear deviation, and microstructure evaluation before and after sintering. Statistical analysis was performed by Kruskal-Wallis H and post-tested by the Bonferroni correction method. There was no significant difference in the cure depth according to the presence or absence of the UV absorber, the difference in geometric overgrowth was from 2.1 to 12.5%, and the overgrowth significantly decreased as the amount of added UV absorber increased. This result may contribute to improved precision of 3D multilayer ceramic products.

Long-term follow-up implant site development in the submerged mandibular primary second molars: a case report.

Treatment of ankylosed and submerged primary molars without permanent successors is challenging, as normal vertical dentoalveolar growth is compromised. Thus, grafting techniques and distraction osteogenesis are performed for ridge augmentation before implant restoration. However, these techniques are invasive with limited success. Another treatment for implant site development is noninvasive forced eruption. This case report describes long-term follow-up of alveolar ridge augmentation in the submerged mandibular primary second molars using subluxation and orthodontic forced eruption for implant site development. A 19-year old female had Class II molar relationships, upper anterior crowding with large overjet, missing four second premolars and submerged mandibular primary second molars with inadequate vertical development of alveolar bone. For the vertical alveolar bone alterations in the mandible, forced eruption with subluxation of ankylosed lower primary second molars was applied. Treatment outcome was evaluated over 5 years with stable occlusion, healthy periodontal tissues, and successful radiographic results.

Creation of Digital Virtual Patient by Integrating CBCT, Intraoral Scan, 3D Facial Scan: An Approach to Methodology for Integration Accuracy.

ABSTRACT: The purpose of this paper was to introduce a method for creating a digital virtual patient by combining cone-beam computed tomography (CBCT), intraoral scan, and facial scan with a high accuracy of integration. CBCT scan, facial scan, and intraoral scan were obtained from initial visit. The virtual patient was created using the integration of these imaging modalities. Once the virtual patient was generated, digital workflow could be applied to initial patient consultation, diagnosis, treatment planning, virtual tooth setup, virtual treatment simulation, and post-treatment evaluation. integration of digital technology allows clinicians to improve diagnosis and treatment outcome. in addition, it allows for favorable patient communication. This technique eliminates the traditional impression process and complicated laboratory procedures for evaluating patient's occlusion during smile and habitual resting position. Based on this protocol, it is possible to create a digital virtual patient using CBCT, intraoral scan, and facial scan with a high accuracy of integration. it would be helpful for precision diagnosis and accurate treatment as well as favorable communication with patient.

Hybrid porous zirconia scaffolds fabricated using additive manufacturing for bone tissue engineering applications.

For the formation of new bone in critical-sized bone defects, bioactive scaffolds with an interconnected porous network are necessary. Herein, we fabricated three-dimensional (3D) porous hybrid zirconia scaffolds to promote hybrid functionality, i.e., excellent mechanical properties and bioactive performance. Specifically, the 3D printed scaffolds were subjected to Zn-HA/glass composite coating on glass-infiltrated zirconia (ZC). In addition, to pertain the extracellular matrix of bone, biopolymer (alginate/gelatine) was embedded in a developed 3D construct (ZB and ZCB). A zirconia-printed scaffold (Z) group served as a control. The structural and mechanical properties of the constructed scaffolds were studied using essential characterization techniques. Furthermore, the biological performance of the designed scaffolds was tested by a sequence of in vitro cell tests, including the attachment, proliferation, and osteogenic differentiation of dental pulp cells (DPCs). The ZC and ZCB scaffolds exhibited 20% higher compression strength than the zirconia (Z) scaffolds. More importantly, the ZC constructs exhibited superior cell-adhesion, distribution, and osteogenic differentiation ability due to the synergistic effects of the composite coating. In addition, the biopolymer-embedded scaffolds (ZB, ZCB) showed an excellent biological and mechanical performance. Thus, our results suggest that the Zn-HA/glass composite-coated glass-infiltrated zirconia (ZC, ZCB) scaffolds are a dynamic approach to designing bioactive 3D scaffolds for the load-bearing bone regeneration applications.

Effect of Zinc Oxide Nanoparticle Addition to Polycaprolactone Periodontal Membranes on Antibacterial Activity and Cell Viability.

During the design of membranes for guided tissue regeneration (GTR) to treat periodontal diseases, infection of the exposed membranes and postoperative complications can be prevented by increasing bacterial resistance. This study evaluated the antibacterial activity of PCL/ZnO membranes and their effect on cell viability via addition of antibacterial zinc oxide (ZnO) nanoparticles to a biocompatible and biodegradable material such as polycaprolactone (PCL). Neat PCL membranes and PCL/ZnO membranes containing 0.5 wt.% and 5 wt.% ZnO were produced, and divided into PCL (0% ZnO), LZ (0.5 wt.% ZnO), and HZ (5 wt.% ZnO) groups, respectively. The surface characteristics of the membranes including morphological features and changes in composition were analyzed. Adhesion of bacteria, including Streptococcus mutans and Porphyromonas gingi-valis, was analyzed using a crystal violet assay. The proliferation of MC3T3-E1 osteoblasts was evaluated using a WST-8 assay. Significant differences were analyzed using the Kruskal-Wallis test (P < 0.05). The results of groups were compared using the Mann-Whitney test (P < 0.017). ZnO nanoparticles were dispersed in the PCL matrix of PCL/ZnO membranes. Compared with neat PCL membranes, their ability to form crystals decreased and their amorphous structure increased. The adhesion of S. mutans and P. gingivalis in the LZ and HZ groups containing ZnO was significantly decreased compared with that of the neat PCL membranes (P < 0.05). No significant differences were observed in the proliferation of MC3T3-E1 cells between the PCL/ZnO membranes and the neat PCL membranes both on days 2 and 5 of culture (P > 0.05). This study has demonstrated that the PCL membranes carrying the ZnO nanoparticles inhibited bacterial adhesion without affecting the viability of osteoblasts, suggesting the potential application of ZnO in GTR to increase antibacterial activity of membranes.

Eggshell membrane as a bioactive agent in polymeric nanotopographic scaffolds for enhanced bone regeneration.

A bone regeneration scaffold is typically designed as a platform to effectively heal a bone defect while preventing soft tissue infiltration. Despite the wide variety of scaffold materials currently available, such as collagen, critical problems in achieving bone regeneration remain, including a rapid absorption period and low tensile strength as well as high costs. Inspired by extracellular matrix protein and topographical cues, we developed a polycaprolactone-based scaffold for bone regeneration using a soluble eggshell membrane protein (SEP) coating and a nanotopography structure for enhancing the physical properties and bioactivity. The scaffold exhibited adequate flexibility and mechanical strength as a biomedical platform for bone regeneration. The highly aligned nanostructures and SEP coating were found to regulate and enhance cell morphology, adhesion, proliferation, and differentiation in vitro. In a calvaria bone defect mouse model, the scaffolds coated with SEP applied to the defect site promoted bone regeneration along the direction of the nanotopography in vivo. These findings demonstrate that bone-inspired nanostructures and SEP coatings have high potential to be applicable in the design and manipulation of scaffolds for bone regeneration.

Fabrication and Characterization of 45S5 Bioactive Glass/Thermoplastic Composite Scaffold by Ceramic Injection Printer.

45S5 bioactive glass (45S5) scaffolds were fabricated using a novel additive-manufacturing (AM) technology. A ceramic injection printer (CIP) was designed by combining injection molding and fused deposition modeling, for the fabrication of three-dimensional constructs of ceramic materials. A high fraction (50 vol%) of 45S5 powder was mixed with the thermoplastic polymer. The synthesized 45S5 composites were subjected to Brunauer-Emmett-Teller (BET) analysis, X-ray diffraction (XRD) analysis, and field-emission scanning electron microscopy (FE-SEM). The BET results of prepared 45S5 powder were confirmed to have a mean pore diameter of 11.402 nm, and specific surface area is 0.966 m²/g. The prepared 45S5/thermoplastic composite powder was subjected to Thermogravimetric/Differential thermal analysis (TG/DTA). The debinding process of polymer occurred at 192.5, 360.8, and 393 °C. The elastic modulus and ultimate stress of these scaffolds were measured to be 312.49±87.36 MPa and 21.83±6.67 MPa, respectively. The XRD results revealed the presence of Na6Ca3Si6O18 phases. The presence of Si, Ca, P, and Na was confirmed via energy-dispersive X-ray spectroscopy (EDS). The printed scaffold exhibited amorphous calcium phosphate (ACP) expression after immersion in simulated body fluid (SBF) and also it was observed that the intensity of the crystalline phase of 45S5 was decreased, as the immersion time increases. Bioactive glass composites with the high volume fraction can be able to construct 3D complex porous scaffolds using CIP.

Evaluation of Bioabsorbable Mg-Mn Alloy with Anodic Oxidation Treatment.

Magnesium alloys as biodegradable materials have been examined that may replace bone screws and plates in recent studies. But the velocity control of magnesium alloy is very difficult. Until now, the magnesium alloys degrade very fast, thus it couldn't maintain the function in clinical field. Thus the purpose of this study is to evaluate the degradability of anodized magnesium alloy for control the velocity. For this experiment, a Mg-xMn (x = 0, 0.5, 1 wt%) binary alloy was cast in argon gas (99.99%) atmosphere. The specimens of the surface treatment group were anodized for 15 minutes at a voltage of 120 V at room temperature using calcium gluconate, sodium hexametaphosphate, and sodium hydroxide electrolyte. For the mechanical test, SEM, roughness test, hardness test were examined. The degradation test was conducted to measure the hydrogen gas formation volume. For biologic test, cell viability were tested. After anodic oxidation treatment, the surface showed the crater formation, the size of craters were about 200~300 nm. Among nonanodized group, the Mg-0.5Mn showed the highest Vickers hardness and cell viability. However for biodegradability test, Mg-1Mn showed the lowest the hydrogen gas formation. For anodic oxidation treatment, anodic oxidation treatment makes rougher surface, higher hardness, good cell response and lower degradation rate. Overall, anodized Mg-1Mn showed the possibility for clinical application in bone screw and bone plate.

Wear Behavior of the Human Enamel Antagonist to Different Glazed Zirconia.

In this study, the wear behavior of glazed zirconia was investigated to the antagonist with human enamel after simulated mastication. Twenty Y-TZP specimens were divided into 4 groups: untreated zirconia (Z), glazed zirconia with IPS e.max Ceram (GZE), glazed zirconia with VITA AKZENT® Plus (GZV), and glazed zirconia with glass (GZG). Glazing glass was mainly composed of SiO2, B2O3, Al2O3, Na2O and K2O (nearly 91 wt%). The surface roughness of the specimens was evaluated using roughness profiler. The maxillary premolar teeth were selected as the antagonist. The wear of human enamel against human enamel was used as a control. Five-disc specimens per group were subjected to chewing stimulation CS-4 (SD Mechatronic GmbH, Germany) for 240,000 cycles against human enamel. The wear loss of antagonistic teeth was calculated using a three-dimensional profiling system and the volume loss of the tooth was scanned using a 3D scanner. 3D data obtained before and after testing were overlapped using 3D software (Dentacian Software, EZplant, Korea). The wear loss of glazed zirconia GZE, GZV and GZG groups showed significantly lower than that of human enamel. Whereas, the zirconia (Z) group exhibits significantly lower volume loss than glazed zirconia and enamel. These results show that the wear of the glazing glass is comparable to other commercial glazing materials. Glazing materials are both more susceptible to wear the antagonist relative to zirconia.

Effect of Plasma Surface Treatment on Shear Bond Strength with Denture Base Resin in Co-Cr Alloy, Ti-6Al-4V Alloy, and CP-Ti Alloy.

The purpose of this study was to examine the effect of plasma treatment by treating the surface of Co-Cr alloy, Ti-6Al-4V alloy, and CP-Ti alloy as a material for denture metal frameworks with non-thermal atmospheric pressure plasma (NTAPP) and measuring their shear bond strength (SBS) with a heat-cured resin. 20 specimens were prepared for each of Co-Cr, Ti-6Al-4V, and CP-Ti alloys. Each metal alloy group was divided into the following subgroups depending on NTAPP treatment: C (Co-Cr alloy without plasma), T (CP-Ti without plasma), A (Ti-6Al-4V alloy without plasma), CP (Co-Cr alloy with plasma), TP (CP-Ti with plasma) and AP (Ti-6Al-4V alloy with plasma). Specimens were treated with a metal conditioner and bonded to a denture base resin. SBS was measured using a universal testing machine. All data obtained were statistically analyzed using two-way analysis of variance (ANOVA), Tukey's honestly significant difference (HSD) test, and independent t-test. The mean values (SD) of SBS (MPa) were: 10.31 (1.19) for C group; 12.43 (0.98) for T group; 13.75 (2.02) for A group; 13.53 (1.61) for CP group; 16.87 (1.55) for TP group; 17.46 (1.65) for AP group. The SBS of the AP group was the highest while that of the C group was the lowest. SBS of specimen treated with NTAPP was significantly increased regardless of metal alloy types (p < 0.001). Within the limitations of this study, NTAPP can increases the SBS of Co-Cr alloy, CP-Ti alloy, and Ti-6Al-4V alloy with a denture base resin.

Denture flask fabrication using fused deposition modeling three-dimensional printing.

PURPOSE: This paper describes a method for making a customized denture flask using fused deposition modeling (FDM) by three-dimensional (3D) printing. We have proposed a new digital dental prosthesis using conventional dental base materials and artificial teeth. METHODS: Using the universal development system software, a denture-designed Standard Tessellation Language (STL) file and a denture flask STL file were superimposed, and the denture region was set as an empty space. After setting the offset value to 200µm between the denture base and teeth for artificial tooth positioning, the flask was created by FDM 3D printing. Conventional artificial teeth were inserted into the 3D-printed flask, and resin packing, finishing, and polishing were performed using the conventional method for fabricating the complete denture. CONCLUSIONS: The 3D printing materials used to make digital dental prostheses have not yet been fully validated. Therefore, the production of a 3D-printed denture flask, which can use conventional complete denture materials, presents a new alternative to the digital fabrication of dentures.

Comparison of different impression techniques for edentulous jaws using three-dimensional analysis.

PURPOSE: The purpose of this study was to compare two novel impression methods and a conventional impression method for edentulous jaws using 3-dimensional (3D) analysis software. MATERIALS AND METHODS: Five edentulous patients (four men and one woman; mean age: 62.7 years) were included. Three impression techniques were used: conventional impression method (CI; control), simple modified closed-mouth impression method with a novel tray (SI), and digital impression method using an intraoral scanner (DI). Subsequently, a gypsum model was made, scanned, and superimposed using 3D analysis software. Mean area displacement was measured using CI method to evaluate differences in the impression surfaces as compared to those values obtained using SI and DI methods. The values were confirmed at two to five areas to determine the differences. CI and SI were compared at all areas, while CI and DI were compared at the supporting areas. Kruskal-Wallis test was performed for all data. Statistical significance was considered at P value <.05. RESULTS: In the comparison of the CI and SI methods, the greatest difference was observed in the mandibular vestibule without statistical significance (P>.05); the difference was < 0.14 mm in the maxilla. The difference in the edentulous supporting areas between the CI and DI methods was not significant (P>.05). CONCLUSION: The CI, SI, and DI methods were effective in making impressions of the supporting areas in edentulous patients. The SI method showed clinically applicability.

Evaluation of Cure Depth and Geometrical Overgrowth Depending on Zirconia Volume Fraction Using Digital Light Processing.

The optical properties of zirconia photopolymer suspension for DLP (Digital Light Processing) were evaluated. The light source and intensity were set to 395 nm and 30 mW/cm². Experimental groups were divided into 48, 50, 52, 54, 56 and 58 vol% according to the zirconia volume fraction. The cure depth of all groups was at least 47.35 um when cured for 1 sec, which was higher than layer parameter values of the 3D printer. The geometrical overgrowth showed 28.55% at 48 vol% and 36.94% at 58 vol%. As the volume fraction of zirconia increased, the geometrical overgrowth increased and the cure depth reduced.

Bonding Evaluation Between Nanotube by Anodic Oxidation and Machined Dental Titanium Implant in Beagle Dog.

This study is to evaluate the bonding test between nanotube surface and machined dental titanium implant during the clinical procedure in beagle dog. A total of 24 screw-shaped implants (4 mm in diameter and 8.5 mm in length) were used. The implants were classified into 2 groups (n = 12): machined surface (M group) and nano surface which is nanotube formation on the machined surface (MA group). Anodic oxidation was performed at a 20 V for 10 min with 1 M H3PO4 and 1.5 wt% HF solutions. The implant were installed on beagle dog's humerus. After 4 and 12 weeks later, the beagle dog is sacrificed and the implant were removed with torque force. The removed implant was evaluated by SEM and EDX to observe the implant surface and nanotube's deformation. By investigating removed implant surfaces using SEM and EDX, M group was partially covered with bone, and MA groups were completely covered with bone. Nanotube was not shown any deformity. It indicated that nanotube showed good bonding stability with dental titanium implant.

Shear Bond Strength of Zirconia to Titanium Implant Using Glass Bonding.

This study evaluated the shear bond strength of zirconia to titanium implant components using silica-based glasses and compared the strength with that of implant components bonded using a commercial resin cement. Forty cylindrical zirconia specimens and forty titanium disks (Grade IV) were divided equally into four groups, depending on the adhesive used: three different types of glasses (group G, group GI, group GIB) and a self-adhesive resin cement (group U200), which was used as a control. The shear bond strength was evaluated using a universal testing machine and failure mode was examined by optical microscope. Data was analyzed using One-way ANOVA with p-value <0.05, which was considered statistically significant. The shear bond strength of the three glass groups was significantly higher than that of group U200 (p<0.05). Failure mode in all groups was a combination of adhesive and cohesive modes. Shear bond strength of zirconia to titanium bonded using glasses was higher than that using self-adhesive resin cement.