Tissue Engineering for Periodontal Ligament Regeneration: Biomechanical Specifications.

The periodontal biomechanical environment is very difficult to investigate. By the complex geometry and composition of the periodontal ligament (PDL), its mechanical behavior is very dependent on the type of loading (compressive versus tensile loading; static versus cyclic loading; uniaxial versus multiaxial) and the location around the root (cervical, middle, or apical). These different aspects of the PDL make it difficult to develop a functional biomaterial to treat periodontal attachment due to periodontal diseases. This review aims to describe the structural and biomechanical properties of the PDL. Particular importance is placed in the close interrelationship that exists between structure and biomechanics: the PDL structural organization is specific to its biomechanical environment, and its biomechanical properties are specific to its structural arrangement. This balance between structure and biomechanics can be explained by a mechanosensitive periodontal cellular activity. These specifications have to be considered in the further tissue engineering strategies for the development of an efficient biomaterial for periodontal tissues regeneration.

Effect of a hyperbaric environment (diving conditions) on adhesive restorations: an in vitro study.

Objectives No recent study has addressed the effect of diving conditions (pressure increase) on adhesive restorations. We evaluated the impact of a simulated hyperbaric environment on microleakage of the dentine-composite resin interface. The ultimate aim was to propose recommendations for restorative dentistry for patients who are divers to limit barodontalgia (dental pain caused by pressure variations of the environment) and may lead to dangerous sequelae.Methods We bonded 20 dentine disks by using an adhesive system (Scothbond Universal) to ten intact composite cylinders and ten composite cylinders with porosity (Ceram X mono). For each group, the samples were divided into two subgroups, one submitted to a simulated hyperbaric environment and the other to an ambient environment. All samples were immersed in a silver nitrate solution to evaluate microleakage at the interface after analysis with a camera.Results Dye percolation for groups in the hyperbaric environment was greater than groups in ambient environment. For each subgroup, dye percolation was greater for samples with than without porosity.Conclusions High percolation percentages demonstrate that our simulated hyperbaric condition led to loss of sealing at the dentine-composite resin interface, especially with porous composites.Clinical significance Respect of the protocol and the quality of condensation for adhesive restorations are important in all clinical situations, especially for patients who are divers. A more interventionist approach must be adopted with these patients.

Mechanical characteristic and biological behaviour of implanted and restorative bioglasses used in medicine and dentistry: A systematic review.

OBJECTIVE: Nowadays bioactive glasses are finding increasing applications in medical practice due to their ability to stimulate re-mineralisation. However, they are intrinsically brittle materials and the study of new compositions will open up new scenarios enhancing their mechanical properties and maintaining the high bioactivity for a broader range of applications. This systematic review aims to identify the relationship between the composition of bioactive glasses used in medical applications and their influence on the mechanical and biological properties. METHODS: Various electronic databases (PubMed, Science Direct) were used for collecting articles on this subject. This research includes papers from January 2011 to March 2016. PRISMA guidelines for systematic review and meta-analysis have been used. 109 abstracts were collected and screened, 68 articles were read as relevant articles and a total of 22 papers were finally selected for this study. RESULTS: Most of the studies obtained enhanced mechanical properties and the conservation of bioactivity behaviours; although a lack of homogeneity in the characterization methods makes it difficult to compare data. SIGNIFICANCE: New compositions of bioactive glasses incorporating specific ions and the addition in polymers will be the most important direction for future researches in developing new materials for medical applications and especially for dentistry.

In vitro biocompatibility of a dentine substitute cement on human MG63 osteoblasts cells: Biodentine™ versus MTA(®).

AIM: To compare the in vitro biocompatibility of Biodentine™ and White ProRoot(®) mineral trioxide aggregate (MTA(®) ) with MG63 osteoblast-like cells and to characterize the cement surface. METHODOLOGY: A direct contact model for MG63 osteoblast-like cells with cements was used for 1, 3 and 5 days. Four end-points were investigated: (i) cement surface characterization by atomic force microscopy (AFM), (ii) cell viability by MTT assay, (iii) protein amount quantification by Bradford assay and (iv) cell morphology by SEM. Statistical analyses were performed by analysis of variance (anova) with a repetition test method. RESULTS: The roughness of the cements was comparable as revealed by AFM analysis. The MTT test for Biodentine™ was similar to that of MTA(®) . Biodentine™ and MTA(®) induced a similar but slight decrease in metabolic activity. The amount of total protein was significantly enhanced at day three (P < 0.05) but slightly decreased at day five for both tested samples. Biodentine™ was tolerated as well as MTA(®) in all cytotoxicity assays. SEM observations showed improvement of cell attachment and proliferation on both material surfaces following the three incubation periods. CONCLUSION: The biocompatibility of Biodentine™ to bone cells was comparable to MTA(®) .

Functionalization of titanium surface with chitosan via silanation: 3D CLSM imaging of cell biocompatibility behaviour.

INTRODUCTION: Biocompatibility ranks as one of the most important properties of dental materials. One of the criteria for biocompatibility is the absence of material toxicity to cells, according to the ISO 7405 and 10993 recommendations. Among numerous available methods for toxicity assessment; 3-dimensional Confocal Laser Scanning Microscopy (3D CLSM) imaging was chosen because it provides an accurate and sensitive index of living cell behavior in contact with chitosan coated tested implants. OBJECTIVES: The purpose of this study was to investigate the in vitro biocompatibility of functionalized titanium with chitosan via a silanation using sensitive and innovative 3D CLSM imaging as an investigation method for cytotoxicity assessment. METHODS: The biocompatibility of four samples (controls cells, TA6V, TA6V-TESBA and TA6V-TESBAChitosan) was compared in vitro after 24h of exposure. Confocal imaging was performed on cultured human gingival fibroblast (HGF1) like cells using Live/Dead® staining. Image series were obtained with a FV10i confocal biological inverted system and analyzed with FV10-ASW 3.1 Software (Olympus France). RESULTS: Image analysis showed no cytotoxicity in the presence of the three tested substrates after 24 h of contact. A slight decrease of cell viability was found in contact with TA6V-TESBA with and without chitosan compared to negative control cells. CONCLUSION: Our findings highlighted the use of 3D CLSM confocal imaging as a sensitive method to evaluate qualitatively and quantitatively the biocompatibility behavior of functionalized titanium with chitosan via a silanation. The biocompatibility of the new functionalized coating to HGF1 cells is as good as the reference in biomedical device implantation TA6V.

A systematic review of methods for tissue analysis in animal studies on orthodontic mini-implants.

Anchorage devices are increasingly used in orthodontics, and their clinical performance is directly dependent on the tissue response to these devices. This study aims to identify assessment parameters for evaluating tissue reactions around orthodontically loaded implants and to propose parameters to be included in a standardized method. Several electronic databases (PubMed, ScienceDirect, the Cochrane database) were explored for papers from January 1999 to December 2009. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement was used as a guideline for the methodology of systematic reviews. Twenty-five publications were selected from 123 potentially relevant abstracts. The selected studies mainly aimed to answer a clinical question and particularly the ability of immediate loading in orthodontics. Very few studies aimed to understand the healing mechanism around the devices leading to a lack of information on this topic. The most frequent combination of assessment methods was clinical evaluation, histology/histomorphometry and intravital bone labeling. Although the dog model is mainly used, pigs represent an interesting animal model, especially when studying devices in growing bone. Despite the extensive use of miniscrews in growing individuals, only few studies have included young subjects in their protocol. Moreover, in such studies, an oral hygiene program is absolutely necessary to avoid complications. Finite element analysis could improve the knowledge of the relationship between design and bone reaction; unfortunately, this elaborated method is complex and impossible to perform routinely. For standardization, the authors recommend to include specific criteria in study protocols when assessing tissue response to orthodontically loaded devices.

In vitro orthodontic bracket bonding to porcelain.

This in vitro study investigated the influence of using different combinations of bracket, adhesive, and light-curing source on the tensile bond strength to porcelain and on failure patterns at debonding. Tensile tests were performed using: one ceramic bracket versus one metal bracket, two orthodontic composites; type bisphenol A-glycidyldimethacrylate and urethane dimethacrylate (UDMA), and four light-curing units with the same range of emission spectrum but various light intensities: three light-emitting diode (LED) units and one halogen-based unit. One hundred and sixty porcelain samples were randomly divided into 16 equal groups. The porcelain surface was conditioned with 9 per cent hydrofluoric acid before silane application. The composite was photo-polymerized for 40 seconds. After storage in water at 37°C for 24 hours, the samples were subjected to tensile force until bond failure. Bond strength and bond failure mode were recorded; results were analysed (α = 0.05) using R language; linear model with constant variance for the bond strength and multinomial distribution for the failure mode. The bond strength in all groups was sufficient to withstand orthodontic treatment (>6 MPa). There was no statistical difference between the adhesives, but comparing bracket × light interaction, it was significantly higher with the ceramic bracket. No significant differences were seen between the metal bracket groups, but for the ceramic bracket, the results were significantly higher with the LED light. No fracture was observed in porcelain with the metal bracket but it occurred in 35 per cent of the ceramic bracket samples and the risk was higher when using UDMA composite and lower with LED high intensity light.

Response of fibroblast activity and polyelectrolyte multilayer films coating titanium.

OBJECTIVES: The study of surface properties is a recent and crucial issue in the biomaterial fields applied to Odontology. The reference biomaterial in dental implantology is titanium. The principal objective is a perfect bio-integration in the oral ecosystem, both in terms of mucosal and bone tissues. The aim of this work was to optimize the tissue-titanium interface by applying polyelectrolyte multilayer films on the surface of titanium. METHODS: The experimental study was undertaken on pure titanium samples. Two types of film ending with polycations or polyanions were selected. Both film types were built with a first poly(ethyleneimine) (PEI) base layer and composed either of poly(styrene sulfonate) (PSS) and poly(allylamine hydrochloride) (PAH) or of hyaluronic acid (HA) and poly(l-lysine) (PLL) layers. Final architectures were as follows: PEI-(PSS/PAH)(10), or PEI-(PSS/PAH)(10)-PSS, or chemically cross-linked PEI-(HA/PLL)(10) or PEI-(HA/PLL)(10)-HA. An analysis of the physicochemical characteristics of the surfaces was carried out by tensiometry measurements (dynamic contact angle, wettability, contact angle hysteresis) and atomic force microscopy. A biological study with human fibroblasts was followed over a 7-day culture period at days 0, 2, 4 and 7 to observe the cellular response in terms of morphology (scanning electron microscopy) and viability (Mosmann's test). RESULTS: The results showed that polyelectrolyte multilayer films could be successfully deposited onto titanium as previously described for glass or composite. Fibroblast adhesion and proliferation was strongly dependent on film type. SEM observations of cells on the different films agreed with the viability cell test. Furthermore, films containing PSS/PAH generated a better cellular response than films containing cross-linked HA/PLL. CONCLUSION: PSS/PAH polyelectrolyte films coating titanium could represent a new approach for oral bio-integration with great potential for clinical application in the fields of dental implantology. More particularly, the specific biofunctionalization of PSS/PAH films coating titanium could be envisioned by introducing layers of molecules that encourage the bio-integration process between the films.

Effect of type of polymerization on different properties of dental composites.

The aim of this study is to assess the influence of plasma lamps on the properties of the composites compared to the influence of conventional polymerization. Vickers hardness tests, three-point bending tests, and measurement of the shrinkage marginal gap by scanning electron microscopy were carried out on three resin composites (Tetric Ceram, Z-100 and Inten-S) irradiated with to lamps (Flipo) plasma and Astralis 7 halogen lamps). With a 3-second exposure, the results of Vickers hardness and resistance to flexion (excepting values for Z-100) were lower for the composites cured by the Flipo plasma lamp, than after 40-second curing by the conventional halogen lamp (Astralis 7), notably at a depth of 3 mm. With a 5-second exposure the results of Vickers hardness and resistance to flexion obtained using the plasma lamp approached those obtained by using the halogen lamp. Whatever the polymerization protocol used, the measurements of the gap between the tooth and the filling are very similar except for Z-100/Astralis 7, for which shrinkage results are more important. For any one resin composite and lamp used, the shrinkage values obtained at a depth of 4 mm are twice higher than those obtained at the surface. In conclusion, for a 3-second exposure the level of polymerization obtained by plasma curing is lower than the one obtained by halogen curing, particularly in depth. On the other hand, 5-second plasma curing results recommends the use of this kind of lamp.

Mechanical properties of two orthodontic adhesive materials polymerized with halogen and plasma curing.

OBJECTIVES: The aim of this study is to compare the efficiency of two polymerization techniques (halogen curing--Astralis 7 and plasma curing--Flipo), with two orthodontic adhesive materials (Enlight, a composite resin, and Fuji Ortho LC, a glass ionomer cement). METHODS: The efficiency of the polymerization techniques was shown by two mechanical tests. The hardness test was carried out on the exposed and non-exposed surfaces using 10 x 4 x 3-mm samples, polymerized either by halogen curing (40 seconds) or by plasma curing (5 seconds). The three-point bending tests were carried out on 2 x 2 x 25-mm samples polymerized as above. The samples were kept 1 hr at room temperature, then for 24 hrs in distilled water at 37 degrees C. RESULTS: Whatever the polymerization technique used, the results are similar for hardness and flexion, with the exception of the hardness tests carried out after polymerization with the Flipo light on the surface not directly exposed. CONCLUSION: In orthodontic practice, both polymerization techniques can be used. But a multi-bracket session can be long, and the reduction of time spent in the chair obtained by using plasma lamps seems to make this technique preferable.

Influence of autoclave sterilization on the surface parameters and mechanical properties of six orthodontic wires.

Orthodontic wires are frequently packaged in individual sealed bags in order to avoid cross-contamination. The instructions on the wrapper generally advise autoclave sterilization of the package and its contents if additional protection is desired. However, sterilization can modify the surface parameters and the mechanical properties of many types of material. The aim of this research was to determine the influence of one of the most widely used sterilization processes, autoclaving (18 minutes at 134 degrees C, as recommended by the French Ministry of Health), on the surface parameters and mechanical properties of six wires currently used in orthodontics (one stainless steel alloy: Tru-Chrome RMO; two nickel-titanium shape memory alloys: Neo Sentalloy and Neo Sentalloy with Ionguard GAC; and three titanium-molybdenum alloys: TMA(R) and Low Friction TMA Ormco and Resolve GAC). The alloys were analysed on receipt and after sterilization, using surface structure observation techniques, including optical, scanning electron and atomic force microscopy and profilometry. The mechanical properties were assessed by three-point bending tests. The results showed that autoclave sterilization had no adverse effects on the surface parameters or on the selected mechanical properties. This supports the possibility for practitioners to systematically sterilize wires before placing them in the oral environment.

[Evaluation of orthodontic friction using a tribometer with alternating movement]. / Evaluation du frottement orthodontique par un tribomètre a mouvement alternatif.

It is essential for orthodontists to control the complex phenomenon of friction. The in vitro techniques, usually dynamometers or tensile testing machines, used to measure the frictional resistance between arch wires and brackets are linear and unidirectional and can be criticised because tooth movements, such as tipping and uprighting, as well everyday oral activities, primarily chewing, are not uni-dimensional but more closely resemble the small amplitude oscillatory phenomena known as fretting. We therefore decided to develop a fretting machine not with linear but with alternating movements better suited to evaluate the frictional behaviour of orthodontic bracket-wire combinations. Once we had completed construction of this device, we proceeded to measure the frictional resistance between one stainless steel bracket (MicroArch GAC) and five wires currently used in orthodontics (Two nickel-titanium shape memory alloys: Neo Sentalloy and Neo Sentalloy with Ionguard GAC--Three titanium-molybdenum alloys: TMA and Low Friction TMA Ormco and Resolve GAC). We were able to set up a classification of the wires according to their coefficient of friction, demonstrating the inefficacy of ion implantation and quantifying the increase in the coefficient of friction which occurs when Resolve wires are placed in the oral environment for approximately one year.

Electrochemical studies of the corrosion behaviour of titanium and the Ti-6Al-4V alloy using electrochemical impedance spectroscopy.

OBJECTIVES: The aim of this study was to compare the electrochemical behaviour of two materials used in oral implantology. METHODS: The resistance to corrosion of Ti grade 2 and the alloy Ti-6Al-4V was studied in an artificial saliva solution. It has been observed that the passivation of titanium by an oxidised layer can be shown both by cyclic voltametry and by electrochemical impedance spectroscopy. Moreover, this latter technique, rarely used in odontology, opens up interesting perspectives, enabling a more quantitative approach to the resistance of the passive layer to be adopted. RESULTS: Also, the impedance data recorded for Ti grade 2 and the alloy Ti-6Al-4V, in the artificial saliva solution were shown that Ti grade 2 has a higher resistance to corrosion and a thicker oxide layer than the alloy Ti-6Al-4V. SIGNIFICANCE: The fact that the electrochemical properties of Ti-6Al-4V are lower than that titanium's ones indicate than a release of ions aluminum and or vanadium ions in the body can occur. This is why we recommend to the dental practitioners to preferably use titanium in implantology.

[Biocompatibility and resistance to corrosion of orthodontic wires]. / Résistance à la corrosion et biocompatibilité des fils orthodontiques.

Various materials are currently used to make orthodontic wires. This article suggests a synthesis on their resistance to corrosion and biocompatibility. In the first part, after a review of some basic notions on the corrosion processes, the authors develop the electrochemical characteristics of the three main groups of alloys used in orthodontics. They study more precisely corrosion resistance of nickel-titanium alloys and, through their own experimental results, they show that this type of alloy is subject to corrosion in acid and fluoridated environment. In the second part, the authors study those alloys biocompatibility. They first mention nickel toxicity and allergy induced by this element. Then, biocompatibility of alloys used in orthodontics is assessed following studies on the release of metallic elements from orthodontic wires, and studies on cell-compatibility when in contact with those wires. It is proved that the state of materials surface has a very high influence on their biocompatibility. As a conclusion, in spite of numerous studies carried out so far, showing a satisfactory biological behaviour of those orthodontic wires, many questions are yet to be answered: long term in vivo performances of those materials have not yet been exactly assessed. Further studies must definitely be carried out.

Comparison of corrosion behaviour in presence of oral bacteria.

The aim of this study was to compare the resistance of the corrosion of dental alloys in a solution containing oral bacteria named Actinomyces viscosus (ATCC19246). In this paper, we explain the choice of this precise species of bacteria, then specify its culture in artificial saliva and the experimental precautions needed to avoid the pollution by other bacteria. The electrochemical behaviour of two dental alloys (Ni-Cr alloy and gold-based alloy) was investigated by electrochemical means in sterile Fusayama artificial saliva (AS), AS enriched with sterile yeast extract (YE) and YE modified by introducing bacteria (AV). Open-circuit potentials, potentiodynamic curves, polarization resistance and impedance spectroscopy are the electrochemical procedures selected for this work. It has thus been shown that the open-circuit potential of the non-precious alloy is always lower than that of the gold precious alloy, and the colonization of metal surface by bacteria caused a drop in open circuit potential. The electrochemical impedance spectroscopy results have shown that the electrolyte resistance decreased between the AS, YE and AV milieu, in the presence of bacteria a slight decrease in polarization resistance was observed with the precious alloy and an increase with the non-precious alloy. The drop in the electrolyte resistance cannot explain the change in polarization resistance. The influence of Actinomyces viscosus might be essentially due to the consumption of oxygen at the metal/electrolyte interface of the specimen. For the non-precious alloy, the absence of oxygen (instigator of corrosion) led to an increase in polarization resistance whereas the slight decrease for the precious alloys might be justified by the organic and inorganic metabolites released by bacteria in to the electrolyte. The scanning electron micrography after electrochemical analysis, confirmed the absence of contaminants. These preliminary results demonstrate the unquestionable influence of this bacteria on the corrosion behaviour of the alloys studied, however, further studies are necessary.

Measurement and evaluation of galvanic corrosion between titanium/Ti6A14V implants and dental alloys by electrochemical techniques and auger spectrometry.

The purpose of this study was to investigate, in different experimental conditions, the galvanic corrosion phenomena which can exist between a dental suprastructure and a dental implant. The electrochemical behavior of 7 alloy superstructures with titanium and titanium alloy (Ti6A14V) implants was investigated by electrochemical means in Fusayama-Meyer de-aerated saliva and Carter-Brugirard (AFNOR) non de-aerated saliva. Different techniques were used to obtain the value of the galvanic coupling current and potential for each couple. All showed very low corrosion rates, ranging from 10(-6) to 10(-8) A. Surface analysis confirmed these results.