Clinical Applications In Dentistry Research Articles

Analysis of Active Oral Tactile Sensitivity in Individuals with Complete Natural Dentition

To evaluate the active tactile sensitivity in individuals with complete natural dentition, determining the smallest thickness detected by the participants, and clarifying if there is a difference between the thicknesses analyzed. Active tactile sensitivity was evaluated in 40 research participants. Inclusion criteria included participants with complete natural dentition, without active or history of periodontal disease, absence of temporomandibular disorders, bruxism, and restorations in the evaluated area. Exclusion criteria included age below 18 years. The active tactile perception threshold was evaluated by using carbon sheets of different thicknesses (0, 12, 24, 40, 80, 100, and 200 μm), which were inserted in the participants' premolars, bilaterally. The carbon sheet was inserted so as not to come into contact with the oral soft tissues. Subsequently, the participant occluded and was asked about the perception of the intraocclusal object 20 times in each occlusal contact. The collected data were tabulated considering the amount of positive and negative responses for each carbon thickness. Values of p < 0.05 were considered significant. The results showed that there was linearity in perception, on both sides, besides, the natural dentition was able to perceive difference in thickness from 12 μm. We conclude that the 12 μm thickness is noticeable in occlusion and can be differentiated from other thicknesses in natural dentition and that there is no difference between the tactile sensitivity of the right and left sides. A better understanding of active oral tactile sensitivity will contribute to numerous clinical applications in dentistry, including occlusal adjustment in dental rehabilitation, dental implants prosthesis design, and survival of prosthetic rehabilitation.

Cytotoxicity of Ti–6Al–4V–5Cu Alloy to MC3T3-E1 Cells

The aim of this work was to study the cytotoxicity of Ti–6Al–4V–5Cu (TC4–Cu) alloy for dental applications and evaluate the cell viability of different fabricated TC4–Cu alloys in contact with MC3T3-E1 cells in vitro. Ti–6Al–4V (TC4) alloy was used as a negative control to evaluate the cytotoxicity level of TC4–Cu alloy so as to provide basic support for the dental clinical application. Control group TC4 and experimental group TC4–Cu with different fabrications were incubated in the cell culture medium. The absorbance value of mouse osteoblast MC3T3-E1 cells was detected by CCK-8 assay after 1, 3 and 7 days, respectively. The relative proliferation rate of cells was calculated, and then the toxicity level was valued for each group. Cell morphology on the surface was also studied by observing the cytoskeleton through F-actin filament staining. The experimental results showed that the absorbance values for the experimental and the negative control groups were not same at different time points. Compared with different fabricated TC4–Cu alloys, the annealing-TC4–Cu alloy showed much better biocompatibility. The mouse osteoblast MC3T3-E1 cells cultured with annealing-TC4–Cu, rolling-TC4–Cu and solution + aging-TC4–Cu have no toxic effects, and these alloys could promote the proliferation of mouse osteoblasts.

Mathematical Study for laser and its Clinical Applications in dentistry: Review and Outlook

The paper for the survey is to recapitulate applications of laser, mathematically and also discusses whether the laser can furnish a similar or ameliorate treatment for traditional care. Studies have shown that the use of lasers in the different fields is an efficacious device to increase efficiency, quality, easiness, cost and convenience in dental therapy. The laser is an influential dental auxiliary to control pollution, wound reparations, the discharge and control of tremolo in the expulsion of hard tissues. Lasers designed specifically for this region are surgical and medical devices at the forefront of technology and are used by a large number of doctors in everyday use. Dental laser uses wavelengths that are absorbed in soft or solid tissues and given exceptional privacy in tissue. Its clinical capabilities are extremely complex, providing very good comfort for the patient. Clinical conditions will characterize the various and diverse applications of dental lasers depending on the power used during exposure and absorption of wavelengths in soft or hard tissues, emphasizing the benefits for each case.

Physicochemical, mechanical and cytotoxicity evaluation of chitosan-based accelerated portland cement

In recent years, the possibility of using accelerated portland cement (APC) as a cheaper alternative to endodontic materials attracts attention. Chitosan-based accelerated portland cement (APC-CT) material was prepared with different concentrations of chitosan (CT) solutions of 0%, 0.625%, 1.25% and 2.5% (w/v), and its physicochemical, mechanical and cytotoxicity properties were evaluated. The results indicated that APC-CT exhibited good physicochemical and mechanical properties, the addition of CT improved the pH and solubility of APC and extended its setting times. However, compressive strengths were reduced and minimum effect on microhardness was observed. Surface morphology of APC-CT was characterized by the presence of CT crystallites which spread and filled the spaces in APC structure that resulted in more homogeneous phases. The chemical compositions of APC and APC-CT were almost identical with intensified O, C and Si in APC-CT, and the interaction of chitosan with APC was confirmed by FTIR spectra. The cytotoxicity and cell attachment assays indicated that APC-CT supports the cell proliferation and shows favourable interaction and cell response to the materials in vitro which imply that this material is non-toxic. In conclusion, the results exhibit suitable physicochemical, mechanical and biocompatibility properties of APC-CT as a promising endodontic material for clinical dental applications. Further development of APC-CT is indicated for the synthesis of variable dental restorative materials.

Antimicrobial Efficacy of Nitrogen-Based Non-thermal Atmospheric Pressure Plasma Jet on Dental Biofilm

Biofilms on the tooth surface that are not removed regularly can lead to dental caries, gingivitis, or periodontal disease. Recently, numerous newly developed sterilization approaches and techniques based on nonthermal temperature gas plasma have been introduced in the medical field. This study investigates the influence of nitrogen-based nonthermal atmospheric pressure plasma jet (NTAPPJ) treatment on dental biofilms. To this end, oral biofilms were formed on saliva-coated hydroxyapatite (HA) disks in a batch culture at 37 °C under 5% CO2. HA disks were treated with NTAPPJ for 0, 30, 60, and 120 s. The antibacterial efficacy of the NTAPPJ treatment was determined from the number of colony forming units (CFU). Morphology and structural changes in the bacteria were examined using scanning electron microscopy. The surface characteristics of the HA disks were analyzed with X-ray photoelectron spectroscopy (XPS) and contact angle measurements. CFU were reduced, and biofilm morphology and structure were significantly affected by plasma treatment. XPS and contact angle analysis showed that the surface of plasma-treated specimens was significantly richer in hydroxyl groups and more hydrophilic relative to untreated samples. There was no significant difference between the cytotoxicity of the treated and untreated samples for each test group. Therefore, these results show that atmospheric plasma treatment is very effective for biofilm release, which makes NTAPPJ a promising technique for various clinical dental applications, including bacterial sterilization.

Applying synthetic radiography to intraoral tomosynthesis: a step towards achieving 3D imaging in the dental clinic.

A practical approach to three-dimensional (3D) intraoral imaging would have many potential applications in clinical dentistry. Stationary intraoral tomosynthesis (sIOT) is an experimental 3D imaging technology that holds promise. The purpose of this study was to explore synthetic radiography as a tool to improve the clinical utility of the images generated by an sIOT scan. Extracted tooth specimens containing either caries adjacent to restorations (CAR) or vertical root fractures (VRF) were imaged by sIOT and standard dental radiography devices. Qualitative assessments were used to compare the conspicuity of these pathologies in the standard radiographs and in a set of multi-view synthetic radiographs generated from the information collected by sIOT. The sIOT-based synthetic 2D radiographs contained less artefact than the image slices in the reconstructed 3D stack, which is the conventional approach to displaying information from a tomosynthesis scan. As a single sIOT scan can be used to generate synthetic radiographs from multiple viewing angles, the interproximal space was less likely to be obscured in the synthetic images compared to the standard radiograph. Additionally, the multi-view synthetic radiographs can potentially improve the display of CAR and VRFs as compared to a single standard radiograph. This preliminary experience combining synthetic radiography and sIOT in extracted tooth models is encouraging and supports the ongoing study of this promising approach to 3D intraoral imaging with many potential applications.

Development and application of a 3D periodontal in vitro model for the evaluation of fibrillar biomaterials

BackgroundPeriodontitis is a chronic inflammation of the tooth supporting structures that finally can lead to tooth loss. As chronic periodontitis is associated with systemic diseases multiple approaches have been followed to support regeneration of the destructed tissue. But very few materials are actually used in the clinic. A new and promising group of biomaterials with advantageous biomechanical properties that have the ability to support periodontal regeneration are self-assembling peptides (SAP). However, there is still a lack of 3D periodontal models that can evaluate the migration potential of such novel materials.MethodsAll experiments were performed with primary human periodontal ligament fibroblasts (HPLF). Migration capacity was assessed in a three-dimensional model of the human periodontal ligament by measuring the migration distance of viable cells on coated (Enamel Matrix Protein (EMP), P11–4, collagen I) or uncoated human dentin. Cellular metabolic activity on P11–4 hydrogels was assessed by a metabolic activity assay. Deposition of ECM molecules in a P11–4 hydrogel was visualized by immunostaining of collagen I and III and fibrillin I.ResultsThe 3D periodontal model was feasible to show the positive effect of EMP for periodontal regeneration. Subsequently, self-assembling peptide P11–4 was used to evaluate its capacity to support regenerative processes in the 3D periodontal model. HPLF coverage of the dentin surface coated with P11–4 increased significantly over time, even though delayed compared to EMP. Cell viability increased and inclusion of ECM proteins into the biomaterial was shown.ConclusionThe presented results indicate that the 3D periodontal model is feasible to assess periodontal defect coverage and that P11–4 serves as an efficient supporter of regenerative processes in the periodontal ligament.Clinical relevanceThe establishment of building-block synthetic polymers offers new opportunities for clinical application in dentistry. Self-assembling peptides represent a new generation of biomaterials as they are able to respond dynamically to the changing environment of the biological surrounding. Especially in the context of peri-implant disease prevention and treatment they enable the implementation of new concepts.

A Case Report: Dental Hygiene Process of Care based on Dental Clinical Application

A Case Report: Dental Hygiene Process of Care based on Dental Clinical Application

Fabrication of strontium-incorporated protein supramolecular nanofilm on titanium substrates for promoting osteogenesis.

The inherent biological inertness of Ti substrates is a general challenge in orthopedic and dental clinical application. In this study, the strontium-containing phase change lysozyme coating was prepared on titanium via a supramolecular self-assembly method for accelerating osseointegration. Successful preparation of the Sr-incorporated lysozyme nanofilm onto the Ti substrate (Ti-Ly-Sr) was proved by tests of scanning electron microscopy (SEM), atomic force microscopy (AFM), X-ray photoelectron spectroscopy (XPS) and Contact angle (CA). Furthermore, the results of cell morphology observation, cell viability assay, alkaline phosphatase staining and quantitative analysis showed that Ti-Ly-Sr substrate enhanced early adhesion, proliferation and osteogenic differentiation of bone marrow stromal cells (BMSCs). The quantitative real-time polymerase chain reaction (qRT-PCR) assays confirmed that Ti-Ly-Sr enhanced the expression of osteogenic related genes (BMP2, OPG, Runx2 and COL-1) of BMSCs at the molecular level. Moreover, Micro-CT and histological analysis proved that the strontium-incorporated lysozyme nanofilm modified Ti implants had significant capability of new bone formation in vivo after implantation for 4weeks. We anticipate that the present system would provide a facile and effective means for surface modification of Ti-based implants. Relevant ideas and techniques in this study will contribute to the development of new implant devices.

Comparison of experimental peri-implantitis models after application of ex vivo BMP2 gene therapy using periodontal ligament stem cells

Peri-implantitis is an inflammatory disease that results in bone destruction around dental implants. A preclinical study using beagle models is frequently performed prior to clinical application in dentistry. Previously, we proposed an immediate peri-implantitis experimental model with a shorter experimental duration and less expense than the conventional experimental model. However, the differences in the regenerative outcomes between the immediate and conventional models were not fully revealed. In this study, we aimed to compare the regenerative outcomes between both models when ex vivo BMP2 gene therapy using autologous periodontal ligament stem cells (B2/PDLSCs) was applied to peri-implantitis defects. The results showed that the defect depths were significantly different between both models. New bone formation occurred in both models, but there were significant differences between the models. More than 70% of the defects were filled with newly formed bone in the conventional model, whereas 30–40% of the defects were filled in the immediate model. However, after adjustment for the differences in the defect depths between the models, the statistically significant differences in the regenerative outcomes between the models were lost. In conclusion, the inferior regenerative outcome of an immediate peri-implantitis model at B2/PDLSCs transplantation resulted from the defect depths, not the model itself.

Setting time, mechanical and adhesive properties of magnesium oxide nanoparticles modified glass-ionomer cement

Nanoparticle modifications of glass-ionomer cement are interesting research subjects. This study investigated the effect of MgO nanoparticles on the setting time, compressive and diametral tensile strength, and adhesive properties of glass-ionomer cement. A conventional GIC was modified by the incorporation of MgO nanoparticles at 1%, 2.5%, 5%, and 10% (w/w) ratios with an unmodified GIC used as the control group. The data were analysed using a one-way analysis of variance (ANOVA) and Tukey's HSD test (p < 0.05). Although the GICs with 1% and 2.5% MgO nanoparticles were still within the ISO standard range specified for the GIC setting time, increasing the MgO nanoparticle concentration significantly increased the setting time of the tested cement (p < 0.05). GICs with 1% MgO nanoparticles had the highest compressive and diametral tensile strength values. Increasing the nanoparticle content from 5% and more significantly decreased the cement strength (p < 0.05). The shear bond strength (SBS) of enamel and dentine showed statistically significant differences among the tested groups (p < 0.05). However, the addition of MgO nanoparticles up to 5% (w/w) did not have an unfavourable effect on the cement adhesiveness. Although cohesive and mixed type failure modes were more common than adhesive failure modes, no statistically significant associations were found between the failure mode and type of GIC (p > 0.05).Within the limitations of this study, the current findings suggest that modifying GICs by incorporating MgO nanoparticles up to 2.5% (w/w) could be a promising restorative material for clinical dental applications.

Accuracy of a simplified 3D-printed implant surgical guide

Statement of problemThe accuracy of 3D printing technology is essential for clinical applications. However, depending on the 3D printing method, machine, and environment, the accuracy varies even if the same computer-aided design (CAD) model is printed. PurposeThe purpose of this in vitro study was to evaluate the differences between the CAD model and the printed parts with a simplified guide designed based on the implant guide and to compare the accuracy among 3 types of 3D printers. Material and methodsA maxilla and mandible implant guide made of complex anatomic structures is difficult to measure accurately. For accurate measurements, 16 simplified guides were designed based on the maxilla and mandible implant guide. The 16 simplified guides were fabricated by using the following 3 different 3D printer technologies: photopolymer jetting (PolyJet), stereolithography apparatus (SLA), and multijet printing (MJP). Each simplified guide was measured 4 times with digital calipers for 20 linear measurements. The measured simplified guides were compared with the CAD model, and the accuracy of the 3D printers was compared. The mean absolute difference and mean relative difference were calculated, and the Bland–Altman analysis was used to evaluate the limits of agreement between the CAD model and the printed parts. The Wilcoxon signed-rank test was performed to evaluate the significant differences among the 3D printers (α=.05). ResultsThe mean absolute difference and the mean relative difference between the CAD model and the 3D-printed parts were 0.06 ±0.05 mm (0.46 ±0.51%) for PolyJet, 0.09 ±0.05 mm (0.66 ±0.62%) for SLA, and 0.31 ±0.33 mm (1.11 ±0.70%) for MJP. When the 3D printers were compared, significant differences were found between SLA and MJP (P=.006) and between PolyJet and MJP (P=.001). ConclusionsWhen the CAD models and the 3D-printed parts of the simplified implant guides were compared, significant accuracy differences were observed. The PolyJet and SLA 3D printers met the required accuracy for clinical applications in dentistry. The most suitable 3D printer, however, should be selected considering all factors.

Ozone: A paradigm shift in dental therapy

Objectives: Ozone has been used in medicine for over a century, but its clinical applications in dentistry have just begun to be explored. The effects of ozone either as gas, water, or oil in the treatment of dental diseases such as caries, periodontitis, and hypersensitivity have been investigated and the results are promising. Thus, the objective of this review is to shed light on the recent clinical oral applications of ozone and summarize the various research findings regarding the use of ozone in dentistry. This review would enable researchers to know the background of ozone in dentistry and to help them formulate new and improved protocols to study the possible applications of ozone in clinical dentistry. Data Sources: Pertinent literature on the application of ozone to treat various dental diseases was thoroughly searched using Medline, PubMed, Central, Cochrane, and Embase. Conclusion: Clinical use of ozone is a minimally invasive approach toward the prevention and control of oral diseases. The present literature review observed encouraging results on the use of ozone in various modalities of dental treatments. However, the use of ozone in dentistry needs further investigation using controlled clinical trials, with sufficient, follow-up period and standardized measurements to establish ozone therapy as a standard treatment modality in dental practice.

3D Printing in Dentistry-State of the Art.

Three-dimensional (3D) printing is a rapidly developing technology that has gained widespread acceptance in dentistry. Compared to conventional (lost-wax technique) and subtractive computer numeric controlled methods, 3D printing offers process engineering advantages. Materials such as plastics, metals, and ceramics can be manufactured using various techniques. 3D printing was introduced over three decades ago. Today, it is experiencing rapid development due to the expiration of many patents and is often described as the key technology of the next industrial revolution. The transition to its clinical application in dentistry is highly dependent on the available materials, which must not only provide the required accuracy but also the necessary biological and physical properties. The aim of this work is to provide an up-to-date overview of the different printing techniques: stereolithography, digital light processing, photopolymer jetting, material jetting, binder jetting, selective laser sintering, selective laser melting, and fused filament fabrication. Additionally, particular attention is paid to the materials used in dentistry and their clinical application.

Optimized Surface Characteristics and Enhanced in Vivo Osseointegration of Alkali-Treated Titanium with Nanonetwork Structures.

Alkali-treated titanium (Ti) with a porous, homogeneous, and uniform nanonetwork structure (TNS) that enables establishment of a more rapid and firmer osteointegration than titanium has recently been reported. However, the mechanisms underlying the enhanced osteogenic activity on TNS remains to be elucidated. This study aimed to evaluate the surface physicochemical properties of Ti and TNS, and investigate osteoinduction and osteointegration in vivo. Surface characteristics were evaluated using scanning electron microscopy (SEM), scanning probe microscopy (SPM), and X-ray photoelectron spectrometry (XPS), and the surface electrostatic force of TNS was determined using solid zeta potential. This study also evaluated the adsorption of bovine serum albumin (BSA) and human plasma fibronectin (HFN) on Ti and TNS surfaces using quartz crystal microbalance (QCM) sensors, and apatite formation on Ti and TNS surfaces was examined using a simulated body fluid (SBF) test. Compared with Ti, the newly developed TNS enhanced BSA and HFN absorbance capacity and promoted apatite formation. Furthermore, TNS held less negative charge than Ti. Notably, sequential fluorescence labeling and microcomputed tomography assessment indicated that TNS screws implanted into rat femurs exhibited remarkably enhanced osteointegration compared with Ti screws. These results indicate that alkali-treated titanium implant with a nanonetwork structure has considerable potential for future clinical applications in dentistry and orthopedics.

Use of carbon dioxide lasers in dentistry

This paper aims to perform a descriptive analysis by reviewing publications concerned with the production of carbon dioxide (CO2) lasers and their technological advancement, optical properties, and parameters in relation to clinical applications in dentistry. This review was based on the literature search in Scopus, Google Scholar, and PubMed in English. The last search was made in December 2017 and there was no publication-year limit. : The 10,600-nm CO2 laser is a readily available dental laser on the market. It enables performance of a bloodless surgical procedure and reduces post-operative discomfort in soft tissue dental surgery. Due to the advancement of technology, CO2 lasers with short pulse duration and high peak power are available. This new-parameter CO2 laser causes less collateral thermal damage to soft tissue than conventional lasers with continuous wave mode. Recently, a 9,300-nm wavelength CO2 laser has been introduced for clinical use in dental hard tissue removal. These developments make CO2 lasers fitting for dental hard tissue preparation. The 10,600-nm CO2 laser is widely accepted for soft tissue surgery applications. Although CO2 lasers have been studied extensively in caries prevention, they have not been applied in clinical practice. The optical properties of 9,300-nm and 9,600-nm CO2 wavelengths are suitable for dental hard tissue treatment. Technological advancements in software and laser parameters will aid in new clinical application and technique development. CO2 lasers as hard tissue lasers will become more popular and more widely accessible to researchers and clinicians.

Bioengineering Tooth Bud Constructs Using GelMA Hydrogel.

Bioengineered dental tissues and whole teeth that exhibit features and properties of natural teeth can functionally surpass currently used artificial dental implants. However, no biologically based alternatives currently exist for clinical applications in dentistry. Here, we describe a newly established bioengineered tooth bud model for eventual applications in clinical dentistry. We also describe methods to fabricate and analyze bioengineered tooth tissues, including cell isolation, in vivo implantation, and post-harvest analyses.

Dental clinical application of a new radical sterilization technology

Dental clinical application of a new radical sterilization technology

Infiltration and Profiles of Mesoporous Silica Nanoparticles in Dentinal Tubules.

Mesoporous silica nanoparticles (MSNs), the inorganic nanomaterials with stable physicochemical property and versatile surface functional groups, have been increasingly studied and applied in biomedical field as nanocarriers. There are a limited number of reports on their potential applications in clinical dentistry. Herein, we fabricated the fluorescence-labeled MSNs (RITC-NPs) and investigated for the first time their infiltration profiles in the dentinal tubules of extracted permanent teeth prepared by different irrigation approaches. Ethylenediaminetetraacetic acid (EDTA) enabled removal of the smear layer efficiently and exposure of the dentinal tubules on the root canal walls. Confocal scanning laser microscopy showed that the RITC-NPs could accumulate on the root canal walls, and effectively infiltrate into the dentin. In general, the fluorescence intensity in dentin from EDTA-treated group was much higher than that from the ultrasound-treated group, and stronger red fluorescence was observed at the crown and middle sections than the apical one in the EDTA group. The field-emission gun scanning electron microscopy further confirmed the infiltration effects of RITC-NPs in the dentin, through the patent dentinal tubules. The present findings on the infiltration of MSNs in the root canal system may provide a potential approach for further applying MSN-encapsulated antimicrobials in advanced endodontic therapy.

Preparation and characterization of fluoride calcium silicate composites with multi-biofunction for clinical application in dentistry

Abstract Fluoride calcium silicate (FCS) are widely used in dental tissue engineering due to their excellent biological properties. This study aimed to develop novel FCS with multiple biofunctions as toothpaste additives. In this study, the preparation of composite FCS, morphologies of the composites and the in vitro biofunctions were investigated. Calcium silicate with 0.7% (wt) fluoride was prepared by co-precipitation method. Pure calcium silicate (CS) was synthesized for controlling study. Biomimetic mineralization study was conducted in simulated body fluid (SBF), the composition, phase structure, apatite formation and morphology were investigated by X-ray Fluorescence Analysis (XPS), X-ray diffraction analysis (XRD), Fourier transform infrared spectroscopy (FTIR), scanning electron microscope (SEM) and transmission electron microscope (TEM). In vitro cell viability studies showed that the fluoride ions promoted cell proliferation and differentiation. This study indicated that FCS shown good bioactivity to induce apatite formation and it could be a promising toothpaste additives with specific biofunction.