Clinical Applications In Dentistry Research Articles

Clinical considerations of nanobiomaterials in endodontics: A systematic review

Introduction: Clinical dentistry and primary oral care continue to experience significant improvements in quality at different levels of dentistry. These changes and improvements are of great benefit to both patients and clinicians because of significant achievements and advances in the physical, chemical, and biological sciences. Nanotechnology and its varied products are eloquent examples of these revolutionary trajectories in scientific discoveries and endeavors. Scientific revolution of nanotechnology has afforded the dental profession with a wealth of novel nanobiomaterials, templates for dental tissues regeneration, oral fluid nanodiagnostics, and the potential ability to use nanoparticles to replace lost dental hard tissues. Materials and Methods: A manual and systematic electronic search was conducted using the PubMed database. Several keywords were used: “nanocharacterization” “nanoclinical applications” “endodontics” “nanodentistry” “nanotechnology (263) (278) papers were excluded because they were duplicated papers,” “nanoparticles” and “regeneration.” Relevant articles published up to 2016 in the English language were retrieved. Results: Initial electronic and manual searches identified (571) studies. Preliminary analysis was performed on a total of (332) publication by screening titles and abstracts of articles. A second phase, data studies, or unrelated reports were excluded. Full texts of the remaining (54) papers were retrieved. A manual search added (6) publications on the topic to give a total of (60) publications, literature reviews, which were included in this review. Conclusions: Physical and chemical improvements in nanotechnology products continue to occur and may soon lead to the development of “smart” endodontic therapeutic agents and materials. The future looks auspicious for sustained dramatic inventions in novel nanomaterials for clinical dental applications.

Mechanical properties of bio compatible functional prototypes for joining applications in clinical dentistry

In the presented research, work investigations have been made for mechanical properties of the functional prototypes prepared from biocompatible filament of fused deposition modelling (FDM), comprising of hydroxyapatite (HAp), polypropylene (PP) and polyvinyl chloride (PVC). The functional prototypes will be used in clinical dentistry (mainly for joining application for job-type production activities). The filament has been prepared in house using twin screw extrusion process. For evaluation purpose, standard tensile specimens as per ASTM D-638 have been prepared on FDM. This study highlights the effect of three parameters of FDM (namely: infill percentage, layer thickness and speed of extrusion head) on the mechanical properties (namely: load at peak and load at break). The results of the study suggest that infill density has majorly contributed, 92% on load at peak and 89% for load at break, and deposition speed has very less contribution i.e., 1% towards the mechanical strength of the specimen. Further, the results are supported with thermal analysis using differential scanning calorimeter (DSC), which ensures that the specimen prepared are thermally stable and can be put in for joining applications for job-type production activities in clinical dentistry.

Dynamic measurement of the optical properties of bovine enamel demineralization models using four-dimensional optical coherence tomography.

Dental enamel mineral loss is multifactorial and is consequently explored using a variety of in vitro models. Important factors include the presence of acidic pH and its specific ionic composition, which can both influence lesion characteristics. Optical coherence tomography (OCT) has been demonstrated as a promising tool for studying dental enamel demineralization. However, OCT-based characterization and comparison of demineralization model dynamics are challenging without a consistent experimental environment. Therefore, an automated four-dimensional OCT system was integrated with a multispecimen flow cell to measure and compare the optical properties of subsurface enamel demineralization in different models. This configuration was entirely automated, thus mitigating any need to disturb the specimens and ensuring spatial registration of OCT image volumes at multiple time points. Twelve bovine enamel disks were divided equally among three model groups. The model demineralization solutions were citric acid (pH 3.8), acetic acid (pH 4.0), and acetic acid with added calcium and phosphate (pH 4.4). Bovine specimens were exposed to the solution continuously for 48 h. Three-dimensional OCT data were obtained automatically from each specimen at a minimum of 1-h intervals from the same location within each specimen. Lesion dynamics were measured in terms of the depth below the surface to which the lesion extended and the attenuation coefficient. The net loss of surface enamel was also measured for comparison. Similarities between the dynamics of each model were observed, although there were also distinct characteristic differences. Notably, the attenuation coefficients showed a systematic offset and temporal shift with respect to the different models. Furthermore, the lesion depth curves displayed a discontinuous increase several hours after the initial acid challenge. This work demonstrated the capability of OCT to distinguish between different enamel demineralization models by making dynamic quantitative measurements of lesion properties. This has important implications for future applications in clinical dentistry.

Evaluation of the osseointegration of dental implants coated with calcium carbonate: an animal study

In an attempt to overcome the limitations of titanium in dental and orthopaedic clinical applications, a new method has been developed to prepare calcium carbonate coatings on sandblasted and acid-etched (SA) titanium implants. The purpose of this study was to investigate the effect of calcium carbonate-SA (CC-SA) implants on osseointegration in vivo. The surfaces of SA and CC-SA implants were characterised for surface morphology and surface chemistry. Subsequently, these two kinds of implants were implanted in the femoral condyles of rabbits. The implants were retrieved and prepared for histological and histomorphometric evaluation 1, 2, 4, 8 and 12 weeks after implantation. Significantly higher values of bone-to-implant contact of the entire implant except the gap area (BIC_ALL) and the bone-to-implant contact of the gap area (BIC_GAP) were found in animals with the CC-SA implants than in those with the SA implants at 4 weeks. Higher values of total gap bone were found in those with the CC-SA implants than in those with the SA implants at 1, 2 and 4 weeks. In conclusion, the current findings demonstrate that the calcium carbonate coating can improve and accelerate the early ingrowth of bone and osseointegration at the early healing phase. This may reduce clinical healing times and thus improve implant success rates.

SURVEY OF DENTAL STUDENTS’ ATTITUDE REGARDING ORIENTAL MEDICINE/COMPLEMENTARY AND ALTERNATIVE MEDICINE: COMPARISON BETWEEN TWO JAPANESE DENTAL SCHOOLS

Background:The present study aimed to examine the impact of “curricula for undergraduate education in oriental medicine (OM)/complementary and alternative medicine (CAM)” on student awareness of OM. A questionnaire survey was conducted involving the Nagasaki University School of Dentistry (NUSD), a university that implements education in OM as part of its undergraduate curriculum, and Tokyo Dental College (TDC), which does not teach OM.Materials and methods:The third- and fifth-year students of both NUSD and TDC underwent the anonymous questionnaire survey, which included questions regarding their knowledge of OM and CAM, interests in these subjects, and their opinions on the necessity of teaching OM in the undergraduate dental education, and the results were collected for analysis.Results:Whereas 33% of 5th year NUSD students had knowledge of OM/CAM was 33%, only 10% of 5th year TDC students reported knowledge on the subject. 69% of 5th year NUSD students interested in OM/CAM, while 5th year TDC students who interest them were only 45%. Although 77% of 5th year NUSD students were in favor of OM education implemented in the Faculty of Dentistry, the percentages of TDC students of that were smaller (46% in 3rd year and 48% in 5th year). Whereas 26% of 5th year TDC students did not recognize the necessity of oriental medicine education, only one 5th year NUSD student (2%) did not so.Conclusion:Introduction of education in OM in the undergraduate dental education program helps students to increase their interests in dental clinical applications.

Bone Marrow and Adipose Tissue Derived Mesenchymal Stem Cells in Regeneration of Cleft Lip and Alveolus: A Review of Literature

Congenital abnormalities are worldwide major health problem. One of these abnormalities is; cleft lip and palate. Such a condition when occur, it can affect the child and provoke physiological and psychological consequences. One of the desired and sparkling line of treatment is stem cells engineering. There are many different types of stem cells. The most popular stem cells used in craniofacial treatment are; bone marrow derived mesenchymal stem cells (BM-MSCs) and adipose tissue derived mesenchymal stem cells (AT-MSCs). Although both showed positive results, still there are few comparative studies that evaluate the effectiveness of AT-MSCs over BM-MSCs. The purpose of this review was to provide an overview of stem cells and their clinical uses, and to compare the effectiveness of BM-MSCs and AT-MSCs in cleft lip and alveolus patients. Electronic search of English scientific papers from 2000 to 2017 was accomplished using PubMed, Cochrane Database and Google Scholar search engines. The following search terms used were, Cleft Lip and Palate, Bone Marrow Derived Mesenchymal Stem Cells, Adipose Tissue Derived Mesenchymal Stem Cells, Clinical Applications in Dentistry, Animal Studies. Stem cells offer a new era for craniofacial reconstruction. Both of adipose and bone marrow derived stem cells show effective results in the level of restoring function and esthetic. However, the AT-MSCs were easier to obtain without any harm to the patients.

Apitherapy - a natural antidote for oral diseases: an overview

Natural commodities of honeybees have various ingredients within them, which contribute to their incredible properties. These products have been used in traditional medicine since ancient times, due to its biologically active nature in preventing infections, wound healing and in promoting health. This nature is credited to their antibacterial, antioxidant, immunomodulating, anti-inflammatory and wound healing property. As natural remedies are showing promising results in management of oral diseases in the modern era, this paper attempts to highlight the properties of various products of honeybees and clinical applications in dentistry.

Biocompatibility study of lithium disilicate and zirconium oxide ceramics for esthetic dental abutments.

PurposeThe increasing demand for esthetically pleasing results has contributed to the use of ceramics for dental implant abutments. The aim of this study was to compare the biological response of epithelial tissue cultivated on lithium disilicate (LS2) and zirconium oxide (ZrO2) ceramics. Understanding the relevant physicochemical and mechanical properties of these ceramics will help identify the optimal material for facilitating gingival wound closure.MethodsBoth biomaterials were prepared with 2 different surface treatments: raw and polished. Their physicochemical characteristics were analyzed by contact angle measurements, scanning white-light interferometry, and scanning electron microscopy. An organotypic culture was then performed using a chicken epithelium model to simulate peri-implant soft tissue. We measured the contact angle, hydrophobicity, and roughness of the materials as well as the tissue behavior at their surfaces (cell migration and cell adhesion).ResultsThe best cell migration was observed on ZrO2 ceramic. Cell adhesion was also drastically lower on the polished ZrO2 ceramic than on both the raw and polished LS2. Evaluating various surface topographies of LS2 showed that increasing surface roughness improved cell adhesion, leading to an increase of up to 13%.ConclusionsOur results demonstrate that a biomaterial, here LS2, can be modified using simple surface changes in order to finely modulate soft tissue adhesion. Strong adhesion at the abutment associated with weak migration assists in gingival wound healing. On the same material, polishing can reduce cell adhesion without drastically modifying cell migration. A comparison of LS2 and ZrO2 ceramic showed that LS2 was more conducive to creating varying tissue reactions. Our results can help dental surgeons to choose, especially for esthetic implant abutments, the most appropriate biomaterial as well as the most appropriate surface treatment to use in accordance with specific clinical dental applications.

Biological and bactericidal properties of Ag-doped bioactive glass in a natural extracellular matrix hydrogel with potential application in dentistry.

The aim of this study was the fabrication and evaluation of a novel bioactive and bactericidal material, which could have applications in dentistry by supporting tissue regeneration and killing oral bacteria. Our hypothesis was that a new scaffold for pulp-dentin tissue engineering with enhanced antibacterial activity could be obtained by associating extracellular matrix derived from porcine bladder with an antibacterial bioactive glass. Our study combines in vitro approaches and ectopic implantation in scid mice. The novel material was fabricated by incorporating a sol-gel derived silver (Ag)-doped bioactive glass (BG) in a natural extracellular matrix (ECM) hydrogel in ratio 1:1 in weight% (Ag-BG/ECM). The biological properties of the Ag-BG/ECM were evaluated in culture with dental pulp stem cells (DPSCs). In particular, cell proliferation, cell apoptosis, stem cells markers profile, and cell differentiation potential were studied. Furthermore, the antibacterial activity against Streptococcus mutans and Lactobacillus casei was measured. Moreover, the capability of the material to enhance pulp/dentin regeneration in vivo was also evaluated. Our data show that Ag-BG/ECM significantly enhances DPSCs' proliferation, it does not affect cell morphology and stem cells markers profile, protects cells from apoptosis, and enhances in vitro cell differentiation and mineralisation potential as well as in vivo dentin formation. Furthermore, Ag-BG/ECM strongly inhibits S. mutans and L. casei growth suggesting that the new material has also anti-bacterial properties. This study provides foundation for future clinical applications in dentistry. It could potentially advance the currently available options of dental regenerative materials.

Surface modification of multipass caliber-rolled Ti alloy with dexamethasone-loaded graphene for dental applications.

Titanium (Ti) and its alloys with a high mechanical strength and a small diameter can be effectively exploited for minimally invasive dental implantation. Here, we report a multipass caliber-rolled Ti alloy of Ti13Nb13Zr (MPCR-TNZ) with a high mechanical strength and strong fatigue characteristics. For further dental applications, MPCR-TNZ was surface-modified with reduced graphene oxide (RGO) and loaded with osteogenic dexamethasone (Dex) via π-π stacking on the graphitic domain of RGO. The Dex-loaded RGO-MPCR-TNZ (Dex/RGO-MPCR-TNZ) resulted in significantly enhanced growth and differentiation of MC3T3-E1 cells into osteoblasts, which was confirmed by Alizarin red staining, alkaline phosphatase activity test, immunocytochemistry, and real-time PCR. Moreover, we could confirm the feasibility of Dex/RGO-MPCR-TNZ from the implantation test of a prototype of a dental implant to an artificial bone block for clinical dental applications.

The synergistic effects of CO2 laser treatment with calcium silicate cement of antibacterial, osteogenesis and cementogenesis efficacy

Calcium silicate-based material (CS) has been successfully used in dental clinical applications. Some researches show that the antibacterial effects of CO2 laser irradiation are highly efficient when bacteria are embedded in biofilm, due to a photo-thermal mechanism. The purpose of this study was to confirm the effects of CO2 laser irradiation on CS, with regard to both material characterization and human periodontal ligament cell (hPDLs) viability. CS was irradiated with a dental CO2 laser using directly mounted fiber optics in wound healing mode with a spot area of 0.25 cm2, and then stored in an incubator at 100% relative humidity and 37 °C for 1 d to set. The hPDLs cultured on CS were analyzed, along with their proliferation and odontogenic differentiation behaviors. The results indicate that the CO2 laser irradiation increased the amount of Ca and Si ions released from the CS, and regulated cell behavior. CO2 laser-irradiated CS promoted cementogenic differentiation of hPDLs, with the increased formation of mineralized nodules on the substrate’s surface. It also up-regulated the protein expression of multiple markers of cementogenic and the expression of cementum attachment protein. The current study provides new and important data about the effects of CO2 laser irradiation on CS. Taking cell functions into account, the Si concentration released from CS with laser irradiated may be lower than a critical value, and this information could lead to the development of new regenerative therapies for dentin and periodontal tissue.

The Study on Inhibition of Planktonic Bacterial Growth by Non-Thermal Atmospheric Pressure Plasma Jet Treated Surfaces for Dental Application.

Investigation of the effects by non-thermal atmospheric pressure plasma jet (NTAPPJ) treatment on the titanium dental implant surfaces for the inhibition of two common pathogens related with dental infections, Streptococcus mutans and Staphylococcus aureus, was carried out in this study. The commercially pure titanium was used as specimen, which were irradiated by NTAPPJ for 30, 60 and 120 seconds. Specimen without being treated with NTAPPJ was assigned as the control group. The X-ray photoelectron spectroscope and surface contact angle goniometer were used to analyze the effects of NTAPPJ treatment on surface chemistry and hydrophilicity of the specimen. The effects of the NTAPPJ treatment on surfaces, in terms of bacterial attachment, growth, morphology and structural changes were evaluated by the number of colony forming units (CFU) and scanning electron microscopy (SEM) observations. The results showed that there was a reduction of CFUs and the significant change in morphology of bacteria as they were cultured on the titanium surfaces treated with NTAPPJ. These results were related to surface chemical changes and hydrophilicity changes by NTAPPJ. The NTAPPJ treatment is very effective on the dental implant titanium surface treatment that resulted in the inhibition of bacteria and has a great potential to be a promising technique in various clinical dental applications.

Nanobiomaterial Coatings in Dentistry.

During the last decade, there has been a major increase in the interest of nanostructured materials in advanced technologies for biomedical and dental clinical applications. Nanostructured materials are associated with a variety of applications within the dental and biomedical field, for example nanoparticles in drug delivery systems and nanostructured scaffolds in tissue engineering. More importantly, nanotechnology has also been linked with the modification of surface properties of synthetic implants in an attempt to improve their bioactivity, reliability and protection from the release of harmful or unnecessary metal ions. This is achieved through the use of nanocoatings and nanocomposite coatings. These new-generation coatings based on inorganic materials and biological materials such as proteins and peptides are currently investigated and applied. This chapter aims to give an overview of the recent advances in nanocoatings and their composites being investigated or used in dentistry.

Laser Treatment Based on Minimal Intervention - Report of Cases

Since the development of the ruby laser by Maiman in 1960, many lasers are available today for clinical application in dentistry, based on minimally invasive (Ml) dental treatment in routine clinical procedures including dental cavity preparation, removal of dental calculus, caries prevention, and treatment of dentin hypersensitivity, anti-iriflammation for soft tissues, pain relief, surgical operations, and hemostasis. Dental treatment using a laser is a minimally invasive, painless treatment with a low burden on the patient, and may therefore be seen as a treatment that complies with the Ml concept. However, safe use of lasers must be the underlying goal of proposed or future laser therapy. To ensure that safe, effective Ml treatment is practiced when using lasers, it is essential to have a full understanding of their advantages and disadvantages before using them. DOI: http://dx.doi.org/10.3329/bjdre.v4i2.20257 Bangladesh Journal of Dental Research and Education Vol.4(2) 2014: 91-93

How to Choose and Use the CBCT

The emergence of Cone Beam Computed Tomography(CBCT) in the late 1990s represented an innovative advancement in the field of dental and maxillofacial radiology because it greatly reduced the radiation exposure to patients and offered 3D images easily. The 3D information generated by this technique brings the potential of improved diagnosis and treatment planning for a wide range of clinical applications in dentistry. The use of CBCT includes diagnosis and surgical assessment of the orofacial hard tissue lesions, dental implant treatment planning and postoperative evaluation, TMJ assessment, diagnosis of craniofacial fracture, orthodontics, endodontics, and so on. All CBCT examinations should be justified on an individualized needs. The clinical benefits to the patient for each CBCT scan must outweigh the potential risks associated with exposure to ionizing radiation. CBCT scans should be taken with initially obtained medical and dental histories of patients and a close clinical examination. CBCT should be considered as an imaging alternative of other conventional radiography in cases where the anatomical structures of interest may not be seen. The smallest possible field of view(FOV) and the lowest setting of tube current and scan time should be chosen, and the entire images scanned should be interpreted by a qualified expert.

Caries Prevention by Arginine Metabolism in Oral Biofilms: Translating Science into Clinical Success

Knowledge acquired from microbiological studies of oral arginine metabolism over the past 40 years has recently found its way to clinical application in dentistry. Novel arginine formulations incorporated into dentifrices have proven to be effective as an approach to prevent dental caries. In oral biofilms, arginine metabolism via the arginine deiminase system (ADS) produces ammonia, which inhibits tooth demineralization by neutralizing glycolytic acids and by suppressing the emergence of a cariogenic microflora. Evidence from translational science studies suggests that arginine metabolism in oral biofilms decreases the risk for caries development. These studies have expanded the focus of caries research beyond cariogenic bacteria to health-related, ADS-positive bacteria. The focus of this article is on the contribution of arginine metabolism to pH homeostasis in oral biofilms and its impact on the etiology of dental caries.

Flavonoids - Clinical effects and applications in dentistry: A review.

Flavonoids include a huge group of naturally occurring organic compounds. It is found in a large variety of plants including fruits, seeds, grains, tea vegetables, nuts, and wine. Many studies have shown that there is a strong association between flavonoid intake and the long-term effects on mortality. It is widely used in dentistry and it has many clinical effects. This article summarizes the effects of flavonoids to humankind and its clinical applications in dentistry.

Radio Frequency Identification (RFID) Inserted Fixed Prosthesis and its Applications in Clinical Dentistry

RFID-enabled dental prostheses can facilitate the use of relatively noninvasive procedures, and such a fixed prosthesis may provide significant additional benefits. This article describes the insertion of High frequency (13.56 MHz) RFID devices in dental fixed prostheses. A high frequency (13.56 MHz) system using sheet-type RFID-tags is inserted in the bilateral lower first molar buccal area to allow for direct identification through the cheeks without saliva contaminations. Simulations and experiments indicate that both the area occupied by the antenna and the number of coil turns influence the density of the electromagnetic field. Experimental results show that, as the tag’s area increases, the tag’s detecting distance is increased to more than 1 cm throughout the agarose, consisting of about 98% water to mimic the physiology of a human cheek. We also successfully download data from the tag including the prostheses design date, installing dentist identifier, and the materials used. Such a mechanism can protect patient privacy, while providing benefits for medical therapy as well as facilitating forensic identification. Further studies to minimize the antenna dimensions and improve its directional propagation are still needed for future applications.

Deactivation of Streptococcus mutans Biofilms on a Tooth Surface Using He Dielectric Barrier Discharge at Atmospheric Pressure

This paper presents a study of the effect of the low temperature atmospheric helium dielectric barrier discharge (DBD) on the Streptococcus mutans biofilms formed on tooth surface. Pig jaws were also treated by plasma to detect if there is any harmful effect on the gingiva. The plasma was characterized by using optical emission spectroscopy. Experimental data indicated that the discharge is very effective in deactivating Streptococcus mutans biofilms. It can destroy them with an average decimal reduction time (D-time) of 19 s and about 98% of them were killed after a treatment time of 30 s. According to the survival curve kinetic an overall 32 s treatment time would be necessary to perform a complete sterilization. The experimental results presented in this study indicated that the helium dielectric barrier discharge, in plan-parallel electrode configuration, could be a very effective tool for deactivation of oral bacteria and might be a promising technique in various dental clinical applications.

Biphenyl liquid crystalline epoxy resin as a low-shrinkage resin-based dental restorative nanocomposite

Low-shrinkage resin-based photocurable liquid crystalline epoxy nanocomposite has been investigated with regard to its application as a dental restoration material. The nanocomposite consists of an organic matrix and an inorganic reinforcing filler. The organic matrix is made of liquid crystalline biphenyl epoxy resin (BP), an epoxy resin consisting of cyclohexylmethyl-3,4-epoxycyclohexanecarboxylate (ECH), the photoinitiator 4-octylphenyl phenyliodonium hexafluoroantimonate and the photosensitizer champhorquinone. The inorganic filler is silica nanoparticles (∼70–100nm). The nanoparticles were modified by an epoxy silane of γ-glycidoxypropyltrimethoxysilane to be compatible with the organic matrix and to chemically bond with the organic matrix after photo curing. By incorporating the BP liquid crystalline (LC) epoxy resin into conventional ECH epoxy resin, the nanocomposite has improved hardness, flexural modulus, water absorption and coefficient of thermal expansion. Although the incorporation of silica filler may dilute the reinforcing effect of crystalline BP, a high silica filler content (∼42vol.%) was found to increase the physical and chemical properties of the nanocomposite due to the formation of unique microstructures. The microstructure of nanoparticle embedded layers was observed in the nanocomposite using scanning and transmission electron microscopy. This unique microstructure indicates that the crystalline BP and nanoparticles support each other and result in outstanding mechanical properties. The crystalline BP in the LC epoxy resin-based nanocomposite was partially melted during exothermic photopolymerization, and the resin expanded via an order-to-disorder transition. Thus, the post-gelation shrinkage of the LC epoxy resin-based nanocomposite is greatly reduced, ∼50.6% less than in commercialized methacrylate resin-based composites. This LC epoxy nanocomposite demonstrates good physical and chemical properties and good biocompatibility, comparable to commercialized composites. The results indicate that this novel LC nanocomposite is worthy of development and has potential for further applications in clinical dentistry.