Dental Biomaterials Research Articles

Fabrication and characterization of mesoporous calcium silicate and silver-incorporated mesoporous calcium silicate nanoparticles with low cytotoxicity and antibacterial properties as a dental biomaterial

AimThis study aimed to fabricate and characterize Mesoporous calcium silicate nanoparticles (MCSNs) and silver-incorporated Mesoporous calcium silicate nanoparticles (Ag-MCSNs) as bioactive nanoparticles either for hybridization with contemporary endodontic materials to improve their bioactivity by using (MCSNs) as a drug delivery system, and to achieve both low cytotoxicity and enhanced antibacterial activity by incorporating Ag which is avery potent antibacterial agent to form (Ag-MCSNs) as new multifunctional materials. MethodsThe MCSNs and Ag-MCSNs nanoparticles were made using the template method. Both nanoparticles' mesoporous structure, specific surface area, pore volume, pore size, and shape were examined and characterized by FTIR, XRD, EDS, DLS, and FE-SEM. The ion release, pH change, cytotoxicity by MTT assay, and antibacterial properties against planktonic Enterococcus faecalis were further investigated by colony forming units (CFUs) counting technique. ResultMCSNs nanoparticles were prepared and successfully incorporated with silver as Ag-MCSNs. MCSNs and Ag-MCSN nanoparticles had the characteristic mesoporous material shape and over time showed sustained ion release (Ca2+,Si4+ and Ag+) ,with an alkaline pH value (8.2–9.0). Both materials showed no obvious cytotoxicity but more cell viability with MCSNs (vitality value is >70%). Both nanoparticles showed antibacterial activity against Enterococcus faecalis (p < 0.05). With MCSNs containing Ag (Ag-MCSNs) showing higher antibacterial effect. ConclusionBoth mesoporous calcium silicate nanoparticles (MCSNs) and mesoporous calcium silicate nanoparticles loaded with silver (Ag-MCSNs) displayed a characteristic mesoporous structure, ion release, alkaline pH, minimal cytotoxicity, and outstanding antibacterial performance with MCSNs containing Ag (Ag-MCSNs) showing higher antibacterial effect. This substance may be improved to provide a better root canal filler material, sealer, or novel intracanal medicament in dentistry.

Ceramic Biomaterials in Dentistry: Review

Recent years have seen significant advancements in the field of materials science, accompanied by progress in analytical techniques and the discovery of new control devices and materials. These advancements have paved the way for the development of innovative approaches for raw material selection, with particular attention to creating advanced materials with specific physical and chemical properties tailored to meet desired criteria. This growing demand is particularly pronounced in environments with complex conditions, such as biological environments like the oral cavity. Consequently, there is a pressing need to identify and design materials that meet rigorous standards capable of withstanding such demanding environments. In the search for materials suitable for these applications, the need for advanced additives or biomaterials arises, which not only possess specific physicochemical attributes but also emulate biological materials, such as teeth, once integrated into biological systems. These biomaterials, spanning a wide range from metals, alloys, and polymers to glasses (bioglass), carbon fiber composites, and biological materials, interface with biological systems such as tissues and human fluids. However, it is essential to emphasize that biomaterials, while in contact with biological entities, differ from pharmaceutical materials.

Comparative evaluation of the effect of 2% graphene oxide and 5% hydroxyapatite nanoparticles in isolation and in combination on micro tensile bond strength of 5th generation adhesive

Background Graphene is the thinnest, strongest, and stiffest imaginable material. The biocompatible property of graphene oxide can initiate and facilitate cell adhesion, proliferation, and differentiation of periodontal ligament, osteogenic, and oral epithelial cells. Furthermore, the antibiofilm and anti-adhesion properties of graphene oxide in the prevention of dental biofilm infections, dental caries, and dental erosion as well as for implant surface modification and as an anti-quorum sensing agent. Composites are the most often utilized materials for restoration in the field of dentistry due to adhesive resins' improved mechanical and cosmetic properties. To safeguard the dentin and prevent dental cavities, dentin adhesives are utilized to affix hydrophobic resin composites to hydrophilic dentin tissue. Materials and Method Dental adhesives have a harder time adhering to dentin because it contains more water and is less mineralized than enamel. This makes the method more sensitive. Result As a result, it was chosen to assess and contrast the impact of 5% Hydroxyapatite nanoparticles and 2% Graphene oxide nanoparticles, both separately and together, on the Micro tensile bond strength of 5th generation adhesive. Conclusion Graphene oxide is the most versatile form of Graphite in structural and functional configuration. Graphene oxide possesses extraordinary physical, chemical, optical, electrical and mechanical properties. Among the graphene family nanomaterials, the reduced form of Graphite adding the oxygenated functional group to the structure increases the surface area and therefore exhibits enviable excellent interaction ability with metal and ions as well as organic species. Graphene oxide in dentistry has provided outstanding results in antimicrobial action, regenerative dentistry, bone tissue engineering, drug delivery, physicochemical properties, enhancement of dental biomaterials and oral cancer treatment.

Flapless early implant placement into the uncalcified provisional matrix-Does it lead to osseointegration of the implant? A preclinical study.

To test whether early implant placement into the extraction socket containing an uncalcified provisional matrix leads to successful osseointegration and stable marginal bone levels. In six mongrel dogs, the mandibular molars were extracted. Three weeks later, early implant placement was performed according to three experimental protocols: (i) flapless implant placement with preservation of the provisional matrix; (ii) flap elevation, socket debridement and implant placement; and (iii) flap elevation, socket debridement, implant placement and guided bone regeneration (GBR). One untreated extraction socket served as a control group. Data analyses were based on histologic slides 3 months after implant placement. There were no differences in bone-to-implant contact between the three experimental groups (66.97%, 58.89% and 60.89%, respectively) (inter-group comparison p = .42). Marginal bone levels, first bone-to-implant contact as well as the thickness of the connective tissue did not reveal any significant differences between the groups (p = .85, .60 and .65, respectively). Flapless early implant placement into posterior extraction sockets was as effective as an open flap approach in conjunction with GBR. Mineralization of the socket seems to occur irrespective of the presence of dental implants or biomaterials.

Adverse reactions to dental biomaterials: Experiences from a specialty clinic

ObjectivesThe Dental Biomaterials Adverse Reaction Unit was initiated by the Norwegian health authorities in 1992 as a response to the public concern regarding the safety of dental amalgam and other dental materials. In this paper, experiences from the Unit are briefly summarized. MethodsThe Norwegian health authorities’ strategy included four main topics: (i) development of a manufacturer-independent system for monitoring adverse reactions related to dental materials, (ii) funding of a specialty unit for clinical examinations of referred patients, (iii) development of official guidelines for examination and treatment of patients with health complaints attributed to dental materials, and (iv) funding of an experimental treatment project for patients with health complaints attributed to dental amalgam. ResultsFrom the start, more than 2700 adverse reaction reports were received. In the initial years, amalgam was the most frequent material mentioned in the reports. Reports about polymer-based composite materials have not increased after the prohibition of amalgam in Norway. Clinical examination of referred patients is complex and time consuming, and it is important to consider differential diagnoses. There are methodological challenges associated with the design of experimental treatments used on patients with adverse reactions attributed to dental materials. However, the results from the treatment project indicate lower symptom load after replacement of amalgam with other dental restorative materials. SignificanceProducer independent adverse reaction reporting can provide valuable information about the safety of these materials and could serve as a complement to the mandatory reporting system described in the European medical device regulations (MDR).

Ceramic biomaterials in dentistry: chemical structure and biosafety - a review and a bibliometric visual mapping on Scopus database.

A biomaterial is any non-pharmaceutical substance or a mixture of synthetic or natural substances used independently or as part of a system for any amount of time with the aim of mending, supporting the growth, or replacing tissues, organs, or functions of the body. It is a non-renewable material that interacts with biological systems. The purpose of this study was to assess the advances in ceramic biomaterials and perform a bibliometric mapping of the literature on the subject. The Scopus database was used for manuscript screening (Elsevier, Amsterdam, The Netherlands). The effect of the scientific production has been assessed using scientometric citational metrics. A total of 2,554 pieces of literature, including 2,234 papers, 170 conference proceedings, 109 reviews, 35 book chapters, 3 editorial letters, and 3 short surveys, were retrieved. Based on the research conducted, it is noted that ceramic materials are high-performing by being porous or glassy and can, therefore, serve as fillers, covering materials, and scaffolds in medicine and biotechnology. They are frequently employed not only in orthopedic and maxillofacial surgery but also in dentistry for dental prostheses. Materials monitoring methods enable us to track the three-dimensional evolution of ceramics' volume, as well as flaws or micro-cracks.

Biomaterials in dentistry: Advances in tissue engineering for dental restoration

Background: In regenerative medicine, advances in biomaterials have significantly impacted various medical fields, including dentistry. The use of implants, both metallic and non-metallic, has raised concerns about bacterial adhesion and biofilm formation, which can lead to complications such as peri-implantitis. Innovations in drug delivery systems and additive manufacturing technologies offer new solutions to these challenges. Methods: The review explores recent developments in biomaterials for dental restoration, focusing on drug-eluting implants, additive manufacturing, nanotechnology, and biocompatible coatings. The study evaluates the effectiveness of various drug delivery systems, including hydrogels, nanoparticles, and polymers, and discusses advancements in 3D printing and surface coatings. Results: Additive manufacturing technologies, such as 3D printing, have enabled the creation of precise models and drug delivery systems. Nanotechnology has introduced new materials with improved antimicrobial properties and targeted drug delivery capabilities. Innovations in coatings, such as hydroxyapatite (HA) and calcium phosphate, have enhanced osseointegration and reduced infection risks. Additionally, nanomaterials like gold and silver nanoparticles have shown promise in improving implant functionality and reducing bacterial colonization. Conclusion: Advances in biomaterials and manufacturing technologies have significantly improved the effectiveness and safety of dental implants.

Innovations in the postoperative management of the third molar and use of biomaterials. A look at different studies

The extraction of third molars, commonly known as wisdom teeth, is a common surgical procedure in young adults. Given the complexity of this process, different methods were explored to improve healing, including the use of bioactive materials and platelet-rich fibrin (PRF). Recent advances have shown that PRF, especially in its variants such as A-PRF and L-PRF, can significantly accelerate the healing of hard and soft tissues, and is useful in maintaining tissue volume after extraction. This biomaterial has proven to be effective in reducing pain, inflammation and promoting bone regeneration. However, studies on its effectiveness and direct comparisons with natural healing are varied and require more in-depth analysis. The present study evaluated the effectiveness of natural healing compared to the use of PRF, focusing on lower third molar surgeries. Through a longitudinal experimental design, meta-analysis and systematic reviews of the existing literature were performed to identify, compile and compare clinical outcomes between the use of PRF and conventional healing methods. The research highlighted the potential of PRF in improving postoperative management protocols and suggested future directions for research and clinical application of these biomaterials in dentistry and other medical disciplines

Innovations in the postoperative management of the third molar and use of biomaterials. A look at different studies

The extraction of third molars, commonly known as wisdom teeth, is a common surgical procedure in young adults. Given the complexity of this process, different methods were explored to improve healing, including the use of bioactive materials and platelet-rich fibrin (PRF). Recent advances have shown that PRF, especially in its variants such as A-PRF and L-PRF, can significantly accelerate the healing of hard and soft tissues, and is useful in maintaining tissue volume after extraction. This biomaterial has proven to be effective in reducing pain, inflammation and promoting bone regeneration. However, studies on its effectiveness and direct comparisons with natural healing are varied and require more in-depth analysis. The present study evaluated the effectiveness of natural healing compared to the use of PRF, focusing on lower third molar surgeries. Through a longitudinal experimental design, meta-analysis and systematic reviews of the existing literature were performed to identify, compile and compare clinical outcomes between the use of PRF and conventional healing methods. The research highlighted the potential of PRF in improving postoperative management protocols and suggested future directions for research and clinical application of these biomaterials in dentistry and other medical disciplines

A critical review of dental biomaterials with an emphasis on biocompatibility.

This paper presents the major achievements in the field of biomaterials in restorative dentistry and tissue regeneration reported over the past 3 years. The review aims to summarize the knowledge on important biomaterials and the emerging modification strategies to improve their biointegration, biological activity, mechanical properties, and resistance to the harsh oral environment. We also discuss the main opportunities and challenges associated with the use of biomaterials in dentistry.Much contemporary research focuses on the interactions between biomaterials and the surrounding tissues in the oral environment regarding adhesion, associated stresses and strains, and the durability of dental restoration materials. Dental biomaterials should support cell adhesion and activity, leading to dental tissue regeneration, and are also expected to effectively prevent bacterial infections and inhibit material corrosion in saliva. The degradation, dissolution or corrosion of restorative materials due to exposure to body fluids can alter the structure and mechanical properties of the material, causing various adverse effects.Another aspect addressed in recent literature is the improvement of the mechanical properties and esthetics of restorative materials. The surfaces of biomaterials are usually modified with polymers or nanomaterials to reduce friction while maintaining biocompatibility.Although all modern biomaterials are promising, there is an urgent need for more in vivo and clinical studies to investigate their biological advantages and disadvantages in detail. The computational techniques used to assess the properties of modern dental materials, particularly the mechanical ones, could assist in the development of the materials. Such an approach can help bring new biomaterials to the market by reducing complicated, tedious and expensive experimentation.

Comparative evaluation of the effect of 2% graphene oxide and 5% hydroxyapatite nanoparticles in isolation and in combination on micro tensile bond strength of 5th generation adhesive

Graphene is the thinnest, strongest, and stiffest imaginable material. The biocompatible property of graphene oxide can initiate and facilitate cell adhesion, proliferation, and differentiation of periodontal ligament, osteogenic, and oral epithelial cells. Furthermore, the antibiofilm and anti-adhesion properties of graphene oxide in the prevention of dental biofilm infections, dental caries, and dental erosion as well as for implant surface modification and as an anti-quorum sensing agent. Composites are the most often utilized materials for restoration in the field of dentistry due to adhesive resins' improved mechanical and cosmetic properties. To safeguard the dentin and prevent dental cavities, dentin adhesives are utilized to affix hydrophobic resin composites to hydrophilic dentin tissue. Dental adhesives have a harder time adhering to dentin because it contains more water and is less mineralized than enamel. This makes the method more sensitive. As a result, it was chosen to assess and contrast the impact of 5% Hydroxyapatite nanoparticles and 2% Graphene oxide nanoparticles, both separately and together, on the Micro tensile bond strength of 5th generation adhesive. Graphene oxide is the most versatile form of Graphite in structural and functional configuration. Graphene oxide possesses extraordinary physical, chemical, optical, electrical and mechanical properties. Among the graphene family nanomaterials, the reduced form of Graphite adding the oxygenated functional group to the structure increases the surface area and therefore exhibits enviable excellent interaction ability with metal and ions as well as organic species. Graphene oxide in dentistry has provided outstanding results in antimicrobial action, regenerative dentistry, bone tissue engineering, drug delivery, physicochemical properties, enhancement of dental biomaterials and oral cancer treatment.

The Potential Uses of Baobab Tree's Medicinal Effects in Dentistry: A Literature Review.

Adansonia digitata (Baobab) tree is an African tree with a long history in traditional medicine. The local inhabitants of Africa have been using the different tree components to treat medical diseases, such as fever, diarrhea, malaria, cough, dysentery, and microbial infections. Recently, the tree gained the attention of scientists due to its medical and pharmaceutical properties and nutritional values, which generated a myriad number of investigations regarding its phytochemical and macro- and micronutrient contents. The fruit pulp is especially rich in vitamin C, pectin, fibers, and minerals such as calcium, magnesium, potassium, phosphorus, zinc, iron, and copper. Additionally, the leaves contain high levels of calcium, while the seeds are considered a good source of protein and fat. Altogether, they contain a variety of polyphenols, fatty acids, and amino acids. The tree extracts possess potent antioxidant, cell-protective, and anti-inflammatory activities. However, no information was found in the literature about the use of Baobab tree products in the dental field. The aim of this review is to discuss the well-documented medical effects and chemical and mineral components of the different Baobab tree parts from a dental point of view to open more areas of research concerning its potential applications in the dental field. Antioxidants and vitamin C are known to help in maintaining healthy periodontal and gingival tissues. They also help in wound healing and alveolar bone integrity. Moreover, phytochemicals and phenolic compounds have been utilized in controlling dental plaque and manufacturing intracanal medications as they manifest antimicrobial and anti-inflammatory activities. Furthermore, calcium and phosphorus incorporation in dental biomaterials is commonly used in vital pulp therapy and repairing bone defects. After reviewing the reported medicinal and pharmaceutical activities of the Baobab tree, it can be inferred that the tree extracts possess potential uses in the dental field, which requires further investigation for validation.

Mechanical, chemical and biological properties of PLA 3D printer: A systematic review

The aim of this systematic review is to evaluate, through the in vitro studies included, whether PLA has mechanical, chemical and biological properties that enable its clinical use in dentistry. An electronic search was carried out in the Pubmed, Science Direct, Embase and Scopus databases containing the terms ''polylactic acid'', ''3D printing'',''biomaterials'',''dental materials'', dental prosthesis and dentistry. The objective of the inclusion criteria was to cover articles written and published in English that focused on the use of PLA in the field of dental materials and biomaterials printed using the 3D method. Any articles that did not focus on the study of PLA polymer, as well as systematic reviews, book chapters, abstracts, letters and conference articles were excluded. 1814 references were found, which after applying the exclusion criteria resulted in the final inclusion of 13 articles for the review. Based on the studies included in this systematic review, it is possible to conclude that 3D printed PLA used as a dental material and biomaterial presents favorable mechanical, chemical and biological properties that indicate its potential clinical use.

The Potential Role of Ionic Liquid as a Multifunctional Dental Biomaterial.

In craniofacial research and routine dental clinical procedures, multifunctional materials with antimicrobial properties are in constant demand. Ionic liquids (ILs) are one such multifunctional intelligent material. Over the last three decades, ILs have been explored for different biomedical applications due to their unique physical and chemical properties, high task specificity, and sustainability. Their stable physical and chemical characteristics and extremely low vapor pressure make them suitable for various applications. Their unique properties, such as density, viscosity, and hydrophilicity/hydrophobicity, may provide higher performance as a potential dental material. ILs have functionalities for optimizing dental implants, infiltrate materials, oral hygiene maintenance products, and restorative materials. They also serve as sensors for dental chairside usage to detect oral cancer, periodontal lesions, breath-based sobriety, and dental hard tissue defects. With further optimization, ILs might also make vital contributions to craniofacial regeneration, oral hygiene maintenance, oral disease prevention, and antimicrobial materials. This review explores the different advantages and properties of ILs as possible dental material.

Elucidating osseointegration in vivo in 3D printed scaffolds eliciting different foreign body responses.

Osseointegration between biomaterial and bone is critical for the clinical success of many orthopaedic and dental implants. However, the mechanisms of in vivo interfacial bonding formation and the role of immune cells in this process remain unclear. In this study, we investigated the bone-scaffold material interfaces in two different 3D printed porous scaffolds (polymer/hydroxyapatite and sintered hydroxyapatite) that elicited different levels of foreign body response (FBR). The polymer/hydroxyapatite composite scaffolds elicited more intensive FBR, which was evidenced by more FBR components, such as macrophages/foreign body giant cells and fibrous tissue, surrounding the material surface. Sintered hydroxyapatite scaffolds showed less intensive FBR compared to the composite scaffolds. The interfacial bonding appeared to form via new bone first forming within the pores of the scaffolds followed by growing towards strut surfaces. In contrast, it was previously thought that bone regeneration starts at biomaterial surfaces via osteogenic stem/progenitor cells first attaching to them. The material-bone interface of the less immunogenic hydroxyapatite scaffolds was heterogenous across all samples, evidenced by the coexistence of osseointegration and FBR components. The presence of FBR components appeared to inhibit osseointegration. Where FBR components were present there was no osseointegration. Our results offer new insight on the in vivo formation of bone-material interface, which highlights the importance of minimizing FBR to facilitate osseointegration for the development of better orthopaedic and dental biomaterials.

Unprecedented Benzoquinone Motifs Reveal Post-Oligomerizational Modification of Proanthocyanidins.

Proanthocyanidins (PACs) are complex flavan-3-ol polymers with stunning chemical complexity due to oxygenation patterns, oxidative phenolic ring linkages, and intricate stereochemistry of their heterocycles and inter-flavan linkages. Being promising candidates for dental restorative biomaterials, trace analysis of dentin bioactive cinnamon PACs now yielded novel trimeric (1 and 2) and tetrameric (3) PACs with unprecedented o- and p-benzoquinone motifs (benzoquinonoid PACs). Challenges in structural characterization, especially their absolute configuration, prompted the development of a new synthetic-analytical approach involving comprehensive spectroscopy, including NMR with quantum mechanics-driven 1H iterative functionalized spin analysis (HifSA) plus experimental and computational electronic circular dichroism (ECD). Vital stereochemical information was garnered from synthesizing 4-(2,5-benzoquinone)flavan-3-ols and a truncated analogue of trimer 2 as ECD models. Discovery of the first natural benzoquinonoid PACs provides new evidence to the experimentally elusive PAC biosynthesis as their formation requires two oxidative post-oligomerizational modifications (POMs) that are distinct and occur downstream from both quinone-methide-driven oligomerization and A-type linkage formation. While Nature is known to achieve structural diversity of many major compound classes by POMs, this is the first indication of PACs also following this common theme.

Converting polymer-wastes to green nanocomposites in Saudi Arabia: Investigation of fracture parameters (KIc, KIIc, θc, σc) for quality and sustainability evaluation

The intrinsic fracture-parameters including fracture-envelope (KI-KII), fracture-direction (θc) and fracture-load (σc), are predicted experimentally at different crack inclination-angle (β) for each of pure-original polyethylene (HDPE, LDPE) and advanced green-nanocomposite CPNC made of (95%) recycled waste polyethylene (HDPE, LDPE) and (5%) montmorillonite MMT nanoclay NC. These fracture factors represent evaluation of material quality and sustainability. These fracture parameters are investigated experimentally and compared with characterization of microstructure, interfacial-bond, chemical composition, and crystallinity. These parameters are depending on material type, crack type, crack-location, crack-shape, crack-geometry, crack-orientation, crack-dimensions, and loading type. Nanocomposite called clay-based polymer nanocomposite CPNC is produced of recycled polymers with special mixing technique with (5%) surface modified natural nanoclay. Pre-cracked recycled-CPNC, HDPE and LDPE samples are tested with different crack-orientations of central cracks and edge cracks under far-field tension load. Characterizations of microstructure, bond and chemical composition are conducted by SEM and EDAX for investigating the differences between original and recycled materials. The results are compared to each other with detailed discussion showing good results of converting of contaminated waste-materials to valuable advanced green ecofriendly nanocomposite suitable for different fields like medical applications, dental biomaterials for orthodontics, dental-restoration for fracture under caries and occlusal stresses and other industrial applications.

Merging Design Thinking into Translational Research in a Biomedical Engineering Laboratory (DT-TRBEL) Course

Laboratory classes offered in universities often fail to develop students’ ability to identify questions and encourage creativity to solve authentic problems. Lab exercises tend to provide clear step-by-step instructions, leaving little room for experimentation or creative thinking. Unfortunately, this approach can result in engineering students losing the skills they need to solve unprecedented challenges in their future professional careers. Biomedical engineering is particularly vulnerable to this training approach, given that students are taught to devise ideas to solve medical problems. To address this issue, the current study combined the curriculum designs of translational research and design thinking. This guided students in bringing biomaterials into the clinic and stimulated their interest in biomaterial development. The resulting course, called DT-TRBEL (Design-Thinking: Translational Research in Biomedical Engineering Laboratory Course), focuses on developing dental biomaterials, including material preparation, analysis, and cytotoxicity testing. The data was collected and evaluated through a survey of self-efficacy of creativity, student motivation, and learning scores of both the prerequisite course “Material Science” and DT-TRBEL. The study found that DT-TRBEL did not have a positive effect on overall motivation or the sense of self-efficacy regarding creativity. However, it did have a significant gender effect, benefiting female students more than male students. The discussion covers implementation and further directions for research.

Electrolysed oxidising water as a multi-purpose biocide in dental healthcare-A scoping review.

The objective of this scoping review was to map evidence of electrolysed oxidising water (EOW) as a biocide for dental applications of relevance to older people and identify research gaps. EOW is an emerging, "green," and cost-effective biocide. There are no reviews on the landscape of EOW research as either an antiseptic or disinfectant in dental healthcare or its suitability for the oral healthcare of older people. The review follows the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. Database searches (Google Scholar, PubMed, Web of Science, Ovid, Scopus and Science Direct) were undertaken using MESH terms and Boolean operators with no date restrictions, to identify full-text, original reports published in English-language peer-reviewed journals. The search yielded 114 papers that met the inclusion/exclusion criteria. Dental applications of EOW include its use as an endodontic irrigant (39%); mouth rinse/surgical irrigant (21%); disinfectant for dental unit water lines (19%) and dental biomaterials (17%); and for antimicrobial efficacy, effects on oral tissues and on dental material properties. Most studies (83%) evaluated a single EOW formulation (acidic, moderately acidic or neutral) that was either generated at 'point-of-use' (POU; 72%), bottled ('ready-to-use', RTU; 24%) or from unspecified (3%) sources. Six reports evaluated storage-related parameters and 25 evaluated clinical applications; 89 were in vitro studies and one investigated the cost-effectiveness of POU EOW. Neutral-pH, EOW is effective as an antimicrobial agent without deleterious effects on oral tissues. However, research on the impact of storage conditions, anti-Candida biofilm efficacy and mechanism of action against yeasts, long-term effects on denture materials and cost-effectiveness is required to establish the suitability of EOW as a multipurpose biocide for dental healthcare, including infection-control requirements relating to older people.

An Empirical Model Linking Physico-Chemical Biomaterial Characteristics to Intra-Oral Bone Formation.

Facial trauma, bone resection due to cancer, periodontal diseases, and bone atrophy following tooth extraction often leads to alveolar bone defects that require bone regeneration in order to restore dental function. Guided bone regeneration using synthetic biomaterials has been suggested as an alternative approach to autologous bone grafts. The efficiency of bone substitute materials seems to be influenced by their physico-chemical characteristics; however, the debate is still ongoing on what constitutes optimal biomaterial characteristics. The purpose of this study was to develop an empirical model allowing the assessment of the bone regeneration potential of new biomaterials on the basis of their physico-chemical characteristics, potentially giving directions for the design of a new generation of dental biomaterials. A quantitative data set was built composed of physico-chemical characteristics of seven commercially available intra-oral bone biomaterials and their in vivo response. This empirical model allowed the identification of the construct parameters driving optimized bone formation. The presented model provides a better understanding of the influence of driving biomaterial properties in the bone healing process and can be used as a tool to design bone biomaterials with a more controlled and custom-made composition and structure, thereby facilitating and improving the clinical translation.