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Spheroids based on chondrocytes are gaining interest in the treatment of injured cartilage tissue due to their regenerative potential. In this study, chondrocyte-based aggregates were formed by culturing cells on a polymeric coating of a lactose-modified chitosan (CTL) and their evolution was followed for 14 days of culture. Morphological analyses through scanning electron microscopy indicated that these cell aggregates formed by a process of cell aggregation rather than proliferation, resulting in structures with an irregular morphology that were up to 1 mm in size. Chondrocytes interact very closely with CTL. In the early days of cellular aggregation, CTL is distributed among the cells, while in later stages, it is localized in the inner part of the aggregates, forming an amorphous matrix. The initial outer position of the polymer is replaced over time by an increased matrix deposition whose main component is type II collagen. Transmission electron microscopy pointed out that the chondrocytes internalized the polymer during the first days of culture. The presence of CTL does not affect the ability of cells to migrate from chondro-aggregates when transferred to uncoated wells, mimicking the ability of cells to colonize a cartilage defect. Overall, these results suggest that CTL plays a role as a temporary matrix for chondrocytes aggregation during chondro-aggregates formation. This opens up innovative therapeutic approaches for cartilage regeneration without the need to use a scaffold to deliver cells to the damaged site.KEYWORDS: chondrocytes, spheroids, lactose-modified chitosan, cartilage regeneration, bioactive polysaccharide

We analysed the major, minor and trace elements chemistry of forty-two Cr-spinels from four Siberian kimberlites. They showed a wide range in Mg# (Mg/(Mg + Fe2+); 0.42–0.78) and Cr# (Cr/(Cr + Al); 0.32–0.92) and a common trend of increasing Cr# with decreasing Mg#. The major element classification schemes suggested that there were spinels deriving from a peridotitic source (Xen) and spinels crystallised from kimberlitic melts (Chr). Laser-Ablation Inductively Coupled Plasma Mass Spectrometry on both groups showed that the trace elements with the highest abundance were Mn (985–3390 ppm), Ni (531–3162 ppm), V (694–2510 ppm) and Zn (475–2230 ppm). Testing the effectiveness of trace elements in determining the source for Cr-spinels, we found out that Cr-spinels crystallised directly from a kimberlitic melt usually showed higher Mn, Ni, Sc and V concentrations with respect to those of peridotitic origin. In addition, using the available partitioning models, we found that the correlations between major elements and Ni, Co, Sc and Ga in the Xen group could be explained by subsolidus equilibration between spinel, olivine and clinopyroxene at 800–1000 °C, thus supporting a peridotitic source for this group. Finally, we calculated the composition of the possible melts in equilibrium with the Cr-spinels of the Chr group, using a selected set of partition coefficients. Calculated abundances of Cu, Ga and Zr were comparable to those of the kimberlite, while V was never close to the kimberlite composition. This simulation highlighted the need for new data on the trace elements partition coefficients between kimberlitic melts and Cr-spinel.

Objective Resin coating in implants rehabilitation not always can be aesthetic, durable and comfortable for the patient mainly due to the limited dimensions of the final structure. Intraoral welding technique and computer-aided designed prosthetic shells may be a solution.This in vitro study evaluates the capacity of load and the weakest point of implant-supported provisional prosthesis using welded titanium framework.Methods Twelve samples were produced to simulate an implant supported fixed prosthetic bridge. Two implants (Ankylos; Dentsply Implant Manufacturing; Germany) were inserted inside blocks of nanoceramic material produced with a stereolithographic 3D printer. A polymethylmethacrylate (PMMA) resin shell was performed with CAD/CAM and relined on welded framework. Six samples were performed with the same procedure reducing resin thickness. The samples were subjected to fatigue test (6’500’000 cycles) using ElectroForce 3310 fatigue machine (t1); subsequently a mechanical compression test using a universal Shimadzu AGS-X 10 machine (t2). The samples were analyzed with photographic and radiographic documentation at t0, t1 and t2.Results The samples survived mechanical fatigue test without evidence of failure. The radiographic and photographic evaluation revealed the fracture of resin coating after mechanical compression test. The samples with minimal resin thickness fracture first.Conclusion Adequate assessment of the resin thickness is mandatory for the improve the longevity of this rehabilitations.Clinical Relevance CAD-CAM digital prosthetic design allows us to optimize the thicknesses and the prosthetic shapes, allowing us to obtain good degrees of resistance even in the presence of reduced prosthetic spaces

Purpose To evaluate the surface profile of a new-generation extended range-of-vision intraocular lens (IOL) and to compare it with that obtained for a monofocal IOL based on the same platform. Methods Prospective, experimental, laboratory study comparing the surface profile of the DFT015 (AcrySof IQ Vivity; Alcon Laboratories, Inc.), a new-generation presbyopia-correcting IOL, with the profile of the SN60WF (AcrySof IQ; Alcon Laboratories, Inc.), an aspheric monofocal IOL based on the same platform. Raw profiles were obtained using contact profilometry. The best-fit form was then subtracted from each raw profile to highlight potential differences. Results No significant differences were appreciated in raw profiles. On the contrary, after form removal, the new extended range-of-vision IOL showed a peculiar profile characterized by the presence of two altitudinal symmetrical changes in the order of 1 µm, localized in the central portion of the optic. Conclusions The new-generation extended range-of-vision IOL evaluated showed a smooth change of its surface compared to the same platform monofocal IOL. The altitudinal changes blended in the central design of the new presbyopia-correcting IOL, although micrometric, might play a crucial role in creating a continuous focal range while minimizing visual disturbances.

Purpose: The purpose of this study was to evaluate resin infiltration (RI) technique's effects on the in vivo functional treatment of molar hypomineralization (MH)-affected permanent first molars (PFMs). Methods: Fifteen MH-affected PFMs were resin-infiltrated and evaluated for a three-month follow-up (FU). In vivo resin replicas were used for profilometric and scanning electron microscope (SEM) analysis of PFM surfaces; any variation of clinical aspect and dentin hypersensitivity was registered as: T0 equals baseline; T1 equals right after treatment; T2 equals oneweek follow-up; and T3, T4, and T5 equal one-, two-, and three-month FU. Results: At T0, MH-affected surfaces were rougher and more irregular than sound ones; at T1, resin-infiltrated surfaces were smoother while a progressive increase of superficial roughness was observed over time. Hypersensitivity improved at T1 and remained stable over time in severe MH cases. Conclusions: Resin infiltration seems to be a promising treatment, especially in managing severe molar hypomineralization cases for the evaluated follow-up.

The study of bone morphology is of great importance as bone morphology is influenced by factors such as age and underlying comorbidities and is associated with bone mechanical properties and fracture risk. Standard diagnostic techniques used in bone disease, such as Dual-Energy X-ray absorptiometry and ultrasonography do not provide qualitative and quantitative morphological information. In recent years, techniques such as High Resolution Computed Tomography (HR-CT), micro- CT, Magnetic Resonance Imaging (MRI), and Low Field Nuclear Magnetic Resonance (LF-NMR) have been developed for the study of bone structure and porosity. Data obtained from these techniques have been used to construct models to predict bone mechanical properties thanks to finite element analysis. Cortical porosity has been extensively studied and successfully correlated with disease progression and mechanical properties. Trabecular porosity and pore size distribution, however, have increasingly been taken into consideration to obtain a comprehensive analysis of bone pathology and mechanic. Therefore, we have decided to evaluate the ability of micro- CT (chosen for its high spatial resolving power) and LF-NMR (chosen to analyze the behavior of water molecules within trabecular bone pores) to characterize the morphology of trabecular bone in osteoporosis. Trabecular bone samples from human femoral heads collected during hip replacement surgery were from osteoporosis (test group) and osteoarthritis (control group) patients. Our data show that both micro- CT and LF-NMR can detect qualitative changes in trabecular bone (i.e., transition from plate-like to rod-like morphology). Micro- CT failed to detect significant differences in trabecular bone morphology parameters between osteoporotic and osteoarthritic specimens, with the exception of Trabecular Number and Connectivity Density, which are markers of osteoporosis progression. In contrast, LF-NMR was able to detect significant differences in porosity and pore size of trabecular bone from osteoporotic versus osteoarthritic (control) samples. However, only the combination of these two techniques allowed the detection of structural morphometric changes (increase in the larger pore fraction and enlargement of the larger pores) in the trabecular bone of osteoporotic specimens compared to osteoarthritic ones. In conclusion, the combined use of LF-NMR and micro- CT provides a valuable tool for characterizing the morphology of trabecular bone and may offer the possibility for a new approach to the study and modeling of bone mechanics in the context of aging and disease.

The employment of coaxial fibers for guided tissue regeneration can be extremely advantageous since they allow the functionalization with bioactive compounds to be preserved and released with a long-term efficacy. Antibacterial coaxial membranes based on poly-epsilon-caprolactone (PCL) and rifampicin (Rif) were synthesized here, by analyzing the effects of loading the drug within the core or on the shell layer with respect to non-coaxial matrices. The membranes were, therefore, characterized for their surface properties in addition to analyzing drug release, antibacterial efficacy, and biocompatibility. The results showed that the lower drug surface density in coaxial fibers hinders the interaction with serum proteins, resulting in a hydrophobic behavior compared to non-coaxial mats. The air-plasma treatment increased their hydrophilicity, although it induced rifampicin degradation. Moreover, the substantially lower release of coaxial fibers influenced the antibacterial efficacy, tested against Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa. Indeed, the coaxial matrices were inhibitory and bactericidal only against S. aureus, while the higher release from non-coaxial mats rendered them active even against E. coli. The biocompatibility of the released rifampicin was assessed too on murine fibroblasts, revealing no cytotoxic effects. Hence, the presented coaxial system should be further optimized to tune the drug release according to the antibacterial effectiveness.

Polysaccharide electrospun wound dressings should be an effective strategy in the field of wound care, as they combine an extracellular matrix-like structure with excellent biomimicry. However, their high hydrophilicity and large surface area cause a rapid dissolution in aqueous environments, compromising their clinical employment. In the present paper, electrospun membranes prepared using hyaluronic acid, a bioactive lactose-modified chitosan (CTL), and polyethylene oxide have been crosslinked using glutaraldehyde, genipin, EDC/NHS or thermal treatments, obtaining very poor results in terms of membrane stability. Therefore, carbonyldiimidazole (CDI) and methacrylic anhydride were investigated in an innovative way, where CDI proved to be the best compromise between nanofiber water resistance, architecture maintenance and degradability. Indeed, the swelling and degradation behavior as well as the water vapor permeability of these matrices were tested, revealing the effectiveness of the electrospun products in absorbing large amount of liquid while maintaining the balance between water retention and gas permeability.

MgAl2O4 spinels from Allende and NWA 763 carbonaceous chondrites were studied by X-ray single crystal diffraction, SEM, electron microprobe, LA-ICP-MS, and Raman spectroscopy. Those from Allende are almost pure, but, in one case, we found a strong FeOtot zonation. Spinels from NWA 763 show Mg-Fe2+ substitutions. Almost pure MgAl2O4 spinels from both meteorites underwent slow cooling and reached their intracrystalline closure temperature (Tc) in the range 460–520 °C. The NWA 763 spinel with higher FeO content shows a Tc of about 720 °C. X-ray single crystal diffraction and Raman spectroscopy suggest a slow cooling and an ordered structure with trivalent cations in M site and divalent in T site. Among the trace elements, Ti and Co are enriched with respect to the terrestrial analogs, while Mn, Ni, and Sn show intermediate values between different terrestrial occurrences. Vanadium cannot be used as a tracer of extraterrestrial origin as for Cr-spinels, because its content is similar in extraterrestrial and terrestrial spinels. In the zoned crystal from Allende, Co show a strong zonation similar to that of FeO.

Purpose: To analyze and compare the surface properties of commercially available hydrophobic acrylic intraocular lenses (IOLs). Setting: Eye Clinic, University of Trieste, Italy. Design: Experimental study. Methods: The following 6 single-piece hydrophobic acrylic IOL models with the same dioptric power were studied and compared: Clareon SY60WF, Tecnis PCB00, enVista MX60, CT Lucia 601P, Vivinex iSert XY1, and iSert 251. Topography of the IOL surface was analyzed using atomic force microscopy (AFM). Surface contact angle measurements using the sessile drop method were performed to assess IOL wettability. Results: The AFM analysis showed that the Vivinex iSert XY1 IOL and Clareon SY60WF IOL had the lowest surface roughness (P < .05); there was no statistically significant difference in surface roughness between the those 2 IOL models (P > .05). Surface contact angle measurements showed that the iSert 251 IOL had the highest hydrophobicity. The CT Lucia 601P IOL had the lowest contact angle of all IOL models. Conclusions: The AFM analysis and surface contact angle measurements of all IOLs tested showed that the Vivinex iSert XY1 IOL and Clareon SY60WF IOL had the best topographic features. The smoother, more regular surface of these new IOL models might reduce cell adhesion and therefore lower the incidence of posterior capsule opacification.

Purpose: To assess the effects of grade IV titanium ultrasonic tip instrumentation on different grade IV titanium implant surfaces and compare the decontamination of different implant surfaces using chlorhexidine, blue laser, or ozone. Materials and methods: Profilometry and energy-dispersive x-ray spectroscopy (EDS) analyses were performed on smooth, laser-micropatterned, and sandblasted grade IV titanium sample disks before (t0) and after (t1) ultrasonic instrumentation with an ultrasonic grade IV titanium tip. Samples were also incubated with a Streptococcus sanguinis culture. Each surface type was then treated with chlorhexidine, blue laser, or ozone (three test groups + control group). Scanning electron microscopy (SEM) images were taken after bacterial growth and after decontamination. Results: After ultrasonic instrumentation, surface roughness (Ra) decreased on sandblasted and micropatterned surfaces, whereas it remained substantially unvaried on the smooth surface. SEM images revealed that the laser-micropatterned structure remained substantially unvaried after instrumentation. EDS revealed a minimal quantity of carbon and iron, found in the laser-treated and sandblasted group at t0. A minimal quantity of aluminum and oxygen was found on the sandblasted surface at t0 and t1. Ozone therapy achieved the highest decontaminating effect, regardless of implant surface topography. Conclusion: Among the alternative therapies to ultrasonic instrumentation with titanium tips, ozone appears to be effective regardless of the type of implant surface; it can be used for the decontamination treatment of implants without altering the surface structure.

Bioactive and biodegradable porous scaffolds can hasten the healing of bone defects; moreover, patient stem cells seeded onto scaffolds can enhance the osteoinductive and osteoconductive properties of these biomaterials. In this work, porous alginate/hydroxyapatite scaffolds were functionalized with a bioactive coating of a lactose-modified chitosan (CTL). The highly interconnected porous structure of the scaffold was homogeneously coated with CTL. The scaffolds showed remarkable stability up to 60 days of aging. Human Dental Pulp Stem Cells (hDPSCs) cultured in the presence of CTL diluted in culture medium, showed a slight and negligible increase in terms of proliferation rate; on the contrary, an effect on osteogenic differentiation of the cells was observed as a significant increase in alkaline phosphatase activity. hDPSCs showed higher cell adhesion on CTL-coated scaffolds than on uncoated ones. CTL coating did not affect cell proliferation, but stimulated cell differentiation as shown by alkaline phosphatase activity analysis.

Simple Summary The interest in chairside Computer-aided design/computer-assisted manufacturing (CAD/CAM) restorations has increased the diversity of the restorative material. The promise of accurate, esthetic restorations delivered rapidly to the patient has manly benefits for clinicians in the light of minimally invasive dentistry dictates. New materials have been developed by the industry in order to offer ceramic, composite, and hybrid materials with optimized properties, suitable mechanical and aesthetic features. However, this comes at the expense of making the application more complicated. This article is aimed at providing an overview regarding the main advantages and disadvantages of the CAD/CAM chairside materials. Abstract Restorative materials are experiencing an extensive upgrade thanks to the use of chairside Computer-aided design/computer-assisted manufacturing (CAD/CAM) restorations. Therefore, due to the variety offered in the market, choosing the best material could be puzzling for the practitioner. The clinical outcome of the restoration is influenced mainly by the material and its handling than by the fabrication process (i.e., CAD/CAM). Information on the restorative materials performances can be difficult to gather and compare. The aim of this article is to provide an overview of chairside CAD/CAM materials, their classification, and clinically relevant aspects that enable the reader to select the most appropriate material for predictable success.

Nine antibacterial di-methacrylate monomers based on bis-quaternary ammonium salts (bis-QAMs) were synthesized and structurally characterized. The biological activity of the bis-QAMs was tested in terms of minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) on different bacterial strains achieving promising results and, in most cases, a complete bactericidal effect using a bis-QAM concentration lower than 1 mg/mL. Two of the structures showed comparable and superior activity against S. mutans than the commercial monomer 12-methacryloyloxydodecyl pyridinium bromide (MDBP). All the bis-QAMs here described were able to inhibit S. mutans biofilm formation at a concentration equal to the MIC value. From the analysis of the obtained data, some correlation regarding the structure and the antibacterial activity of the bis-QAMs could be drawn: a flexible alkyl C12 spacer between the two quaternary ammonium moieties increased the monomer antibacterial effect in comparison to the aromatic ones; the equilibrium between hydrophobic and hydrophilic moieties was directly correlated to the bactericidal range of action; the increase of the steric hindrance of the ammonium side groups might be both advantageous or disadvantageous to the antibacterial efficacy depending on the whole monomer chemical structure. Even though the possible correlation between the monomer structures and their bacteriostatic or bactericidal effect is under investigation, the monomers exhibited low cytotoxicity on human dental pulp stem cells, confirming their promising potential in the dental materials' field. Statement of significance The use of dental resins with antibacterial monomers might prevent the formation of secondary caries at the restoration margins. For this purpose, a series of di-methacrylate bis-quaternary ammonium monomers (QAMs) was developed. Unlike antibacterial mono-methacrylate monomers already described in the literature, the synthesized di-methacrylate monomers have the potential of acting as cross-linkers stabilizing the polymeric network and bear two quaternary ammonium groups that increase their antibacterial ability. The QAMs exert bactericidal activity on both Gram(+) and Gram(−) bacterial strains maintaining at the same time good biocompatibility with the oral environment. Some structural elements of the monomers were clearly related to high antibacterial properties, and this can help design new active structures and better understand their mechanism of action.

Chronic wounds deeply invalidate patient's quality of life, involving very high costs for the medical system. Numerous wound dressings have been studied over the years, and active wound dressings replaced traditional passive dressings to promote tissue regeneration and wound closure. Aiming at an optimal reproduction of the physiological environment, electrospun wound dressings are emerging since they mimic the architecture of the extracellular matrix and provide a large contact surface area, enabling exudate absorption and permeability as well as good conformability to the wound site. The use of polysaccharides offers an excellent biomimicry, as they ensure good biocompatibility, biodegradability, and non-immunogenicity. Furthermore, they possess bioactive properties, such as antimicrobial, anti-inflammatory, and antioxidant properties, which can promote and enhance the healing process. The aim of this review is to present the morphological, physical, and chemical features of an ideal wound dressing together with the traditional and the current strategies, and the already commercialized wound dressings. Moreover, the review is focused on the preparation of polysaccharide-based electrospun nanofibrous devices and on the strategies for the modulation and improvement of membrane stability and bioactivity. Lastly, a comprehensive consideration on the process and requirements that lead to the commercialization of the wound dressings is reported.

Electrospun polycaprolactone (PCL) membranes have been widely explored in the literature as a solution for several applications in tissue engineering and regenerative medicine. PCL hydrophobicity and its lack of bioactivity drastically limit its use in the medical field. To overcome these drawbacks, many promising strategies have been developed and proposed in the literature. In order to increase the bioactivity of electrospun PCL membranes designed for guided bone and tissue regeneration purposes, in the present work, the membranes were functionalized with a coating of bioactive lactose-modified chitosan (CTL). Since CTL can be used for the synthesis and stabilization of silver nanoparticles, a coating of this compound was employed here to provide antibacterial properties to the membranes. Scanning electron microscopy imaging revealed that the electrospinning process adopted here allowed us to obtain membranes with homogeneous fibers and without defects. Also, PCL membranes retained their mechanical properties after several weeks of aging in simulated body fluid, representing a valid support for cell growth and tissue development. CTL adsorption on membranes was investigated by fluorescence microscopy using fluorescein-labeled CTL, resulting in a homogeneous and slow release over time. Inductively coupled plasma-mass spectrometry was used to analyze the release of silver, which was shown to be stably bonded to the CTL coating and to be slowly released over time. The CTL coating improved MG63 osteoblast adhesion and proliferation on membranes. On the other hand, the presence of silver nanoparticles discouraged biofilm formation by Pseudomonas aeruginosa and Staphylococcus aureus without being cytotoxic. Overall, the stability and the biological and antibacterial properties make these membranes a valid and versatile material for applications in guided tissue regeneration and in other biomedical fields like wound healing.

Among the materials available for implant production, titanium is the most used while polyetheretherketone (PEEK) is emerging thanks to its stability and to the mechanical properties similar to the ones of the bone tissue. Material surface properties like roughness and wettability play a paramount role in cell adhesion, cell proliferation, osteointegration and implant stability. Moreover, the bacterial adhesion to the biomaterial and the biofilm formation depend on surface smoothness and hydrophobicity. In this work, two different treatments, sandblasting and air plasma, were used to increase respectively roughness and wettability of two materials: titanium and PEEK. Their effects were analyzed with profilometry and contact angle measurements. The biological properties of the material surfaces were also investigated in terms of cell adhesion and proliferation of NIH-3T3 cells, MG63 cells and human Dental Pulp Stem Cells. Moreover, the ability of Staphylococcus aureus to adhere and form a viable biofilm on the samples was evaluated. The biological properties of both treatments and both materials were compared with samples of Synthegra® titanium, which underwent laser ablation to obtain a porous micropatterning, characterized by a smooth surface to discourage bacterial adhesion. All cell types used were able to adhere and proliferate on samples of the tested materials. Cell adhesion was higher on sandblasted PEEK samples for both MG63 and NIH-3T3 cell lines, on the contrary, the highest proliferation rate was observed on sandblasted titanium and was only slightly dependent on wettability; hDPSCs were able to proliferate similarly on sandblasted samples of both tested materials. The highest osteoblast differentiation was observed on laser micropatterned titanium samples, but similar effects, even if limited, were also observed on both sandblasted materials and air plasma treated titanium. The lowest bacterial adhesion and biofilm formation was observed on micropatterned titanium samples whereas, the highest biofilm formation was detected on sandblasted PEEK samples, and in particular on samples not treated with air-plasma, which displayed the highest hydrophobicity. The results of this work showed that all the tested materials were able to sustain osteoblast adhesion and promote cell proliferation; moreover, this work highlights the feasible PEEK treatments which allow to obtain surface properties similar to those of titanium. The results here reported, clearly show that cell behavior depends on a complex combination of surface properties like wettability and roughness and material nature, and while a rough surface is optimal for cell adhesion, a smooth and less hydrophilic surface is the best choice to limit bacterial adhesion and biofilm formation.

The aim of this study was to evaluate the influence of the acidity of saliva on changes to the surface roughness, friction and microhardness of NiTi alloys with various coatings. Three types of commercially available NiTi archwires: uncoated, rhodium coated and nitrified (dimension 0.508×0.508 mm, 10 cm long) were immersed in 10 mL of artificial saliva with the pH ranging from 4.8 to 6.6 for a period of 28 d. Surface roughness, friction and microhardness were analyzed and compared to the unexposed as-received wires. These mechanical properties were influenced by the wire coating with a moderate-to-high effect size (p

An innovative powder-foaming process able to produce thermal and acoustic insulating foams obtained by sol-gel and a subsequent freeze-drying process was developed. Gel containing glass powder was formed using alginate, a polysaccharide composed of 1-4linked α-L-guluronic acid and β-D-mannuronic acid, capable to form stable gels in presence of calcium cations. In order to obtain a porous foam, gels were frozen and then freeze-dried. Foam properties strongly depend on production parameters, particle dimension and different binder concentrations, their influence was investigated. The resulting glass foams were characterized in order to evaluate structure, density, mechanical and acoustic properties. The results pointed out an improved acoustic insulating performance respect to rock wool. Foams were also subjected to a thermal process to better fix powders into the final glass structure.

Purpose To evaluate the surface chemical composition and roughness of different phaco tips before and after their use during cataract surgery. Setting Eye Clinic, University of Trieste, Trieste, Italy. Design Experimental study. Methods Of the 66 tips studied, 33 (15 new, 15 after single use, and 3 after multiple uses) were studied with X-ray photoemission spectroscopy and 33 (15 new, 15 after single use, and 3 after multiple uses) were examined using scanning electron microscopy with energy dispersive X-ray spectroscopy analysis and contact profilometry. All analyses were performed on the far end of the tip. Results Used phaco tips showed signs of wear at the end of the tip, with the deposition of debris. The cutting edge appeared to be rounded and irregular. After surgery, an increase in the surface roughness was detected. The chemical analyses showed modification of the superficial alloy composition and the biological origin of some debris deposited after surgery. The deterioration and wear observed were more remarkable after multiple surgical procedures. Conclusions Used phaco tips showed relevant signs of deterioration and deposition of biological material, mostly involving the cutting edge. Reusable tips might release remnants of previous procedures. The adoption of single-use disposable phaco tips seems to be highly advisable.

Adhesive coatings for implantable biomaterials can be designed to prevent material displacement from the site of implant. In this paper, a strategy based on the use of melanin-like nanoparticles (MNPs) for the development of adhesive coatings for polysaccharidic membranes was devised. MNPs were synthesized in vitro and characterized in terms of dimensions and surface potential, as a function of pH and ionic strength. The in vitro biocompatibility of MNPs was investigated on fibroblast cells, while the antimicrobial properties of MNPs in suspension were evaluated on E. coli and S. aureus cultures. The manufacturing of the adhesive coatings was carried out by spreading MNPs over the surface of polysaccharidic membranes; the adhesive properties of the nano-engineered coating to the target tissue (intestinal serosa) were studied in simulated physiological conditions. Overall, this study opens for novel approaches in the design of naturally inspired nanostructured adhesive systems.

The effects of the saliva and oral probiotic supplements on roughness, friction and microhardness of the stainless steel (SS) and nickel-titanium (NiTi) alloys used in dentistry was studied. The specimens of stainless steel, uncoated, rhodium-coated and nitrided NiTi were exposed to artificial saliva with pH 4.8 and artificial saliva with addition of probiotic supplements containing bacteria Lactobacillus reuteri Prodentis through 28 days. First 5 days specimens were subjected to thermocycling to simulate intraoral conditions, 2500 cycles from 5 °C to 50 °C and the following days to the temperature of the 37±2 °C. Analyses demonstrated that oral probiotic supplements do not influence microhardness, roughness or friction of stainless steel above the influence of saliva. Probiotics increase roughness in NiTi, but without significant influence on friction, while microhardness in NiTi is not influenced. Surface nitriding reduces the influence of probiotics on roughness while rhodium coating increases it, Die Einflüsse des Speichels und oraler Probiotika auf die Rauigkeit, Reibung und Mikrohärte von Edelstahl und Nickel-Titan-Legierungen, die in der Zahnmedizin angewendet werden, wurden untersucht. Es wurden unbeschichtete und Rhodium beschichtete Edelstahlproben sowie nitrierte Nickel-Titan-Legierungen bei den Versuchen berücksichtigt. Die Proben wurden künstlichem Speichel mit pH 4,8 ausgesetzt und dem Speichel mit Zusatz von Probiotikum, der das Bakterium Lactobacillus reuteri Prodentis enthält, für 28 Tage ausgesetzt. Für die ersten 5 Tage wurden die Proben mit 2500 Zyklen von 5 °C bis 50 °C thermocycliert, um die intraoralen Umstände zu simulieren und die nächsten Tage bei der Temperatur von 37�2 °C. Die Analysen bzw. Ergebnisse zeigen, dass die oralen Probiotika die Rauigkeit, Reibung und Mikrohärte des Edelstahls nicht mehr beeinflussen als Speichel. Die Probiotika vergrößern die Rauigkeit der Nickel-Titan-Legierungen, haben aber keinen bedeutsamen Einfluss auf die Reibung und die Mikrohärte der Nickel-Titan-Legierungen. Das Nitrieren der Oberfläche reduziert den Einfluss der Probiotika auf die Rauigkeit während sie die Rauigkeit der Rhodium-Beschichtung vergrößert.

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Purpose To test the stiffness and displacement of different vitreous forceps. Physical features and deformation after multiple procedures were also measured. Methods Eleven different 23-, 25-, and 27-gauge vitreous forceps were studied. The measurements were repeated loading the probe at different distances from the tip: at the top of the tip and 10 and 20 mm from the tip, respectively. For each probe, 10 successive identical bending tests were performed. The total length and the internal and external diameters of each forceps were also measured. Results A total of 330 successive identical bending tests were performed. No progression in deformation after the repeated measurements was recorded ( p > 0.05). In each gauge group, displacement differences were detected according to the manufacturing metal properties, the total length, and the thickness of the shaft wall. A minimal adequate model to describes forceps displacements in terms of their significant predictors, such as gauge, model, and load distance from the tip, was created. Conclusion We provided a precise assessment of the stiffness and displacement of different vitreous forceps to enable surgeons to select the optimal instrument according to the benefits and limitations of each forceps.

Purpose: To evaluate the surface profile of different new-generation intraocular lenses (IOLs) designed to improve intermediate vision. Setting: Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy. Design: Prospective experimental laboratory study. Methods: One higher-order aspheric monofocal IOL (Tecnis Eyhance ICB00) and 2 extended depth-of-focus (EDOF) IOLs (Tecnis Symfony ZXR00, Mini Well Ready) were examined and compared with monofocal IOLs with the same platform (Sensar AAB00, Tecnis ZCB00, Mini 4 Ready) using contact profilometry. Raw profiles were obtained and compared. The best-fit circle was then subtracted from each raw profile to highlight differences. Results: The new higher-order aspheric IOL presented a peculiar profile, which appeared similar to the conventional monofocal IOL based on the same platform, with just minimal differences in the central design. One of the EDOF IOLs showed a diffractive design. The EDOF IOL based on spherical aberration presented a central steepening surrounded by a symmetric lateral change in depths. Conclusions: Improved intermediate vision can be achieved by means of different optic designs. Unlike the traditional EDOF and multifocal IOLs based on a diffractive design, the profiles of new-generation IOLs are characterized by smooth and progressive changes of the superficial geometry. New-generation IOLs can enhance the range of vision. Contact surface profilometry analysis of 2 IOLs showed minimal yet peculiar changes of their central optic designs.

We report a case of an explanted stainless steel miniature glaucoma drainage device (EX-PRESS) implanted under a scleral flap for pseudoexfoliation open-angle glaucoma surgical treatment. The glaucoma shunt was implanted in a 75-year-old white man with medically refractive glaucoma. Cataract surgery was performed simultaneously. After 2 years, the shunt extruded through the scleral flap and the conjunctiva and it was, therefore, explanted. Scanning electron microscopy images of the EX-PRESS mini glaucoma shunt were acquired to verify the patency of the device lumen and the presence of fibrosis or cellular adhesion on the device. Energy dispersive spectroscopy for chemical surface characterization of the EX-PRESS shunt was performed. Scanning electron microscopy-acquired images showed minimal extracellular material proliferation on the lumen device. The energy dispersive spectroscopy analysis revealed a high peak of carbon suggesting the organic nature of the residuals found on the shunt lumen. The surface showed few superficial pits, likely due to an initial corrosion process.

The aim of this study was to evaluate in vivo bone regeneration, mediated by adipose-derived stem cells (ADSCs), induced to differentiate into osteoblasts and carried by a scaffold gel. In the test group, bone regeneration was mediated by ADSCs, induced to differentiate into osteoblasts, and carried by a scaffold gel. In the control group a scaffold without cells was used. The scaffold, consisting of chitosan and glycerol phosphate, was maintained in situ by a cross-linked resorbable membrane. The osteogenic potential of ADSCs was confirmed by osteocalcin assay and Von Kossa staining performed before implantation. Histological assays detected an initial increase in bone formation in the test group compared with the control group. Microcomputed tomography analysis did not show significant differences between the two groups. Both histological and microcomputed tomography analysis were performed on the ex vivo specimens after a follow-up period of 8 weeks. We observed that differentiated ADSCs could increase bone regeneration and that the scaffold used here can be a suitable carrier to entrap and maintain the cells in situ. On the contrary, the membrane used was not functional in isolating the site of the defect from surrounding soft tissues and caused a significant inflammatory reaction.

Nowadays platelet concentrates (PCs) show interesting potential in oral surgery for soft tissue healing promotion. However, inductive properties for bone formation remains still controversial. Recently, numerous studies explored the merging of two different tissue healing inducing agents: PCs with osteoinducing agents or scaffolds or antiresorptive drugs. Research trend looks towards the amelioration of the inductive properties of PCs, mainly towards bone regeneration. This paper aims to evaluate i) the durability of the pristine L-PRF membranes in dissolution assay; ii) the opportunity of coupling the obtained membranes with an osteoconductive molecule, such as nanohydroxyapatites (nHAp). Thus, the durability of pristine membrane in SBF was tested. At each time point, one sample was analyzed with SEM; image processing revealed an average fiber diameter of 0.103 ± 0.05µm without any statistically significant differences during time. Degradation assay showed a two-folds increase of the weight related to the SBF absorption in the first 2 days. From the third day a constant degradation was observed. In the time frame of this experiment, the dimensional stability of the fibrin structure up to day 7 suggested that PRF membranes may also be used uncovered in the oral cavity. Subsequently, the effects of the nHAp addition during the forming process of PRF (thus during centrifugation) were investigated.

PURPOSE: The aim of this study was to explore the surface roughness and hardness of the implant head of orthodontic mini-implants made from different alloys before and after their in vitro exposure to agents for prevention of gingivitis, mucositis, and peri-implantitis: chlorhexidine and probiotics. MATERIALS AND METHODS: Three types of commercially available mini- implants were tested: 316 stainless steel, titanium Grade 5, and titanium Grade 23 (both Ti-6Al-4V alloys with the same atomic weight percentage of Ti, Al, and V, with the difference being in maximal reduction of O2 in Grade 23 to 0.13% of atomic weight). They were immersed in three experimental solutions: artificial saliva, saliva with probiotic bacteria Lactobacillus reuteri, and saliva with oral antiseptic chlorhexidine (CHX). Samples were immersed for 28 days, thermocycled, then stored in an incubator at 37°C. Surface roughness and microhardness on five samples of each of the three implant types were measured by atomic force microscopy and the Vickers method, respectively. RESULTS: Exposure of titanium implant Grade 5 to probiotics significantly increased roughness compared with other media (P < .005). Exposure to CHX significantly increased the roughness of steel implants (P < .05). Neither saliva, probiotic, nor CHX altered microhardness of titanium implants significantly. In steel implants, the exposure to CHX and probiotics decreased microhardness compared with unexposed implants (P < .031), but not in comparison to saliva. CONCLUSION: Probiotics seem to increase roughness of titanium mini-implants, while CHX seems to increase roughness of steel mini- implants. Only stainless steel implants had an altered, decreased hardness after exposure to CHX, although the same was found after their exposure to saliva. For patients undergoing orthodontic treatment with temporary anchorage units, CHX could be recommended for titanium, and probiotics for stainless steel mini- implants in oral-hygiene maintenance.

This study assessed the effectiveness of modern endodontic shaping and filling procedures on mesiobuccal roots of maxillary molars with two canals. The canals of 20 mesiobuccal roots were treated with Mtwo rotary files, passive ultrasonic irrigation and Guttafusion obturators. X-ray computed microtomography analysis was carried out prior to treatment, after canal shaping and after canal filling to determine the alterations of the canal volume before and after the instrumentation, the volume of the hard tissue debris, and percentage of the volume occupied by filling materials. The shaping instruments and filling materials reached only partially the endodontic space of the second mesiobuccal canal and the accessory endodontic structures. Canal irregularities, ramifications, and interconnections were accumulation sites of hard tissue debris. This study demonstrated that rotary files, passive ultrasonic irrigation and carrier-based filling systems could be partially effective for the treatment of the mesiobuccal canals and their accessory endodontic structures.

Nanofibre-based membranes or scaffolds exhibit high surface-to-volume ratio, which allows an improved cell adhesion, representing an attractive subgroup of biomaterials due to their unique properties. Among several techniques of nanofiber production, electrospinning is a cost-effective technique that has been, to date, attractive for several medical applications. Among these, guided bone regeneration is a surgical procedure in which bone regeneration, due to bone atrophy following tooth loss, is “guided” by an occlusive barrier. The membrane should protect the initial blood clot from any compression, shielding the bone matrix during maturation from infiltration of soft tissues cells. This review will focus its attention on the application of electrospinning (ELS) in oral surgery bone regeneration. Despite the abundance of published papers related to the electrospinning technique applied in the field of bone regeneration of the jaws, to the authors’ knowledge, no articles report clinical application of these structures. Moreover, only a few records can be found with in vivo application. Therefore, no human studies have to date been detectable. New approaches such as multifunctional multilayering and coupling with bone promoting factors or antimicrobial agents, makes this technology very attractive. However, greater efforts should be made by researchers and companies to turn these results into clinical practice.

Purpose. To compare the capsule edges ultrastructure obtained by two femtosecond laser-assisted cataract surgery (FLACS) platforms and manual continuous curvilinear capsulorhexis (CCC) using scanning electron microscopy (SEM). Setting. Eye Clinic, University of Trieste, Italy. Design. Experimental comparative study. Methods. 150 anterior capsules were collected and divided into three groups as follows: Group 1 (50 capsules) obtained with manual CCC, Groups 2 and 3 (each with 50 capsules) obtained with the Catalys Laser and the LenSx Laser, respectively. All samples were imaged by means of SEM and regularity of the cut surface, and thickness of the capsule edge were evaluated and compared. Results. All femtosecond laser (FSL) capsules were perfectly circular, whereas some alteration of the circular shape was observed in the manual ones. Group 1 showed a smooth and regular capsule edge without any surface irregularity, conversely Groups 2 and 3 showed postage-stamp perforations on the capsule edge. The cut surface irregularity value in Group 2 was 1.4 ± 0.63, while it was 0.7 ± 0.49 in Group 3 (p<0.05). Group 1 had a significantly lower thickness of the capsule edge than the FSL groups (p<0.05). No statistically significant difference in the capsule edge thickness between the FSL groups was found (p=0.244). Conclusions. Despite the presence of slight cut surface irregularities, both FSL capsulotomies showed a better geometry and circularity than the manual ones. Capsulotomy specimens obtained using both FSL capsulotomies showed laser-induced alterations of the capsule edge when compared with smooth and regular edges obtained using manual CCC.

Objective This study evaluated the ability of 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide hydrochloride (EDC) to improve the stability of demineralized dentin collagen matrices when subjected to mechanical cycling by means of Chewing Simulation (CS). Methods Demineralized dentin disks were randomly assigned to four groups ( N = 4): (1) immersion in artificial saliva at 37 °C for 30 days; (2) pre-treatment with 0.5 M EDC for 60 s, then stored as in Group 1; (3) CS challenge (50 N occlusal load, 30 s occlusal time plus 30 s with no load, for 30 days); (4) pre-treatment with 0.5 M EDC as in Group 2 and CS challenge as in Group 3. Collagen degradation was evaluated by sampling storage media for ICTP and CTX telopeptides. Results EDC treated specimens showed no significant telopeptides release, irrespective of the aging method. Cyclic stressing of EDC-untreated specimens caused significantly higher ICTP release at day 1, compared to static storage, while by days 3 and 4, the ICTP release in the cyclic group fell significantly below the static group, and then remained undetectable from 5 to 30 days. CTX release in the cyclic groups, on EDC-untreated control specimens was always lower than in the static group in days 1–4, and then fell to undetectable for 30 days. Significance This study showed that chewing stresses applied to control untreated demineralized dentin increased degradation of collagen in terms of CTX release, while collagen crosslinking agents may prevent dentin collagen degradation, irrespective of simulated occlusal function.

Alginate/hydroxyapatite composites, with isotropic or anisotropic porosity, were developed using two different freezing methods. Morphological analysis highlighted the differences in their three-dimensional network. Swelling and in vitro degradation studies revealed that both structures are highly hydrophilic and stable. Static compression tests showed that isotropic scaffolds possess higher modulus and toughness than anisotropic ones. Cyclic compression tests revealed that wet scaffolds are able to withstand high deformations with a peculiar shape-recovery behaviour. In vitro biological tests showed that osteoblast-like cells proliferate on both types of structures in a comparable manner.

Ionic chitosan gels fabricated using multivalent anions, tripolyphosphate (TPP) or pyrophosphate (PPi), respectively, have been investigated as potential biomaterials to be used in tissue engineering. Starting from the hypothesis that the polymer mesh texture at the microscale affects the final performance of the resulting materials, an innovative image analysis approach is presented in the first part of the article, which is aimed at deriving quantitative information from transmission electron microscopy images. The image analysis of the (more extended) central area of the gel networks revealed differences between both the cross-linking densities and pore size distributions of the two systems, the TPP gels showing a higher connectivity. Chitosan-TPP gels showed a limited degradation in simulated physiological media up to 6 weeks, reasonably ascribed to the texture of the (more extended) central area of the gels, whereas PPi counterparts degraded almost immediately. The release profiles and the calculation of diffusion coefficients for bovine serum albumin and cytochrome c, herein used as model payloads, indicated a different release behavior depending on the polymer network homogeneity/inhomogeneity and molecular weight of loaded molecules. This finding was ascribed to the marked inhomogeneity of the PPi gels (at variance with the TPP ones), which had been demonstrated in our previous work. Finally, thorough in vitro studies demonstrated good biocompatibility of both chitosan gels, and because of this feature, they can be used as suitable scaffolds for cellular colonization and metabolic activity.