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Objective: This paper summarizes the effective components of computer-aided design and computer-aided manufacturing (CAD-CAM) resin composites that contribute to achieving greater mechanical properties and further development., Methods: In silico multi-scale analysis, in silico nonlinear dynamic finite element analysis (FEA), and artificial intelligence (AI) were used to explore the effective components of CAD-CAM resin composites. The effects of the filler diameter and silane coupling ratio on the mechanical properties of CAD-CAM resin composites have been clarified through multi-scale analysis. The effects of the filler contents, and filler and monomer compositions have been investigated by AI algorithms. The fracture behavior of CAD-CAM composite crown was analyzed using in silico non-linear dynamic FEA. The longevity of CAD-CAM composite crown was assessed through step-stress accelerating life testing (SSALT)., Results: As the filler diameter decreases, there is an increase in elastic moduli and compressive strengths at the macroscale. At the nanoscale, a decrease in the filler diameter results in a decrease in the maximum value of the maximum principal strain. When the silane coupling ratio decreases, there is a decrease in the elastic modulus and compressive strength. According to the exhaustive search and feature importance analysis based on the AI algorithm, the combination of certain components was narrowed down to achieve a flexural strength of 269.5 MPa. The in silico non-linear FEA successfully detected the sign of the initial crack of the CAD-CAM composite molar crown. The SSALT revealed that CAD-CAM resin composite molar crowns containing nanofillers with a high fraction of resin matrix demonstrated great longevity., Significance: This paper summarized the effective components of CAD-CAM resin composites for their further development. The integration of in vitro and in silico approaches will expedite the advancement of CAD-CAM resin composites, offering benefits such as time efficiency and reduction of material waste for researchers and manufacturers., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: To evaluate the reliability, maximum principal stress, shear stress, and crack initiation of a computer-aided design/computer-aided manufacturing (CAD/CAM) resin composite (RC) incorporating surface pre-reacted glass (S-PRG) filler for primary molar teeth., Methods: Mandibular primary molar crowns fabricated by experimental (EB) or commercially available CAD/CAM RCs (HC) were prepared and cemented to a resinous abutment tooth using an adhesive resin cement (Cem) or a conventional glass-ionomer cement (CX). These specimens were subjected to a single compressive test (n = 5/each) and the step-stress accelerated life testing (SSALT) (n = 12/each). Data was evaluated using Weibull analyses and reliability was calculated. Afterwards, the maximum principal stress and crack initiation point of each crown was analyzed by finite element analysis. To evaluate bonding of EB and HC to dentin, microtensile bond strength (μTBS) testing was conducted using primary molar teeth (n = 10/each)., Results: There was no significant difference between the fracture loads of EB and HC for either cement (p > 0.05). The fracture loads of EB-CX and HC-CX were significantly lower than EB-Cem and HC-Cem (p < 0.05). The reliability at 600 N for EB-Cem was greater than that for EB-CX, HC-Cem, and HC-CX. The maximum principal stress concentrated on EB was lower than that on HC. The shear stress concentrated in the cement layer for EB-CX was higher than that for HC-CX. There was no significant difference among the μTBSs of EB-Cem, EB-CX, HC-Cem, and HC-CX (p > 0.05)., Significance: The crowns fabricated with the experimental CAD/CAM RC incorporating S-PRG filler yielded greater fracture loads and reliability than the crowns manufactured with commercially available CAD/CAM RC regardless of the luting materials. These findings suggest that the experimental CAD/CAM RC crown may be clinically useful for the restoration of primary molars., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Objectives: This study aimed to develop computer-aided design/computer-aided manufacturing (CAD/CAM) resin composite blocks (RCBs) containing surface pre-reacted glass-ionomer (S-PRG) filler for primary molar teeth and evaluate their physical properties and wear resistance., Methods: Experimental CAD/CAM RCBs containing S-PRG filler for primary molar teeth (EB), a commercial CAD/CAM RCB (HC), two resin composites for primary teeth (BKP and BKZ) and one for permanent teeth (BⅡ) were used. Hardness tests, three-point bending tests, fracture toughness tests, and water absorption tests were conducted. Wear tests were conducted for these materials and stainless steel crowns (SSCs)., Results: The Vickers hardness of EB was lower than that of HC (p < 0.05), and there was no significant difference among BKZ, BKP, and BⅡ (p > 0.05). After 1 week of water immersion, EB and HC showed greater flexural strength than the other materials (p < 0.05). EB showed greater fracture toughness than the other materials (p < 0.05). The water absorption of EB was lower than that of HC, BKZ, and BKP (p < 0.05), and greater than that of BⅡ (p < 0.05). Antagonist wear was significantly smaller in EB than in HC and BⅡ (p < 0.05), and significantly greater than in BKZ (p < 0.05). Antagonist wear could not be measured in SSC because of excessive wear that was out of range of the surface roughness tester., Significance: The CAD/CAM RCBs containing S-PRG filler for primary molar teeth developed in this study demonstrated adequate physical properties and wear performance, suggesting that they are suitable for restoration of primary molar teeth and could function in place of SSCs., (Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.)

Objective: The objective of this study is to prepare new dental resins with a long-lasting antimicrobial activity. Specifically, this study evaluates an approach for controlling infection in root canals using sealers containing polyhydroxyethyl methacrylate trimethylolpropane trimethacrylate (polyHEMA/TMPT) particles loaded with cetylpyridinium chloride (CPC). In addition, the physical properties of sealers containing CPC-loaded polyHEMA/TMPT particles (CLP) are determined., Methods: PolyHEMA/TMPT particles with 10 (10%-CLP) and 25wt.% CPC (25%-CLP) with different particle sizes were fabricated and incorporated in HEMA-based sealers. CPC-release profiles were evaluated over 14 days of immersion in water, followed by 14 days of storage and 14 days of water immersion. The antibacterial activity of these sealers against Enterococcus faecalis in dentinal tubules was assessed using a root-canal-infection model. Their sealing abilities were evaluated by fluid filtration and physical properties were tested according to the ISO 6876 standard. The long-term antibacterial activity of the cured sealer containing 25%-CLP (∼21μm particle diameter) was re-assessed after 1 year of storage., Results: After 28 days of immersion, 25%-CLP exhibited a higher and sustained CPC release unlike 10%-CLP. Residual bacteria in root dentinal tubules were eradicated by obturation with 25%-CLP-containing sealers. The incorporation of 25%-CLP (∼21μm) had no adverse effects on the sealing ability and physical properties of the sealer and resulted in long-term antibacterial activity., Significance: The incorporation of CPC-loaded particles in HEMA resins yielded endodontic sealers with long-term bactericidal activity against E. faecalis in root canals. These sealers can potentially be used to prevent recurrent apical periodontitis., (Copyright © 2021 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objective: A glass-ionomer cement (GIC) containing BioUnion filler has been reported to release Zn 2+ under acidic conditions and to inhibit oral bacteria on its surface. However, previous results are based on in vitro experiments under static conditions. This study aimed to assemble an in vitro saliva-drop setting to simulate in vivo conditions of the oral cavity and to investigate the ion releasing and recharging properties of the GIC containing BioUnion filler., Methods: The effective concentrations of Zn 2+ and F - against Streptococcus mutans and saliva-derived multi-species biofilms were determined. Artificial saliva was dropped on the GIC containing BioUnion filler using the in vitro saliva-drop setting assembly and was periodically replaced with acetic acid. Ion release/recharge properties were investigated by measuring the release concentrations of Zn 2+ and F - ., Results: The concentration of Zn 2+ released from the BioUnion filler-containing GIC during seven days with repeated exposure to acid could be maintained at the level to inhibit S. mutans and saliva-derived multi-species biofilm formation. Moreover, the BioUnion filler-containing GIC could be recharged with Zn 2+ and F - by the application of a tooth gel containing Zn 2+ and F - . The release concentration of Zn 2+ after recharging was significantly higher than the effective concentration of Zn 2+ to hinder S. mutans and saliva-derived multi-species biofilm formation on material surfaces., Significance: The GIC containing BioUnion filler was shown to have the potential to inhibit biofilm formation in the oral cavity. In addition, recharging Zn 2+ and F - would further enhance the effect of the GIC containing BioUnion filler., (Copyright © 2021 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objective: The aim of this study was to evaluate the optical properties of supra-nano spherical fillers with different diameters and the color matching ability of resin composites (RC) incorporating these fillers., Methods: Two types of SiO 2 -ZrO 2 nano fillers with different diameters (150nm and 260nm) were used. The size distribution of each filler was measured and filler morphology was observed. The colors and spectral reflection spectra were measured by a spectral reflectometer. Experimental RCs incorporating ϕ150-nm/ϕ260-nm filler (D150RC/D260RC) were prepared. For the base dentin part, disc specimens (Estelite Astelia: A1B, A2B, A3B, A3.5B, or A4B) were prepared with a cylindrical cavity. Estelite Astelia with NE shade was layered on top as the enamel layer. Disk specimens with different cavity depths were prepared using A3B shade. Experimental RC was used to fill the cavity, and spectral reflection spectrums were obtained and analyzed. Filtek Supreme Ultra (FSU) with A3B shade was used (n=10) as a control., Results: Both ϕ150-nm and ϕ260-nm nano fillers showed uniform spherical shape and exhibited no aggregation. The maximum peaks of the spectral reflection spectra of the ϕ150-nm and ϕ260-nm nano fillers were 380nm and 580nm, producing structural colors close to blue and yellow, respectively. The spectral reflection spectrum of FSU had a broad peak at 540nm, and D150RC had a significant peak at 420nm. The D260RC specimen had a broad peak at 680nm. The peaks of D150RC and D260RC significantly decreased in accordance with the shift in base RC shade from A1B to A4B. There was no significant difference in the peak of the reflection spectral spectra among different cavity depths of D260RC. These results suggest that the experimental RC could reflect base RC colors via the matrix resin, and the amount of transmitted light from the base RC was not much different with cavity depth., Significance: D260RC producing structural color demonstrated a broad spectrum and reduction in brightness and chromatic value by adapting to surrounding restorative materials, suggesting its ability to enhance the chameleon (blending) effects to improve color matching. D260RC showed better color matching ability than resin composite containing uniformly sized ϕ150-nm SiO 2 -ZrO 2 supra-nano spherical filler., (Copyright © 2021 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objective: The aim of this study was to investigate the criteria for predicting the fracture initiation of resin composites (RCs) at the micro-scale and assess the influence of filler shapes on the flexural properties of RCs by combining nano-CT imaging and in silico multi-scale analysis., Methods: Experimental RCs composed of irregular-shaped (IS) silica filler (31.2 vol%/50.0 wt%) and Bis-GMA/TEGDMA were prepared. The RC specimens were scanned by a nano-CT with 500-nm resolution, and 10 micro-scale models (100 × 100 × 100 μm) were randomly extracted from a scanned region. In silico micro-scale models containing sphere-shaped (SS) fillers with the same volume content as the experimental RC were designed. Each RC model's elastic modulus and Poisson's ratio at the macro-scale were calculated using homogenization analysis. The flexural strength of the RC models were predicted by finite element analysis using the elastic moduli and Poisson's ratio values., Results: Significantly greater elastic modulus values were obtained in the X, Y, and Z directions for RC models containing IS fillers than SS fillers. Similarly, smaller Poisson's ratio values were observed in the Y and Z directions for RC model containing IS fillers than SS fillers (p < 0.05). The flexural strength of RC model containing IS fillers was significantly greater than the RC model containing SS fillers (p < 0.05)., Significance: The in silico multi-scale analysis established in this study demonstrated that RC model containing irregular-shaped fillers had greater flexural strength than RC model loaded with SS fillers, suggesting that the mechanical strength of the RC can be improved by optimizing the shape of the silica fillers., (Copyright © 2020 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objectives: Non-biodegradable particles comprising hydroxyethyl methacrylate (HEMA) and trimethylolpropane trimethacrylate (TMPT) have been reported as useful carriers for fibroblast growth factor-2 (FGF-2). They have also been successfully incorporated into the 4-[2-(methacryloyloxy)ethoxycarbonyl]phthalic anhydride/methyl methacrylate-tri-n-butyl borane (4-META/MMA-TBB) resin to promote tissue regeneration. However, smaller particles are required to obtain restorative materials acceptable for clinical use. The aim of this study was to investigate the ability of the 4-META/MMA-TBB resin that comprises small FGF-2-loaded particles to release FGF-2 and promote cell proliferation. In addition, the bonding and physical properties of the experimental resin were evaluated., Methods: The small particles loaded with FGF-2 were newly fabricated and incorporated into the commercial 4-META/MMA-TBB resin. Release profiles of FGF-2 from the experimental resins were assessed, and the cell proliferation cultured with the eluate was evaluated. The bonding and physical properties of the resins were evaluated using shear bond strength and three-point bending tests, and by measuring the curing time, water absorption, and water dissolution., Results: Sustained release of FGF-2 from the experimental resins for two weeks was observed, and the released FGF-2 was demonstrated to promote cell proliferation. All bonding and physical properties of the 4-META/MMA-TBB resins were found acceptable for clinical use., Significance: The small FGF-2-loaded particles incorporated into the 4-META/MMA-TBB resin had the same abilities to release FGF-2 and proliferate cells, as those exhibited by the conventionally sized particles. In addition, there were no adverse influences on bonding and physical properties, suggesting that the bioactive adhesive resin was acceptable for clinical use., (Copyright © 2020 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objective: Recurrent caries is a primary reason for restoration failure caused by biofilm acids. The objectives of this study were to: (1) develop a novel multifunctional composite with antibacterial function and calcium (Ca) and phosphate (P) ion release, and (2) investigate the effects on enamel demineralization and hardness at the margins under biofilms., Methods: Dimethylaminohexadecyl methacrylate (DMAHDM) and nanoparticles of amorphous calcium phosphate (NACP) were incorporated into composite. Four groups were tested: (1) Commercial control (Heliomolar), (2) Experimental control (0% DMAHDM + 0% NACP), (3) antibacterial group (3% DMAHDM + 0% NACP), (D) antibacterial and remineralizing group (3% DMAHDM + 30% NACP). Mechanical properties and Ca and P ion release were measured. Colony-forming units (CFU), lactic acid and polysaccharide of Streptococcus mutans (S. mutans) biofilms were evaluated. Demineralization of bovine enamel with restorations was induced via S. mutans, and enamel hardness was measured. Data were analyzed via one-way and two-way analyses of variance and Tukey's multiple comparison tests., Results: Adding DMAHDM and NACP into composite did not compromise the mechanical properties (P > 0.05). Ca and P ion release of 3% DMAHDM + 30% NACP was increased at cariogenic low pH. Biofilm lactic acid and polysaccharides were greatly decreased via DMAHDM, and CFU was reduced by 4 logs (P < 0.05). Under biofilm acids, enamel hardness at the margins was decreased to about 0.5 GPa for control; it was about 1 GPa for antibacterial group, and 1.3 GPa for antibacterial and remineralizing group (P < 0.05)., Conclusions: The novel 3% DMAHDM + 30% NACP composite had strong antibacterial effects. It substantially reduced enamel demineralization adjacent to restorations under biofilm acid attacks, yielding enamel hardness that was 2-fold greater than that of control composites. The novel multifunctional composite is promising to inhibit recurrent caries., (Copyright © 2020 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objectives: This study aimed to investigate physical properties of a fiber-reinforced CAD/CAM resin disc, which included woven layers of multi-directional glass fibers., Methods: Fiber orientations of CAD/CAM specimens (TRINIA, SHOFU) were specified as longitudinal (L), longitudinal-rotated (LR), and anti-longitudinal (AL). A fiber-reinforced composite (everX posterior, GC (E)) and a conventional composite (Beauti core flow paste, SHOFU (B)) were also tested. A three-point bending test and a tensile test with notchless prism-shaped specimens were conducted using a universal testing machine (AUTOGRAPH AG-IS, Shimadzu). A water absorption test was also carried out after the specimens were stored in water for 24h or 1 week. Flexural strength and fracture toughness were obtained by conducting a three-point bending test., Results: TRINIA L and LR groups showed significantly high flexural strength (254.2±22.3 and 248.8±16.7MPa, respectively). Those were approximately 2.5 times higher than those in AL, E, and B groups (96.8-98.0MPa) (p<0.05, ANOVA and Tukey HSD test). No significant difference was shown in flexural modulus among the experimental groups. The fracture toughness in L group (9.1±0.4MPa/m 1/2 ) was found to be significantly higher than those in other groups (1.9-3.0MPa/m 1/2 ; p<0.05). TRINIA group demonstrated significantly lower water absorption (4.7±1.9μg/mm 3 ) than did E (16.1±3.1μg/mm 3 ) and B (17.3±3.7μg/mm 3 ) groups (p<0.05)., Significance: TRINIA demonstrated distinct anisotropy. TRINIA can be used as a superior restorative material when specifying directions of its fiber mesh layers., (Copyright © 2020 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objective: Guided bone regeneration (GBR) often involves the use of membranes as barriers for soft tissues. Commercially available membranes, however, do not possess an adequately low degradation rate, resulting in limited barrier function. The purpose of this study was to develop and assess the physicochemical and biological characteristics of a novel poly(l-lactic acid/caprolactone) (PLCL) bilayer membrane and determine its usefulness for GBR application., Methods: The experimental bilayer membrane was prepared via a two-step freezing and lyophilization process with a PLCL solution. Next, the PLCL membrane was investigated regarding tensile strength, surface roughness, in vitro degradation and clinical operability. In addition, cell proliferation and differentiation were investigated on each layer of the experimental membrane. For all experiments, a commercially available poly(lactic-co-glycolic) acid membrane was used as a control., Results: In vitro analysis of the PLCL bilayer membrane revealed suitable mechanical strength combined with high breaking strain, which contributed to membrane operability. In addition, the PLCL bilayer membrane had enhanced stability compared to the commercial control due to its slower degradation, and was capable of supporting cell growth and osteogenic differentiation., Significance: The current study confirmed that the PLCL membrane possessed a high biocompatibility and slow degradation rate that contributes to prolonged barrier function and bone regeneration. Altogether, it was considered that the PLCL bilayer membrane developed in this study was applicable for GBR treatment., (Copyright © 2020 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objectives: Antibacterial quaternary ammonium monomers (QAMs) are used in resins. The rnc gene in Streptococcus mutans (S. mutans) plays a key role in resisting antibiotics. The objectives of this study were to investigate for the first time: (1) the effects of rnc deletion on S. mutans biofilms and acid production; (2) the combined effects of rnc deletion with dimethylaminohexadecyl methacrylate (DMAHDM) on biofilm-inhibition efficacy., Methods: Parent S. mutans strain UA159 (ATCC 700610) and the rnc-deleted S. mutans were used. Bacterial growth, minimum inhibitory concentration (MIC), and minimal bactericidal concentration (MBC) were measured to analyze the bacterial susceptibility of the parent and rnc-deleted S. mutans against DMAHDM, with the gold-standard chlorhexidine (CHX) as control. Biofilm biomass, polysaccharide and lactic acid production were measured., Results: The drug-susceptibility of the rnc-deleted S. mutans to DMAHDM or CHX was 2-fold higher than parent S. mutans. The drug-susceptibility did not increase after 10 passages (p < 0.05). Deleting the rnc gene increased the biofilm susceptibility to DMAHDM or CHX by 2-fold. The rnc-deletion in S. mutans reduced biofilm biomass, polysaccharide and lactic acid production, even at no drugs. DMAHDM was nearly 40 % more potent than the gold-standard CHX. The combination of rnc deletion+DMAHDM treatment achieved the greatest reduction in biofilm biomass, polysaccharide synthesis, and lactic acid production., Significance: Gene modification by deleting the rnc in S. mutans reduced the biofilm growth and acid production, and the rnc deletion+DMAHDM method showed the greatest biofilm-inhibition efficacy, for the first time. The dual strategy of antibacterial monomer+bacterial gene modification shows great potential to control biofilms and inhibit caries., (Copyright © 2019 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objectives: Bioactive glass (BG) is widely used as a bioactive material for various clinical applications, and effective and efficient elemental release and an increase in mechanical strength are expected with further development. The purpose of this study is to clarify the physicochemical and biological characteristics of Sr-doped BG-incorporated glass ionomer cements., Methods: Sr-doped BGs (45SiO 2 -6P 2 O 5 -24.5Na 2 O-(24.5-x)CaO-xSrO) (wt%), where × = 0, 6, 12, were prepared, and the particle size, crystallinity, and elemental release profiles were evaluated. The Sr-doped BGs were then incorporated into a glass ionomer cement at a weight ratio of 1:4, and the physicochemical properties (compressive strength, bending strength, hardness, and elemental release profile) were investigated. Cell attachment, cell proliferation, and osteoblastic differentiation were used to evaluate the biological characteristics., Results: The Sr-doped BGs were amorphous phases with a homogeneous particle size and exhibited sustained release of Ca, Si, and Sr. The BG-incorporated cements were able to release these elements while retaining the same mechanical properties as those of the pure glass ionomer cement. In addition, no cytotoxicity of osteoblasts or differences in the cell attachment or proliferation were observed for the BG-incorporated cements. In contrast, the Sr-doped BG-incorporated cements promoted the alkaline phosphatase activities of the osteoblasts without the need for any media supplements for osteoblastic differentiation., Significance: Sr-releasable inorganic cements with high mechanical properties were successfully fabricated by incorporating Sr-doped BGs in glass ionomer cement. These bioactive materials are promising candidates for bone grafting materials, bone cements, and pulp capping materials., (Copyright © 2019 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objective: The aim of this study was to evaluate long-term fatigue behavior using an in vitro step-stress accelerated life test (SSALT), and to determine the crack initiation point using in silico finite element analysis for computer-aided designed and manufactured (CAD/CAM) molar crowns fabricated from three commercial CAD/CAM resin composite blocks: Cerasmart (CS; GC, Tokyo, Japan), Katana Avencia Block (KA; Kuraray Noritake Dental, Niigata, Japan), and Shofu Block HC (HC; Shofu, Kyoto, Japan)., Methods: Fifty-one mandibular first molar crowns luted on a resin core die were embedded in acrylic resin and covered with a polyvinyl chloride tube. Single compressive tests were performed for five crowns. SSALT was conducted for 36 crowns using three profiles and reliabilities at 120,000 cycles, and a Weibull analysis was conducted. The maximum principal strain of each CAD/CAM resin composite crown model was analyzed by three-dimensional finite element analysis., Results: Fracture loads of CS and KA (3784±144N and 3915±313N) were significantly greater than that of HC (2767±227N) (p<0.05). Fracture probabilities at 120,000 cycles were 24.6% (CS), 13.7% (KA), and 14.0% (HC). Maximum principal strain was observed around the mesiolingual cusps of CS and KA and the distobuccal cusp of HC., Significance: CAD/CAM resin composite molar crowns containing nano-fillers with a higher fraction of resin matrix exhibited higher fracture loads and greater longevity, suggesting that these crowns could be used as an alternative to ceramic crowns in terms of fatigue behavior., (Copyright © 2018 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objective: Aiming to achieve bioactive dental resins that promote healing of surrounding tissues, we developed novel poly(2-hydroxyethyl methacrylate/trimethylolpropane trimethacrylate) (polyHEMA/TMPT) particles. These particles have been reported to be useful as a non-biodegradable carrier for fibroblast growth factor-2 (FGF-2) in vitro. The aim of this study was to evaluate the ability of an adhesive resin incorporating FGF-2-loaded polymer particles to promote tissue regeneration in vitro and in vivo., Methods: Experimental adhesive resins were prepared by incorporating FGF-2-loaded polyHEMA/TMPT particles into a 4-META/MMA-based adhesive resin, and the release profiles of FGF-2 were evaluated. The proliferation of osteoblast-like cells in the eluate from cured experimental resin was assessed. When the experimental resin was implanted into rat calvaria defects, bone regeneration was evaluated by microcomputed tomography and histological observations., Results: Sustained release of FGF-2 from the experimental resin was observed for 14 days. Eluate from the cured experimental resin significantly promoted the proliferation of osteoblast-like cells. Significantly greater bone regeneration was observed using the experimental resin compared with the control resin without FGF-2., Significance: 4-META/MMA-based adhesive resin incorporating FGF-2-loaded polymer particles is useful to promote tissue regeneration, suggesting that its application would be beneficial for root-end filling or the repair of fractured roots in cases with severely damaged periodontal tissue., (Copyright © 2018 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Objective: Various commercial products are available for guided tissue regeneration (GTR) therapy; however, they do not combine biosafety with the ability to control cell function. The purpose of this study was to evaluate the physicochemical and biological characteristics of the novel bilayer biodegradable poly(lactic-co-glycolic acid) (PLGA) membrane, and to assess whether the bilayer PLGA membrane could be used for periodontal tissue regeneration., Methods: Bilayer biodegradable membrane was fabricated thorough a two-step freezing and lyophilization process using PLGA solution. The characteristics of bilayer membranes were evaluated with respect to surface morphology, stability, mechanical strength, and operability for clinical use. Cell proliferation and osteogenic differentiation were investigated on the each surface of bilayer membrane. Then, these membranes were implanted to the rat calvaria bone defect models and evaluated their capability for tissue regeneration., Results: Biodegradable membranes composed of the solid and porous layer were successfully prepared and the surface morphologies analyzed. Physicochemical analyses revealed that the membranes possessed enough stability and mechanical properties for clinical use. It was also confirmed that the solid layer inhibited cell proliferation and subsequent connective tissue invasion, while the inner layer promoted proliferation and osteogenic differentiation, thus resulting in bone regeneration in vivo., Significance: The layering technology used to fabricate the bilayer polymer membrane could be applied in the developing of other novel biomaterials. The present study demonstrates that the bilayer biodegradable polymer membranes facilitate tissue regeneration in vivo, and therefore represent a prospective biomaterial for GTR therapy., (Copyright © 2018 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Objective: A surface pre-reacted glass-ionomer (S-PRG) filler is a technology of interest for providing bio-functions to restorative materials. Resin composites containing S-PRG filler have been reported to show less plaque accumulation and reduced bacterial attachment. In this study, experimental resin composites containing S-PRG filler at various concentrations were fabricated, and the inhibitory effects on bacterial growth on their surface and the association of ions released from S-PRG filler with antibacterial activity were evaluated., Methods: Five kinds of experimental resin composites containing S-PRG filler at 0, 13.9, 27.3, 41.8, or 55.9 (vol.%) were fabricated. Streptococcus mutans was cultured on the cured discs for 18h to examine the growth of bacteria in contact with the surface of the experimental resins. The concentrations of Al(3+), BO3(3-), F(-), Na(+), SiO3(2-), or Sr(2+) released from each experimental resin into water were measured. The standardized solutions of each ion were prepared at the concentrations determined to be released from the experimental resin, and their inhibitory effects of single ion species on S. mutans growth were evaluated by using each standardized solution., Results: Resin composites containing S-PRG filler at 13.9 (vol.%) or greater inhibited S. mutans growth on their surface. When S. mutans was incubated in the presence of six kinds of ions at the concentrations released from the resin composite containing S-PRG filler at 55.9 (vol.%), a significant reduction in bacterial number was observed for BO3(3-), F(-), Al(3+), and SiO3(2-). Among these four ions, BO3(3-) and F(-) demonstrated the strongest inhibitory effect on S. mutans growth., Significance: Our findings suggest that resin composites containing S-PRG filler inhibit the growth of S. mutans on their surface. BO3(3-), F(-), Al(3+) and SiO3(2-) released from S-PRG filler have the ability to inhibit S. mutans growth, and the inhibitory effects are mainly attributed to release of BO3(3-) and F(-)., (Copyright © 2016 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Objectives: The objective of this study was to fabricate a radiopaque prosthetic fit-testing material, and to develop methodology to evaluate the fitting accuracy of prostheses three-dimensionally (3D) using a combination of the silicone replica technique and micro-computed tomography (μCT)., Methods: Eight types of prototype specimens of fit-testing materials were prepared by adding contrast agents (zirconia, alumina, and barium-glass) to a commercially available fit-testing material. These specimens were evaluated on their mechanical properties, X-ray absorption coefficients, reproducibility of cement space, and suitability for 3D analysis by μCT. Then, silicone replicas made from prototype specimens were assessed for accurate 3D morphology. Subsequently, color-mapping analyses of the silicone replicas were performed according to replica thickness, and the results were compared with stereomicroscopic images., Results: The mechanical properties, X-ray absorption coefficients, and reproducibility of the cement space demonstrated that prototypes containing 20wt% zirconia (Zr-20) or barium glass (diameter 2μm; Ba2-20) were useful as fit-testing materials. However, the morphology of the Ba2-20 silicone replica was unable to be accurately described using μCT because of its low X-ray absorption threshold. Zr-20, however, could be clearly observed on μCT imaging. Furthermore, color-mapping analysis of the μCT images demonstrated that Zr-20 was the most suitable for 3D observation of prosthetic fit., Significance: This method could allow any professional to evaluate the fit of any type of dental prosthesis, such as inlays, crowns, and fixed and removable dentures. This study demonstrated that the technique presented in the current study is able to accurately describe the abutment-crown prosthetic discrepancy based on silicone replicas., (Copyright © 2016 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Objectives: This study aimed to investigate how use of a fiber sleeve may reduce interfacial debonding and improve fracture strength of pulpless teeth with flared root canals., Methods: Pulpless premolars with flared root canals were restored either with a fiber-reinforced post (FRP) alone or with an FRP wrapped in a hollow tubular fiber sleeve. A normal root restored with an FRP alone served as a control. The integrity of resin-dentin and resin-fiber interfaces in the restored roots was evaluated by a stereoscopic system after penetrating a dye. Four roots were tested for each experimental group. Fracture resistance in pulpless premolars with flared root canals restored with an FRP alone or with an FRP/sleeve combination were investigated under bonded and non-bonded conditions with static fracture testing (n=8), and stress distribution in these restored premolars were tested by finite element analysis (FEA)., Results: Flared root canals restored with an FRP/sleeve combination demonstrated superior integrity at the cervical resin-dentin interface to root canals with an FRP alone. Premolars with a flared root canal restored with an FRP/sleeve combination showed significantly greater fracture resistance compared with premolars restored with an FRP alone. FEA showed that once interfacial de-bonding extended to the cervical region of the root, stress concentration in the root dentin dramatically increased., Significance: The FRP/sleeve combination was effective in reducing debonding and, hence, improving the fracture strength of pulpless premolars with flared root canals., (Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Objectives: Dental resin-based restorative materials are used in a variety of dental treatment modalities such as root-end filling, perforation sealing, and adhesion of fractured roots. However, the prognosis after such treatments is not necessarily favorable because they fail to promote healing of the surrounding alveolar tissue. In the present study, non-biodegradable poly-2-hydroxyethyl methacrylate (polyHEMA)-based hydrogel particles were fabricated as a carrier vehicle for drug delivery that is applied to dental resins., Methods: The loading and release characteristics of bovine serum albumin (BSA) and fibroblast growth factor-2 (FGF-2) from the polyHEMA-based hydrogel particles were evaluated over time in culture. The hydrogel particles were immersed into an aqueous FITC-labeled BSA solution and were observed using confocal laser scanning microscopy (CLSM). To determine the activity of the FGF-2 released from the particles, the proliferation of osteoblast-like cells cultured with eluates collected from the particles for up to 14 days was determined., Results: CLSM revealed that BSA was adsorbed to the surface of the hydrogel particles. A sustained release of BSA and FGF-2 from the particles was detected for up to 14 days. The eluates from the FGF-2-loaded particles increased the proliferation of the osteoblast-like cells, suggesting that the activity of FGF-2 was maintained for at least 2 weeks within the particles., Significance: These polyHEMA-based non-degradable hydrogel particles may be useful tools that can be applied to dental restorative materials to achieve sustained delivery of drugs that promote tissue regeneration., (Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Objective: Although aluminum oxide and silicon oxide nanoparticles are currently available as dental materials, there is a lack of basic information concerning their biocompatibility. This study evaluates the biological responses of cultured macrophages (RAW264) to aluminum oxide (Al2O3NPs) and silicon oxide nanoparticles (SiO2NPs) by analyzing cytotoxicity and genotoxicity., Methods: The nanoparticles are amorphous and spherical, with diameters of 13 nm for the Al2O3NPs and 12 nm for the SiO2NPs. The cultured RAW264 are exposed to the nanoparticles (NPs) and examined for cytotoxicity using the WST-8 cell viability and Hoechst/PI apoptosis assay, for genotoxicity by micronucleus analysis, for changes in nuclear shape (deformed nuclei) and for comet assay using confocal microscopy, and micromorphological analysis is done using scanning and transmission electron microscopes., Results: Nuclei and DNA damage because of exposure to both types of NPs is observed by inmunostaining genotoxicity testing. The cytotoxicity and genotoxicity are well correlated in this study. Numerous NPs are observed as large aggregates in vesicles, but less or nonexistent NP internalization is seen in the nucleus or cytoplasm. These morphological results suggest that a primary cause of cell disruption is the chemical changes of the NPs in the low pH of vesicles (i.e., ionization of Al2O3 or SiO2) for both types of oxide NPs., Significance: Although further research on the elution of NP concentrations on cell or tissue activity under simulated clinical conditions is required, NP concentrations over 200 μg/mL are large enough to induce cytotoxic and genotoxic effects to cells., (Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Objective: Dentin matrices release ICTP and CTX fragments during collagen degradation. ICTP fragments are known to be produced by MMPs. CTX fragments are thought to come from cathepsin K activity. The purpose of this study was to determine if quaternary methacrylates (QAMs) can inhibit matrix MMPs and cathepsins., Methods: Dentin beams were demineralizated, and dried to constant weight. Beams were incubated with rh-cathepsin B, K, L or S for 24h at pH 7.4 to identify which cathepsins release CTX at neutral pH. Beams were dipped in ATA, an antimicrobial QAM to determine if it can inhibit dentin matrix proteases. Other beams were dipped in another QAM (MDPB) to determine if it produced similar inhibition of dentin proteases., Results: Only beams incubated with cathepsin K lost more dry mass than the controls and released CTX. Dentin beams dipped in ATA and incubated for 1 week at pH 7.4, showed a concentration-dependent reduction in weight-loss. There was no change in ICTP release from control values, meaning that ATA did not inhibit MMPs. Media concentrations of CTX fell significantly at 15wt% ATA indicating that ATA inhibits capthesins. Beams dipped in increasing concentrations of MDPB lost progressively less mass, showing that MDPB is a protease-inhibitor. ICTP released from controls or beams exposed to low concentrations were the same, while 5 or 10% MDPB significantly lowered ICTP production. CTX levels were strongly inhibited by 2.5-10% MDPB, indicating that MDPB is a potent inhibitor of both MMPs and cathepsin K., Significance: CTX seems to be released from dentin matrix only by cathepsin K. MMPs and cathepsin K and B may all contribute to matrix degradation., (Copyright © 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Objectives: Many recent adhesives on the market exhibit reasonable clinical performance. Future innovations in adhesive materials should therefore seek out novel properties rather than simply modifying existing technologies. It is proposed that adhesive materials that are "bio-active" could contribute to better prognosis of restorative treatments., Methods: This review examines the recent approaches used to achieve therapeutic polymers for dental adhesives by incorporating bio-active components. A strategy to maintain adhesive restorations is the focus of this paper., Results: Major trials on therapeutic dental adhesives have looked at adding antibacterial activities or remineralization effects. Applications of antibacterial resin monomers based on quaternary ammonium compounds have received much research attention, and the loading of nano-sized bioactive particles or multiple ion-releasing glass fillers have been perceived as advantageous since they are not expected to influence the mechanical properties of the carrier polymer., Significance: The therapeutic polymer approaches described here have the potential to provide clinical benefits. However, not many technological applications in this category have been successfully commercialized. Clinical evidence as well as further advancement of these technologies can be a driving force to make these new types of materials clinically available., (Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Objectives: The protective effects of N-acetyl cysteine (NAC) against cytotoxicity induced by conventional dental resin monomers have been widely documented. However, its effectiveness to detoxify cationic antibacterial monomers has not yet been elucidated. The aim of the present study was to investigate the possible protective effects of NAC against the cytotoxicity of 12-methacryloyloxydodecylpyridiniumbromide (MDPB) and explore the role of adduct formation in NAC-directed detoxification., Methods: The influences of NAC on the cytotoxicity of MDPB were studied in mouse osteoblast-like MC3T3-E1 cells using the MTT assay. Ultra-performance liquid chromatography (UPLC) and liquid chromatography-mass spectrometry (LC-MS) analysis were performed to investigate the possible chemical reaction between NAC and MDPB., Results: While only slight reduction in the cytotoxicity of MDPB by NAC was observed immediately after mixing with MDPB, remarkable protection against MDPB-induced cell death was detected when the mixture was tested after 24h of pre-incubation. UPLC and LC-MS analysis revealed that chemical binding of MDPB and NAC occurred under neutral conditions after 24h of pre-incubation., Significance: Our findings suggest that NAC reduces the toxicity of the cationic antibacterial monomer MDPB, and adduct formation is partially responsible for the detoxification ability of NAC against MDPB-induced cell damage., (Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Objective: Highly porous apatite-based bioceramic scaffolds have been widely investigated as three-dimensional (3D) templates for cell adhesion, proliferation, and differentiation promoting the bone regeneration. Their fragility, however, limits their clinical application especially for a large bone defect., Methods: To address the hypothesis that using a ZrO(2)/hydroxyapatite (HAp) composite might improve both the mechanical properties and cellular compatibility of the porous material, we fabricated ZrO(2)/HAp composite scaffolds with different ZrO(2)/HAp ratios, and evaluated their characteristics. In addition, porous ZrO(2)/HAp scaffolds containing bone marrow derived stromal cells (BMSCs) were implanted into critical-size bone defects for 6 weeks in order to evaluate the bone tissue reconstruction with this material., Results: The porosity of a ZrO(2)/HAp scaffold can be adjusted from 72% to 91%, and the compressive strength of the scaffold increased from 2.5 to 13.8MPa when the ZrO(2) content increased from 50 to 100wt%. The cell adhesion and proliferation in the ZrO(2)/HAp scaffold was greatly improved when compared to the scaffold made with ZrO(2) alone. Moreover, in vivo study showed that a BMSCs-loaded ZrO(2)/HAp scaffold provided a suitable 3D environment for BMSC survival and enhanced bone regeneration around the implanted material., Significance: We thus showed that a porous ZrO(2)/HAp composite scaffold has excellent mechanical properties, and cellular/tissue compatibility, and would be a promising substrate to achieve both bone reconstruction and regeneration needed in the treatment of large bone defects., (Copyright © 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Objectives: Occlusal overloading is one of the causes of peri-implant bone resorption, and many studies on stress distribution in the peri-implant bone by three-dimensional finite element analysis (3D FEA) have been performed. However, the FEA models previously reported were simplified and far from representing what occurs in clinical situations. In this study, 3D FEA was conducted with simulation of the complex structure of dental implants, and the influences of neck design and connections with an abutment on peri-implant bone stress and abutment micromovement were investigated., Methods: Three types of two-piece implant CAD models were designed: external joint with a conical tapered neck (EJ), internal joint with a straight neck (IJ), and conical joint with a reverse conical neck (CJ). 3D FEA was performed with the setting of a "contact" condition at the component interface, and stress distribution in the peri-implant bone and abutment micromovement were analyzed., Results: The shear stress was concentrated on the mesiodistal side of the cortical bone for EJ. EJ had the largest amount of abutment micromovement. While the von Mises and shear stresses around the implant neck were concentrated on the labial bone for IJ, they were distributed on the mesiodistal side of the cortical bone for CJ. CJ had the least amount of abutment micromovement., Significance: Implants with a conical joint with an abutment and reverse conical neck design may effectively control occlusal overloading on the labial bone and abutment micromovement., (Copyright © 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Objectives: Titanium plates and apatite blocks are commonly used for restoring large osseous defects in dental and orthopedic surgery. However, several cases of allergies against titanium have been recently reported. Also, sintered apatite block does not possess sufficient mechanical strength. In this study, we attempted to fabricate a composite material that has mechanical properties similar to biocortical bone and high bioaffinity by compounding hydroxyapatite (HAp) with the base material zirconia (ZrO(2)), which possesses high mechanical properties and low toxicity toward living organisms., Methods: After mixing the raw material powders at several different ZrO(2)/HAp mixing ratios, the material was compressed in a metal mold (8 mm in diameter) at 5 MPa. Subsequently, it was sintered for 5 h at 1500°C to obtain the ZrO(2)/HAp composite. The mechanical property and biocompatibility of materials were investigated. Furthermore, osteoconductivity of materials was investigated by animal studies., Results: A composite material with a minute porous structure was successfully created using ZrO(2)/HAp powders, having different particle sizes, as the starting material. The material also showed high protein adsorption and a favorable cellular affinity. When the mixing ratio was ZrO(2)/HAp=70/30, the strength was equal to cortical bone. Furthermore, in vivo experiments confirmed its high osteoconductivity., Significance: The composite material had strength similar to biocortical bones with high cell and tissue affinities by compounding ZrO(2) and HAp. The ZrO(2)/HAp composite material having micro porous structure would be a promising bone restorative material., (Copyright © 2011 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

The mechanical properties of the cellular microenvironment dramatically alter during tissue development and growth. Growing evidence suggests that physical microenvironments and mechanical stresses direct cell fate in developing tissue. However, how these physical cues affect the tissue morphogenesis remains a major unknown. We explain here that the physical properties of the cell and tissue microenvironment, biomimetically reproduced by using hydrogel, guide the tissue morphogenesis in the developmental submandibular gland (SMG). In particular, the softer gel enhances the bud expansion and cleft formation of SMG, whereas the stiffer gel attenuates them. These morphological changes in SMG tissue are led by soluble factors (FGF7/10) induction regulated by cell traction force derived from the tissue deformation. Our findings suggest that cells sense the mechanics of their surrounding environment and alter their properties for self-organization and the following tissue morphogenesis. Also, physically designed hydrogel material is a valuable tool for producing the biomimetic microenvironment to explore how physical cues affect tissue morphogenesis and to modulate tissue morphogenesis for in vitro tissue synthesis., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

A dentin primer incorporating an antibacterial monomer 12-methacryloyloxydodecylpyridinium bromide (MDPB) shows strong antibacterial effects, and may provide better prognosis for direct capping of infected pulp exposed by caries removal compared with conventional adhesives. However, influences of MDPB on healing of the pulp have not yet been fully elucidated. The purpose of this study was to compare the influences of unpolymerized MDPB on proliferation, differentiation and mineralization of odontoblast-like MDPC-23 cells with those of other resin monomers, Bis-GMA, MDP, TEGDMA and HEMA. The inhibitory effects of MDPB on the proliferation of MDPC-23 were lower than those of Bis-GMA. While MDPB strongly affected the differentiation compared with the other monomers, it was less inhibitory than Bis-GMA and MDP on the mineralization ability of odontoblast-like cells. These findings indicate that MDPB has superior biocompatibility than Bis-GMA in terms of hard tissue formation by odontoblastic cells, suggesting its possible less negative influences on dentinogenesis., ((c) 2009 Elsevier Ltd. All rights reserved.)

Objectives: This study investigated the effects of light penetration and removal of smear layer on the adhesive properties of self-etching adhesives to root canal dentin when using fiber posts., Methods: Altogether 54 human incisors and premolars were decoronated, and the roots after preparing the post space were randomly assigned into six groups. Three groups were treated with a light-cured self-etching adhesive and the other three with a dual-cured self-etching adhesive. In a further sub-division, the first group was light-cured with an irradiation unit; the second was light-cured with the irradiation unit and a light-guiding attachment; and the third was light-cured with the irradiation unit and the attachment after removing smear layer by EDTA and NaOCl. Then, a glass-fiber post was luted into the post space by a dual-cured composite. After 24h, an hourglass-shaped specimen was trimmed and subjected to MTBS testing., Results: Using the light-guiding attachment and removing the smear layer reduced the incidence of pre-testing failure significantly from 57.1% to 19.0% (p<0.05) in the light-cured adhesive groups and from 68.3% to 3.2% (p<0.01) in the dual-cured adhesive groups. The MTBS in different locations within a post space were in the range from 8.9 to 17.5MPa in the light-cured group and from 11.2 to 17.2MPa in the dual-cured group., Significance: Better light penetration in post spaces and removal of the smear layer are effective in improving the adhesive properties of self-etching adhesives to root canal dentin when using fiber posts.

Immobilization of defined chemical functionalities to biomaterial surfaces is employed to optimize them not only for tissue compatibility but also for prevention of bacterial infection. Grafting surfaces with chains of poly(ethylene glycol) (PEG) results in bacterial repellence whereas modification with cationic groups conveys them with bactericidal properties. Since biomaterials in situ will become exposed to a protein-rich environment, it is necessary to investigate the influence of prior protein adsorption on the antibacterial activity of this type of chemical surface modification. In the present study, we immobilized short-chain PEG and two pyridinium group-containing methacrylate monomers, 12-methacryloyloxydodecylpyridinium bromide (MDPB) and 6-methacryloyloxyhexylpyridinium chloride (MHPC), to silicon wafer model surfaces to investigate the influence of prior protein adsorption on the bactericidal activity of the surface coating towards subsequently attached bacteria. Adsorbed amounts of human serum albumin and salivary proteins were found to be two times higher on cationic compared to PEG-modified surfaces. An analogous tendency was found for attachment of Streptococcus gordonii and Streptococcus mutans to the same surfaces without prior protein exposure. However, most bacteria attached to cationic surfaces were found to be dead. Prior exposure of cationic surfaces to protein solutions drastically altered bacterial attachment dependent on the type of protein solution and bacterial species employed. Significantly, the original bactericidal activity of pyridinium-coated surfaces was found greatly reduced upon adsorption of a protein film. As a conclusion we propose that future approaches should combine the protein- and bacteria-repellent properties of PEG-coatings with the bactericidal function of charged cationic groups.

Objectives: Glass-ionomer cements (GICs) are known to have inhibitory effects on bacterial growth, but the biochemical mechanism of this property has not been fully understood. This study aimed to evaluate inhibitory effects of GIC on the acid production of caries-related oral streptococci, and to identify the components responsible for the inhibition., Methods: An eluate was prepared by immersing set GIC in phosphate-buffered saline at 37 degrees C for 24h. Fluoride and other elements in the eluate were quantified by fluoride ion electrode and atomic absorption photometry, respectively. Streptococcus mutans NCTC 10449 and Streptococcus sanguinis NCTC 10556 were used to evaluate the pH fall and the rate of acid production after the addition of glucose in the presence or absence of the eluate. Acidic end products from glucose were also assayed by carboxylic acid analyzer., Results: The eluate contained silicon (1.24+/-0.26 mM), fluoride (0.49+/-0.02 mM) and aluminum (0.06+/-0.00 mM), and inhibited the pH fall and the acid production rate of both streptococci at acidic pH, with a concomitant decrease in lactic acid production. These effects were comparable to those of a potassium fluoride solution containing the same concentration of fluoride as the eluate., Significance: These results indicate that the GIC eluate inhibits the acid production of caries-related oral streptococci at acidic pH and that the effect is due to fluoride derived from the GIC. Thus, adjacent to GIC fillings, bacterial acid production and the subsequent bacterial growth may decrease, establishing a cariostatic environment.

Objectives: The purpose of this study was to evaluate the ability of an experimental self-etching resin coating system to protect against demineralization of the root surface in vitro, comparing its effectiveness with two commercial one-step self-etching adhesives., Methods: The experimental resin coating system (EC), consisting of a self-etching primer and an acrylate-based resin, or the two commercial self-etching adhesives, Adper Prompt-L Pop (AD) and Clearfil Tri-S Bond (S3), was applied to the cementum of a human extracted tooth root. The specimens were immersed in acetate buffer at pH 5.5 for 4 weeks, and the degree of demineralization underneath the materials was evaluated by microscopic observation and contact microradiography. Each material's sealing and interfacial ultrastructure on the cementum was morphologically examined by scanning electron microscopy, and their bonding ability to cementum was determined by microtensile bond strength (MTBS) tests., Results: Application of AD and S3 showed limited effects to protect against demineralization, but no demineralization was observed for EC. EC showed greater coating thickness than the other two materials, with formation of integral hybridized layers with cementum. Although the MTBS values for EC were significantly lower than those for AD and S3, cohesive failure in resins was the prevalent fracture mode for EC, showing no possible disadvantages in bonding ability., Significance: The experimental resin coating system effectively prevented acid demineralization on root surfaces due to its ability to produce an appropriately thick coating and an integral hybridized layer.

Objectives: Superior restorative methods for effectively strengthening pulpless teeth need to be identified, since vertical root fractures of pulpless teeth are still a major problem in everyday clinical practice. The present study tested the null hypothesis that there were no differences in static and fatigue fracture resistances of pulpless teeth restored with different types of post-core systems., Methods: Extracted human premolars were restored with a combination of either a fiber post or metallic post and a composite resin core. Teeth with full crown preparations without post-core restorations served as a control. A 90 degrees vertical or 45 degrees oblique static compressive load was applied to restored teeth, and fracture loads and modes of fracture were recorded. Fatigue fracture tests were conducted by applying sinusoidal cyclic loads to restored teeth from vertical or oblique directions. Fatigue limits for each restoration were calculated using the staircase approach., Results: In both static and fatigue fracture testing under vertical or oblique loadings, the fracture loads of teeth restored with fiber posts were significantly greater than those of teeth restored with metallic posts. The fatigue limits of teeth restored with fiber and metallic posts were 112 kgf and 82 kgf respectively under vertical loadings and 26 kgf and 20 kgf under oblique loadings., Significance: The combination of a fiber post and a composite resin core showed superior fracture resistance against both static and fatigue loadings compared to restorations using a metallic post, and is therefore recommended in restoring pulpless teeth.

Objectives: This study examined the in vivo bonding ability to sound dentin of antibacterial adhesive systems incorporating an antibacterial monomer MDPB based on morphological evaluation of the resin-dentin interface., Methods: Class V cavities were prepared on the buccal surfaces of the teeth of a beagle dog and a composite filling performed using (1) commercial self-etching system Liner Bond 2 (LB primer+LB bond), (2) experimental primer containing 5% MDPB and LB bond, (3) LB primer and experimental bonding-resin containing 2.5% MDPB, or (4) combination of experimental primer and bonding-resin. After 7 days, the tooth crown was cut and fixed in half-Karnovsky's solution, and the sectioned surface observed under scanning electron microscopy (SEM) after treatment with phosphoric acid and NaOCl. The ultrastructure of the bonding interface was also examined by transmission electron microscopy (TEM). Microtensile bond strengths (microTBS) of each group were measured using extracted teeth., Results: SEM demonstrated that all groups produced a 1-2microm thick hybrid layer with funnel shaped resin tags, although the length of tags was shorter for the group in which MDPB-containing bonding-resin was used. TEM examination supported good adhesion of the comprehensive adhesive system employing MDPB-containing primer/bonding-resin, showing integrity between resin and dentin. There were no significant differences in microTBS among the four groups tested (p>0.05, ANOVA)., Significance: This study confirmed that the experimental antibacterial adhesive systems employing MDPB-containing primer or/and bonding-resin could produce an effective bond under in vivo conditions.

Objectives: Since atraumatic restorative treatment (ART) involves removal of carious lesions with manual instruments, improvement of filling materials to guarantee greater success should be considered. This study aimed to evaluate antibacterial, physical, and bonding properties of glass-ionomer cements (GIC) containing chlorhexidine (CHX), and to determine optimal concentrations for incorporation of agents to obtain antibacterial GICs for use with the ART approach., Methods: CHX diacetate combined with CHX dihydrochloride was added to control GIC powder to obtain concentration ratios of 1/0, 2/0, 3/0, 1/1, or 2/2% w/w. Antibacterial activity of each cement against Streptococcus mutans, Lactobacillus casei or Actinomyces naeslundii was examined using agar-diffusion methods, and release of CHX was analyzed by HPLC. Compressive strength, bond strength to dentin, and setting time were measured, and compared with those of control samples., Results: All experimental GICs exhibited inhibition of three bacteria, but sizes of inhibition zones and concentrations of CHX released were not dependent upon CHX content. Incorporation of CHX diacetate at 2% or greater, significantly decreased compressive strength, and bond strength to dentin was adversely affected by addition of CHX diacetate at 2% or more (p<0.05, ANOVA, Fisher's PLSD test), although setting time was extended a little by addition of any concentrations of CHX., Significance: The present results demonstrate that experimental GICs containing CHX are effective in inhibiting bacteria associated with caries, and incorporation of 1% CHX diacetate is optimal to give appropriate physical and bonding properties.

Objectives: This study aimed to investigate the antibacterial effects of the dentin primer of a commercially available self-etching adhesive system, Clearfil Protect Bond, which contains antibacterial monomer 12-methacryloyloxydodecylpyridinium bromide (MDPB)., Methods: Inhibitory effects against Streptococcus mutans, Lactobacillus casei, or Actinomyces naeslundii were examined by an agar-disc diffusion method using the Clearfil Protect Bond primer containing 5% MDPB and an acidic adhesion-promoting monomer MDP, the primer only with MDP, and the primer with 1% cetylpyridinium chloride. The minimum inhibitory/bactericidal concentrations (MIC/MBC) of each primer for the three bacterial species were determined by serial microdilution assays. For testing the bactericidal effects seen in dentin, the primer was applied to demineralized dentin blocks in which S. mutans had been impregnated, and numbers of viable bacteria were counted., Results: For all three bacteria, the sizes of the inhibition zones produced by Clearfil Protect Bond primer were significantly greater than for the other primers (p<0.05, ANOVA and Scheffe's F-test). The MIC/MBC values of Clearfil Protect Bond primer were less than those of the primer without MDPB, and comparable to those of the primer containing cetylpyridinium chloride. No bacterial recovery was obtained after application of Clearfil Protect Bond primer to the bacteria-impregnated dentin, although the primer without MDPB showed some bactericidal effect., Significance: Clearfil Protect Bond primer has strong antibacterial activity based upon MDPB against S. mutans, L. casei and A. naeslundii, and the capability to disinfect cavities containing residual bacteria.

Objectives: The present study was designed to test the null hypothesis that there is no difference in the fracture resistance of pulpless teeth restored with different types of post-core systems and full coverage crowns., Methods: Extracted human upper premolars were restored with a fiber post, prefabricated metallic post or cast metallic post-core. Teeth with full crown preparations without post-core restorations served as a control. All teeth were restored with full coverage crowns. A 90-degree vertical or 45-degree oblique load was applied to the restored teeth with a crosshead speed of 0.5 mm/min, and the fracture loads and mode of fracture were recorded., Results: Under the condition of vertical loading, the fracture load of teeth restored with the cast metallic post-cores was greatest among the groups (two-factor factorial ANOVA and Scheffe's F test, P<0.05). All fractures in teeth restored with all types of post-core systems propagated in the middle portions of roots, including the apices of the posts. Under the condition of oblique loading, the fracture load of teeth restored with pre-fabricated metallic posts was significantly smaller than that in other groups. Two-thirds of fractures in the fiber post group propagated within the cervical area, while most fractures in other groups extended beyond the middle of the roots., Significance: From the results of the present investigations, it was concluded that under the conditions of vertical and oblique loadings, the combination of a fiber post and composite resin core with a full cast crown is most protective of the remaining tooth structure.

Objectives: It has been reported that dental unit waterlines (DUWLs) are contaminated with bacterial biofilm, and that water discharged from a DUWL contains bacteria that might be opportunistic pathogens. This study aimed to investigate the ability of polyvinylidene fluoride (PVDF) tubing to inhibit bacterial contamination in DUWLs., Methods: Newly installed dental units were equipped with either a conventional polyurethane tube (unit A) or a PVDF tube (unit B), and the numbers of bacteria discharged from high- and low-speed handpiece lines were counted using R2A agar plates. Bacterial attachment on surfaces was observed with a scanning electron microscope (SEM) up to 185 days. Bacterial outflow during 1-day clinical service from a DUWL after 1-year usage was also examined. The surface free energy of each tube was determined based on the measurement of contact angles., Results: The number of bacteria discharged from unit B was lower than from unit A at 80 days and thereafter. SEM examination demonstrated that the unit A tube was covered by biofilm constituting rods and filaments after 94 days, while no biofilm was observed in the unit B tube even after 185 days. After 1-year of usage, the unit B released significantly less bacteria than the unit A at every sampling period of 1-day clinic work. Surface free energies, calculated from contact angles measured, of PVDF and polyurethane tubes were 37.7 and 77.8, respectively., Significance: The present results indicate that PVDF tubes, which have lower surface free energy than the conventional tubes, were effective in inhibiting biofilm formation and reducing bacterial outflow from DUWLs.

This paper reviews the research conducted on the evaluation of antibacterial properties of commercial composites and adhesive systems, in addition to the discussion on many attempts to achieve antibacterial composites or adhesives. With regard to composites, commercially available products including fluoride-releasing materials have no antibacterial effect after being cured, which may explain why composites accumulate more plaque than other filling materials. The attempts to provide composites with antibacterial properties involve alterations to the resin components and filler components, and the trials can be subsequently classified into two groups based on the release profile of antibacterial components; agent-releasing or non-agent-releasing materials. Each type of antibacterial composite has advantages and disadvantages, and further modifications are needed to achieve clinically useful materials. Among proprietary dentin bonding systems (DBS), the products which contain glutaraldehyde or have an acidic property exhibit some antibacterial effects. However, the antibacterial properties shown by these products are only side-effects which are derived from the constituents included to produce superior bonding characteristics, and appear to be unreliable. Inclusion of antibacterial components into DBS has also been attempted using several methods, and the results of in vitro tests indicate that some of the trials seem promising. It is worthy of continuing the attempts to develop DBS which can inhibit invading bacteria after the placement of restoration as well as residual bacteria in the cavity. Achievement of bio-functional composites or DBS with therapeutic effects would contribute to prevent secondary caries.

This study examined the antibacterial activity of prepolymerized resin filler, in which the bactericide quaternary ammonium was immobilized. The experimental filler was prepared by grinding prepolymerized resin blocks of methacrylate monomers, silica particles, and the antibacterial monomer methacryloyloxydodecylpyridinium bromide (MDPB). The number of Streptococcus mutans after incubation for 18h in contact with the experimental filler with or without protein adsorption by saliva treatment was determined, and adherence of bacteria to the filler surface was evaluated by scanning electron microscopy. Elution of unpolymerized MDPB from the filler and its influence on bacterial growth were also investigated. The growth of S. mutans was completely inhibited by contact with the experimental filler without saliva treatment. Although the effects were attenuated, the saliva-treated filler still exhibited growth inhibition at >99.9%. Less bacteria attached to the experimental filler than the control filler without MDPB, indicating that the reduction in bacterial number after contact with the experimental filler was not due to bacterial adherence to the particles. Unpolymerized MDPB at 1 microg/ml was eluted from the filler particles but was confirmed to have little effect on bacterial growth. The results indicate that the bactericide-immobilized filler containing MDPB shows significant bacteriostatic effects without releasing antibacterial components, and is useful for incorporation into various resin-based restoratives.

Objectives: The aims of this study were to investigate the antibacterial activity of an adhesive resin incorporating the antibacterial monomer 12-methacryloyloxydodecylpyridinium bromide (MDPB) as well as its bonding characteristics in terms of bond strength into dentin and curing ability., Methods: An experimental adhesive resin was prepared by incorporation of 2.5% MDPB into proprietary adhesive (LB Bond), and the inhibitory effect of cured specimen against the growth of Streptococcus mutans on its surface was determined. Bond strength to human dentin and degree of conversion of the experimental adhesive in combination with 1, 2, or 5% MDPB-containing primers, which were previously reported to possess bactericidal effect, were evaluated by conventional tensile bond strength test and Fourier transformation infrared spectroscopy., Results: The cured experimental adhesive exhibited an inhibitory effect on S. mutans growth, reducing the number of bacteria to approximately 3% of control adhesive without MDPB. Tensile bond strength of experimental adhesive was not significantly different from that of the control (p>0.05), and use in combination with MDPB-containing primer did not show any adverse influence on bond strength. The degree of conversion of the bonding system was not different (p>0.05) between control and experimental adhesive irrespective of addition of MDPB into primer., Significance: These results indicate that an adhesive resin with antibacterial activity after curing could be produced by incorporation of MDPB without influencing bond strength or curing performance, suggesting that the comprehensive bonding system including MDPB-containing primer and adhesive should be highly effective in its antibacterial effect before and after curing.

Calcium phosphates with high solubility in water such as alpha-tricalcium phosphate (alpha-TCP) and tetracalcium phosphate (TetCP) have received considerable attention as components of bone-substitution materials. However, the osteoblast response to these materials has not yet been clearly understood. This study examined the effects of alpha-TCP and TetCP on osteoblast proliferation, differentiation and mineralization in the culture system of MC3T3-E1 cells. Cells were cultured in a differentiation medium with or without alpha-TCP or TetCP at 1 or 10 microM, and the number of cells attached to the culture plates was determined. To examine osteoblast differentiation, the alkaline phosphatase (ALP) activity was measured and the expression of osteoblastic markers analyzed by RT-PCR. In addition, mineralization was evaluated by staining the calcium deposit with Alizalin red. Culture in the presence of alpha-TCP or TetCP showed no significant influence on cell proliferation. ALP activities of the cells were enhanced by both calcium phosphates for 3d and the expression of type I collagen was promoted at 12h and 1d after incubation. Enhancement of bone-like tissue formation by the addition of alpha-TCP or TetCP at 10 microM was observed after 7d incubation and thereafter. The results of the present study indicate that alpha-TCP and TetCP promote osteogenesis by increasing collagen synthesis and calcification of the extra-cellular matrix.

Objective: Previously, we have reported that incorporation of the antibacterial monomer 12-methacryloyloxydodecylpyridinium bromide (MDPB) was effective in immobilizing bactericide in the resin matrix, and an antibacterial composite without release of the agent could be achieved. In this study, an attempt was made to increase the density of bactericide immobilized in composite, and the inhibitory effects of this modified antibacterial composite on plaque accumulation were determined, focusing on the reliability of the effects and the mechanisms to affect the plaque formation., Methods: An experimental composite containing immobilized bactericide at 2.83% was prepared by the incorporation of MDPB into a prepolymerized resin filler of control composite, and elution of antibacterial components and inhibition of in vitro plaque accumulation by Streptococcus mutans were determined. The inhibitory effects of the experimental composite on the attachment, glucan synthesis and growth of S. mutans on the surface were also examined in addition to the comparison of surface roughness and hydrophobicity with controls. The results were analyzed using the Student's t-test., Results: The experimental composite had reproducible inhibitory effects against plaque accumulation compared with control (p<0.05), although it showed no elution of unpolymerized MDPB. The plaque-inhibitory effect of the experimental composite was found to depend upon the ability to inhibit the attachment, glucan synthesis, and growth of bacteria on its surface as no significant differences in the surface characteristics were obtained between control and experimental composites (p>0.05)., Significance: It was indicated that the experimental composite containing bactericide-immobilized filler has the possibility to be used clinically with an effective anti-plaque property.

Objective: Differential thermal analysis (DTA) using a split fiber optic light source has been reported to be a convenient method of measuring the degree of conversion (DC) of light-activated composites. The purpose of this study was to compare the results by DTA and Fourier transformation infrared spectroscopy (FTIR), and evaluate the usefulness of the DTA method., Methods: Experimental 2,2-bis[4-(3-methacryloyloxy-2-hydroxypropoxy)phenyl]propane-based composites containing SiO2 filler and various amounts of triethyleneglycol dimethacrylate (TEGDMA) were prepared, and the DC of each composite was determined by DTA or FTIR with 60s irradiation. The DC of three proprietary composites containing hybrid filler or prepolymerized resin filler were also measured by both methods with 20 or 60s irradiation. The results were analyzed by ANOVA and Fisher's protected least significant difference test., Results: By both DTA and FTIR, the DC of experimental composites increased as the proportion of TEGDMA increased, although DTA showed 3-10% greater values (p<0.05) than FTIR. For proprietary composites that contain hybrid filler, the values by DTA were not significantly different from those by FTIR at 20s exposure. Longer irradiation time resulted in greater DC (p<0.05) for both methods, and DTA showed 5-7% greater values than FTIR. However, the DC of the composite containing prepolymerized resin filler was 30% less by FTIR than by DTA, possibly due to the influence of unpolymerized species in the filler., Significance: The DC values determined by DTA and FTIR showed good agreement for most materials including model composites. In addition, DTA may be more useful than FTIR to measure the DC of composites containing prepolymerized resin filler.

Synthesized hydroxyapatite (HAp) was prepared by the colloidal process. Mixed slurry composed of 25 vol% HAp powder and 75 vol% aqueous solution containing a small amount of polycarboxylic acid ammonium as dispersant was produced. Viscosity of the HAp slurry, microstructure and mechanical property of the synthesized HAp prepared by this process depends on the quantity of dispersant. A mainly uniform microstructure was obtained in both green and sintered HAp with 2 wt% dispersant by preventing the agglomeration of powder in the slurry. A homogeneous microstructure was maintained even after annealing at temperatures between 1200 and 1400 degrees C. Maximum bending strength of 88.5 MPa was also obtained at an optimum dispersant concentration.

Objective: This study was conducted to evaluate the effect of the amount of TEGDMA on post-irradiation polymerization of bis-GMA based composites., Methods: Four experimental composites containing bis-GMA and TEGDMA at the ratios (w/w) of 75/25, 70/30, 67/33, and 50/50 were prepared. The degree of conversion of each composite was measured by Fourier transformation infrared spectroscopy immediately after being cured and after 24 h of storage, and the post-irradiation polymerization was determined. In addition, the change in respective amounts of residual bis-GMA and TEGDMA in cured specimens over 24 h was determined by high performance liquid chromatography. Data were analyzed by means of ANOVA, followed by a Fisher's PLSD test at a significance level of 0.05., Results: At both stages of as-cured and after 24 h-sotrage, the composites containing greater amounts of TEGDMA showed a greater degree of conversion. The amount of post-irradiation polymerization decreased as the content of the incorporated TEGDMA increased. The reduction in the amount of TEGDMA remaining unreacted during post-irradiation polymerization also decreased as the content of TEGDMA increased, while the amount of unreacted bis-GMA showed almost constant values., Significance: An increase in the amount of TEGDMA-incorporation in bis-GMA based composites resulted in less post-irradiation polymerization. As the change in the amount of residual unreacted TEGDMA in cured specimens showed the same trend as the results of the post-irradiation polymerization. TEGDMA is considered to be the main contributor to post-irradiation polymerization of bis-GMA based composites.

The aim of this study was to investigate bactericidal characteristics and cytotoxicity of the newly developed antibacterial monomer 12-methacryloyloxydodecylpyridinium bromide (MDPB). To evaluate the bactericidal activity of MDPB against oral streptococci, the minimum bactericidal concentration (MBC) for seven species and time-kill kinetics against Streptococcus mutans were determined. The cytotoxic effects of MDPB on human pulpal cells were assessed by [3H]-thymidine uptake after contact with MDPB solutions at various concentrations. MDPB showed strong bactericidal activity against seven streptococci, the MBC value ranging from 31.1 to 62.5 micrograms ml-1. Time-kill determination indicated a rapid killing effect of MDPB at 250 micrograms ml-1 or over, and all cells were killed within 1 min by MDPB at 500 micrograms ml-1 or over. No cytotoxic effect was observed on contact with MDPB at concentrations of 10 micrograms ml-1 or less, and the toxicity of MDPB was considered to be similar to those of other monomers used for dental materials. These results suggest that MDPB can be effectively incorporated in dental resin-based materials to provide bactericidal activity against oral bacteria.