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This in vitro study evaluated the influence of combined coffee staining and simulated brushing-induced color changes and surface roughness on 3D-printed orthodontic retainers. Specimens measuring 10 × 10 × 0.75 mm3 were obtained either by conventional vacuum forming or 3D printing at four print angulations (0°, 15°, 30°, and 45°) (n = 10). The prepared specimens were immersed in a coffee beverage and then mechanically brushed using a simulating device. The specimen’s color difference (ΔE) and surface roughness (Ra) were quantified using a spectrophotometer and a non-contact profilometer, respectively. The highest and lowest mean ΔE values were recorded for the 3D-printed-45° (4.68 ± 2.07) and conventional (2.18 ± 0.87) groups, respectively. The overall mean comparison of ΔE between the conventional and 3D-printed groups was statistically significant (p < 0.01). After simulated brushing, all groups showed a statistically significant increase in the Ra values (p < 0.01). The highest Ra was in the 3D-printed-45° (1.009 ± 0.13 µm) and conventional (0.743 ± 0.12 µm) groups, respectively. The overall ΔE of 3D-printed orthodontic retainers was not comparable to conventional VFRs. Among the different angulations used to print the retainers, 15° angulations were the most efficient in terms of color changes and surface roughness and were comparable to conventional VFRs.

Immunomodulation strategies are believed to improve the integration and clinical performance of synthetic bone substitutes. One potential approach is the modification of biomaterial surface chemistry to mimic bone extracellular matrix (ECM). In this sense, we hypothesized that coating synthetic dicalcium phosphate (DCP) bioceramics with bone ECM proteins would modulate the host immune reactions and improve their regenerative performance. To test this, we evaluated the in vitro proteomic surface interactions and the in vivo performance of ECM-coated bioceramic scaffolds. Our results demonstrated that coating DCP scaffolds with bone extracts, specifically those containing calcium-binding proteins, dramatically modulated their interaction with plasma proteins in vitro, especially those relating to the innate immune response. In vivo, we observed an attenuated inflammatory response against the bioceramic scaffolds and enhanced peri-scaffold new bone formation supported by the increased osteoblastogenesis and reduced osteoclastogenesis. Furthermore, the bone extract rich in calcium-binding proteins can be 3D-printed to produce customized hydrogels with improved regeneration capabilities. In summary, bone extracts containing calcium-binding proteins can enhance the integration of synthetic biomaterials and improve their ability to regenerate bone probably by modulating the host immune reaction. This finding helps understand how bone allografts regenerate bone and opens the door for new advances in tissue engineering and bone regeneration. Statement of Significance Foreign-body reaction is an important determinant of in vivo biomaterial integration, as an undesired host immune response can compromise the performance of an implanted biomaterial. For this reason, applying immunomodulation strategies to enhance biomaterial engraftment is of great interest in the field of regenerative medicine. In this article, we illustrated that coating dicalcium phosphate bioceramic scaffolds with bone-ECM extracts, especially those rich in calcium-binding proteins, is a promising approach to improve their surface proteomic interactions and modulate the immune responses towards such biomaterials in a way that improves their bone regeneration performance. Collectively, the results of this study may provide a conceivable explanation for the mechanisms involved in presenting the excellent regenerative efficacy of natural bone grafts.

Biomedical and dental prostheses combining polymers with metals often suffer failure at the interface. The weak chemical bond between these two dissimilar materials can cause debonding and mechanical failure. This manuscript introduces a new mechanical interlocking technique to strengthen metal/polymer interfaces through optimized additively manufactured features on the metal surface. To reach an optimized design of interlocking features, we started with the bio-mimetic stress-induced material transformation (SMT) optimization method. The considered polymer and metal materials were cold-cured Poly(methyl methacrylate) (PMMA) and laser-sintered Cobalt-Chromium (Co-Cr), respectively. Optimal dimensions of the bio-inspired interlocking features were then determined by mesh adaptive direct search (MADS) algorithm combined with finite element analysis (FEA) and tensile experiments such that they provide the maximum interfacial tensile strength and stiffness while minimizing the stress in PMMA and the displacement of PMMA at the Co-Cr/PMMA interface. The SMT optimization process suggested a Y-shape as a more favorable design, which was similar to mangrove tree roots. Experiments confirmed that our optimized interlocking features increased the strength of the Co-Cr/PMMA interface from 2.3 MPa (flat interface) to 34.4 ± 1 MPa, which constitutes 85% of the tensile failure strength of PMMA (40.2 ± 1 MPa). Statement of Significance The objective of this study was to improve metal/polymer interfacial strength in dental and orthopedic prostheses. This was achieved by additive manufacturing of optimized interlocking features on metallic surfaces using laser-sintering. The interlocking design of the features, which was a Y-shape similar to the roots of mangrove trees, was inspired by a bio-memetic optimization algorithm. This interlocking design lowered the PMMA displacement at the Co-Cr/PMMA interface by 70%, enhanced the interfacial strength by more than 12%, and increased the stiffness by 18% compared with a conventional bead design, meanwhile no significant difference was found in the toughness of both designs.

Clinical data regarding newly introduced laser-sintered removable partial dentures (RPDs) are needed before this technique can be recommended. Currently, only a few clinical reports have been published, with no clinical studies.This clinical trial compared short-term satisfaction in patients wearing RPDs fabricated with conventional or computer-aided design and computer-aided manufacturing (CAD-CAM) laser-sintering technology.Twelve participants with partial edentulism were enrolled in this pilot crossover double-blinded clinical trial. Participants were randomly assigned to wear cast or CAD-CAM laser-sintered RPDs for alternate periods of 30 days. The outcome of interest was patient satisfaction as measured using the McGill Denture Satisfaction Instrument. Assessments was conducted at 1, 2, and 4 weeks. The participant's preference in regard to the type of prosthesis was assessed at the final evaluation. The linear mixed effects regression models for repeated measures were used to analyze the data, using the intention-to-treat principle. To assess the robustness of potential, incomplete adherence, sensitivity analyses were conducted.Statistically significant differences were found in patients' satisfaction between the 2 methods of RPD fabrication. Participants were significantly more satisfied with laser-sintered prostheses than cast prostheses in regard to general satisfaction, ability to speak, ability to clean, comfort, ability to masticate, masticatory efficiency, and oral condition (P.05). At the end of the study, 5 participants preferred the laser-sintered, 1 preferred the cast RPD, and 3 had no preference.The use of CAD-CAM laser-sintering technology in the fabrication of removable partial dentures may lead to better outcomes in terms of patient satisfaction in the short term. The conclusion from this pilot study requires confirmation by a larger randomized controlled trial.ClinicalTrials.gov. A study about patient satisfaction with laser-sintered removable partial dentures; NCT02769715.