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Abstract 45S5 Bioglass (BG) is composed of a glass network with silicate based on the component and can be doped with various therapeutic ions for the enhancement of hard tissue therapy. Nanoceria (CeO2) has been shown to indicate redox reaction and enhance the biological response. However, few studies focus on the proportion of CeO2-doped and its effect on the cellular bioactivity of CeO2-doped BG (CBG). In this study, we synthesized the CBG series with increasing amounts of doping CeO2 ranging (1 to 12) wt.%. The synthesized CBG series examined the characterization, mineralization capacity, and cellular activity against BG. Our results showed that the CBG series exhibited a glass structure and indicated the redox states between Ce3+ and Ce4+, thus they showed the antioxidant activity by characterization of Ce. The CBG series had a stable glass network structure similar to BG, which showed the preservation of bioactivity by exhibiting mineralization on the surface. In terms of biological response, although the CBG series showed the proliferative activity of pre-osteoblastic cells similar to BG, the CBG series augmented not only the alkaline phosphatase activity but also the osteogenic marker in the mRNA level. As stimulated the osteogenic activity, the CBG series improved the biomineralization. In conclusion, the CBG series might have a potential application for hard tissue therapeutic purposes.

Background This study aimed to compare and evaluate the marginal fit of nanocomposite computer-aided design/computer-aided manufacturing (CAD/CAM) inlays. Three types of nanocomposite CAD/CAM blocks (HASEM, VITA Enamic, and Lava Ultimate) were used as materials. Methods Class II disto-occlusal inlay restorations were prepared on a typodont mandibular right first molar using diamond rotary instruments. The inlays were fabricated using CAD/CAM technology and evaluated using the silicone replica technique to measure marginal gaps at five locations on each inlay. The data were analyzed by two-way analysis of variance and Tukey post hoc tests (α=0.05). Results There were no significant differences in the marginal gaps based on the type of nanocomposite CAD/CAM inlay used (p=0.209). However, there was a significant difference in the marginal gaps between the measurement regions. The gingival region consistently exhibited a larger marginal gap than the axial and occlusal regions (p

(1) Background: Polyetheretherketone (PEEK) has been used as an alternative to titanium in implant prosthetic systems, but its impact on stress distribution in implant systems needs to be investigated. This study aimed to compare the effect of polyetheretherketone (PEEK) and titanium abutments on implant prosthetic systems and the supporting bone using three-dimensional finite element analysis (FEA). (2) Methods: Three-dimensional finite element analysis was conducted using CATIA V5 and Abaqus V6.12 software to model mandibular first-molar implant systems with titanium and PEEK abutments. Under external loading conditions, finite element analysis was conducted for the stresses in the implant components and surrounding bones of each group. (3) Results: The implant fixture of the PEEK model exhibited the highest von Mises stress (VMS). The lowest VMS was observed in the abutment screw of the titanium model. Both implant systems demonstrated similar stress distributions and magnitudes in cortical and cancellous bones. (4) Conclusion: PEEK abutments show a similar stress distribution in the surrounding bone compared to titanium. However, PEEK absorbs the stresses within the implant system and exhibits the highest VMS values due to its low mechanical and physical properties. Therefore, PEEK abutments need improved mechanical properties for better clinical application.

Surface treatment of implants facilitates osseointegration, with nanostructured surfaces exhibiting accelerated peri-implant bone regeneration. This study compared bone-to-implant contact (BIC) in implants with hydroxyapatite (HA), sand-blasted and acid-etched (SLA), and SLA with calcium (Ca)-coated (XPEED®) surfaces. Seventy-five disk-shaped grade 4 Ti specimens divided into three groups were prepared, with 16 implants per group tested in New Zealand white rabbits. Surface characterization was performed using X-ray diffraction (XRD), field emission scanning electron microscopy (FE-SEM), digital microscopy, and a contact angle analyzer. Cell viability, proliferation, and adhesion were assessed using MC3T3-E1 cells. Apatite formation was evaluated using modified simulated body fluid (m-SBF) incubation. After 4 weeks of healing, the outcomes reviewed were BIC, bone area (BA), removal torque tests, and histomorphometric evaluation. A microstructure analysis revealed irregular pores across all groups, with the XPEED group exhibiting a nanostructured Ca-coated surface. Surface characterization showed a crystalline CaTiO3 layer on XPEED surfaces, with evenly distributed Ca penetrating the implants. All surfaces provided excellent environments for cell growth. The XPEED and SLA groups showed significantly higher cell density and viability with superior osseointegration than HA (p < 0.05); XPEED exhibited the highest absorbance values. Thus, XPEED surface treatment improved implant performance, biocompatibility, stability, and osseointegration.

The biological factors of dental implants have a significant impact on long-term prognosis. In the cement-retained type or screw cement-retained type prosthesis (SCRP) implants, dental luting cement is used between the abutment and the implant fixture. Residual excess cement remaining around the implant and gingiva is one of the major causes of peri-implantitis, which is the most common cause of late implant failure. The TDP implant prosthetic system is a new cementless screw-retained type prosthetic system, which overcomes the limitations of the conventional implant prosthetic systems. Using this system, not only serves to prevent peri-implantitis caused by residual excess cement, but also the risk of screw loosening and fracture is reduced due to the stress distribution through the substructure (link), which is connected to the zirconia crown via frictional force. In this case report, two patients with tooth defects visited our dental hospital for implant treatment. Both patients were treated using the TDP implant prosthetic system. As a result, functional and esthetically excellent implant prostheses were fabricated and delivered to the patients. On the 3-year follow-up examination, both patients showed successful results, respectively.

Abstract Bone healing involves complex processes including inflammation, induction, and remodeling. In this context, anti-inflammatory and osteoconductive multi-functional nanoparticles have attracted considerable attention for application in improved bone tissue regeneration. In particular, nanoparticles that promote suppression of inflammatory response after injury and direction of desirable tissue regeneration events are of immense interest to researchers. We herein report a one-step method to prepare multi-functional nanoparticles using tannic acid (TA) and simulated body fluid (SBF) containing multiple mineral ions. Mineral-tannic acid nanoparticles (mTNs) were rapidly fabricated in 10 min, and their size (around 250–350 nm) and chemical composition were controlled through the TA concentration. In vitro analysis using human adipose derived stem cells (hADSCs) showed that mTNs effectively scavenged reactive oxygen species (ROS) and enhanced osteogenesis of hADSCs by inducing secretion of alkaline phosphatase. mTNs also increased osteogenic marker gene expression even in the presence of ROS, which can generally arrest osteogenesis (OPN: 1.74, RUNX2: 1.90, OCN: 1.47-fold changes relative to cells not treated with mTNs). In vivo analysis using a mouse peritonitis model revealed that mTNs showed anti-inflammatory effects by decreasing levels of pro-inflammatory cytokines in blood (IL-6: 73 ± 4, TNF-α: 42 ± 2%) and peritoneal fluid (IL-6: 78 ± 2, TNF-α: 21 ± 6%). We believe that this one-step method for fabrication of multi-functional nanoparticles has considerable potential in tissue engineering approaches that require control of complex microenvironments, as required for tissue regeneration.

Abstract Background Bone regeneration research is currently ongoing in the scientific community. Materials approved for clinical use, and applied to patients, have been developed and produced. However, rather than directly affecting bone regeneration, these materials support bone induction, which regenerates bone. Therefore, the research community is still researching bone tissue regeneration. In the papers published so far, it is hard to find an improvement in the theory of bone regeneration. This review discusses the relationship between the existing theories on hard tissue growth and regeneration and the biomaterials developed so far for this purpose and future research directions. Mainbody Highly complex nucleation and crystallization in hard tissue involves the coordinated action of ions and/or molecules that can produce different organic and inorganic composite biomaterials. In addition, the healing of bone defects is also affected by the dynamic conditions of ions and nutrients in the bone regeneration process. Inorganics in the human body, especially calcium- and/or phosphorus-based materials, play an important role in hard tissues. Inorganic crystal growth is important for treating or remodeling the bone matrix. Biomaterials used in bone tissue regeneration require expertise in various fields of the scientific community. Chemical knowledge is indispensable for interpreting the relationship between biological factors and their formation. In addition, sources of energy for the nucleation and crystallization processes of such chemical bonds and minerals that make up the bone tissue must be considered. However, the exact mechanism for this process has not yet been elucidated. Therefore, a convergence of broader scientific fields such as chemistry, materials, and biology is urgently needed to induce a distinct bone tissue regeneration mechanism. Conclusion This review provides an overview of calcium- and/or phosphorus-based inorganic properties and processes combined with organics that can be regarded as matrices of these minerals, namely collagen molecules and collagen fibrils. Furthermore, we discuss how this strategy can be applied to future bone tissue regenerative medicine in combination with other academic perspectives.

Titanium (Ti) and Ti-based alloys are commonly used in dental implants, and surface modifications of dental implants are important for achieving osseointegration (i.e., direct connection between the implant surface and bone). This study investigated the effect of an eco-friendly etching solution—a hydrogen peroxide–sodium bicarbonate mixture—on the surface properties and contact angles of osteoblast adhesion and proliferation on Ti surfaces. Disk-shaped Ti specimens were prepared using different surface treatments (machining, sandblasting, and sandblasting/acid-etching), and they were immersed in the etching solution and ultrasonically cleaned. Surface characterization was performed using scanning electron microscopy, digital microscopy, contact angle analysis, and X-ray photoelectron spectroscopy. MG-63 osteoblasts were cultured on the specimens, and their adhesion to the specimen surface and proliferation were examined using staining and the MTT assay, respectively. Additional etching with the etching solution caused the formation of nano/micro hierarchical structures, increased surface roughness, and enhanced hydrophilicity. Osteoblast adhesion and proliferation were found to improve on the modified surfaces. The eco-friendly etching method has the potential to enhance the biological properties of Ti implant surfaces and thereby improve dental implant performance.

Purpose. Loosening and fracture of abutment screws are one of the most common complications in implant-retained fixed prostheses. Thus, applying the proper tightening torque to the abutment screw is important for preventing the loosening effect of the abutment screw and ensuring the stability of the implant fixture-abutment connection. Therefore, in this study, we aimed to investigate the effect of the tightening torque of the abutment screw on the stability of the fixture-abutment connection in a two-piece zirconia implant system using finite element analysis (FEA). Materials and Methods. The two-piece zirconia implant structures used in this study were designed using the CATIA program. The abutment screws with tightening torques of 25 (TT-25), 35 (TT-35), and 45 (TT-45) N·cm were assumed to fix the abutment and fixture. Vertical (200 N) and oblique (100 N) loads were applied to the finite element model generated for FEA simulation, and the stress levels and distributions were investigated. Results. The TT-45 group exhibited the highest von Mises stress in the abutment and fixture, followed by the TT-35 and TT-25 groups. The von Mises and minimal principal stresses of the abutment screw were also highest in the TT-45 group, followed by the TT-35 and TT-25 groups. In all three groups, the area with the highest stress concentration was located at the point of contact with the bottom of the screw head. Furthermore, the TT-25 group showed the highest safety factor value. The TT-35 group showed a safety factor value similar to the safe minimum standard, while the TT-45 group showed a lower safety factor value. Conclusion. When a torque of 35 N cm was applied to the two-piece zirconia implant system, it showed a maximum stress value close to 660 MPa (75% of the yield strength of the Ti-6Al-4V alloy), which is the optimal preload recommended for abutment screws.

The present study comprehensively compared the microstructure, flexural strength, and fracture toughness of zirconia ceramics prepared via two different methods, subtractive milling (SM) and stereolithography (SLA). Disc- or rectangular-shaped zirconia specimens (Prettau (SM) and 3DMix Zirconia (SLA)) were prepared following each manufacturer’s instructions and polished. The microstructures of the two different zirconia specimens were studied by scanning electron microscopy, X-ray diffractometry, energy-dispersive X-ray spectroscopy, and electron backscattered diffractometry. The flexural strength and fracture toughness based on the indentation fracture method were measured for the two different zirconia ceramics. A greater number of small pores and smaller grains were found in the SLA specimen than in the SM specimen. The crystal structure and microstructure analysis revealed that both ceramics had a similar phase composition to each other. No significant differences in flexural strength (p = 0.242) or fracture toughness (p = 0.101) were detected between the two ceramics. The mean flexural strength of the SLA-fabricated zirconia as well as the SM zirconia satisfied the class 5 criteria (>800 MPa) in the ISO 6872 standard.

Against a general consensus regarding the high toxicity and low biocompatibility of cast nickel–chromium (Ni–Cr) alloys, the in vitro biocompatibility of selective laser melting (SLM)-fabricated Ni–Cr alloys was investigated and compared with that of cast alloy. Using a single Ni–Cr alloy powder, two SLM alloys with high (SLM_a) and low (SML_b) porosity were prepared by adjusting the laser process parameters in addition to a cast alloy. The alloys were studied in terms of their microstructure, metal ion release, and cell response. All three alloys were composed of only the γ (face-centered cubic) phase. However, both SLM alloys showed more homogeneous dispersion of Ni, Cr, and molybdenum elements and finer grain formation than the cast alloy. Immersion test results indicated that both SLM alloys (in particular, SML_b) exhibited a significantly lower Ni ion release than the cast alloy (P

This study compared the microstructures and mechanical properties of nickel–chromium–molybdenum (Ni–Cr–Mo) alloys prepared from a single alloy with an identical composition using two new digital processes (selective laser melting (SLM) and soft metal milling (SMM)) and conventional lost-wax casting (LWC). Disc specimens were used to study the microstructures via various analytical methods, while dumbbell-shaped specimens were subjected to tension to determine the mechanical properties (n = 6). The SLM and SMM alloys showed a higher number of large and small pores, respectively, than the LWC alloy. A face-centered cubic (γ)-phased matrix was indexed for all three resultant alloys. The SLM and SMM alloys also showed more homogeneously distributed elements and finer grains (in particular, ultrafine grains in the SLM alloy) when compared to the LWC alloy. Meanwhile, the LWC alloy showed a statistically higher yield strength than the other two alloys (p < 0.001). Notwithstanding, all three resultant Ni–Cr–Mo alloys satisfied the ISO 22674 standard criteria for type 5 materials (yield strength: >500 MPa; percentage elongation: >2%; and elastic modulus: >150 GPa).

Despite numerous advantages of using porous hydroxyapatite (HAp) scaffolds in bone regeneration, the material is limited in terms of osteoinduction. In this study, the porous scaffold made from nanosized HAp was coated with different concentrations of osteoinductive aqueous methylsulfonylmethane (MSM) solution (2.5, 5, 10, and 20%) and the corresponding MH scaffolds were referred to as MH2.5, MH5, MH10, and MH20, respectively. The results showed that all MH scaffolds resulted in burst release of MSM for up to 7 d. Cellular experiments were conducted using MC3T3-E1 preosteoblast cells, which showed no significant difference between the MH2.5 scaffold and the control with respect to the rate of cell proliferation (p > 0.05). There was no significant difference between each group at day 4 for alkaline phosphatase (ALP) activity, though the MH2.5 group showed higher level of activity than other groups at day 10. Calcium deposition, using alizarin red staining, showed that cell mineralization was significantly higher in the MH2.5 scaffold than that in the HAp scaffold (p < 0.0001). This study indicated that the MH2.5 scaffold has potential for both osteoinduction and osteoconduction in bone regeneration.

Three-dimensional (3D) printing technologies have been widely used to manufacture crowns and frameworks for fixed dental prostheses. This systematic review and meta-analysis aimed to assess the reliability of the marginal fit of 3D-printed cobalt-chromium-based fixed dental prostheses in comparison to conventional casting methods. Articles published until 25 June 2020, reporting the marginal fit of fixed prostheses fabricated with metal 3D printing, were searched using electronic literature databases. After the screening and quality assessment, 21 eligible peer-reviewed articles were selected. Meta-analysis revealed that the marginal gap of the prostheses manufactured using 3D printing was significantly smaller compared to that manufactured using casting methods (standard mean difference (95% CI): −0.92 (−1.45, −0.38); Z = −3.37; p = 0.0008). The estimated difference between the single and multi-unit types did not differ significantly (p = 0.3573). In the subgroup analysis for the measurement methods, the tendency of marginal discrepancy between the 3D printing and casting groups was significantly different between articles that used direct observation and those that used the silicone replica technique (p < 0.001). Metal 3D printing technologies appear reliable as an alternative to casting methods in terms of the fit of the fixed dental prostheses. In order to analyze the factors influencing manufacturing and confirm the results of this review, further controlled laboratory and clinical studies are required.

Dentin bonding is a key in restorative dentistry. Here, we developed a self-etching two-bottle adhesive system containing 10-methacryloyloxidecyl dihydrogen phosphate monomer (MDP) and the physical, mechanical, and biocompatible properties were evaluated. The characteristics of MDP were analyzed using nuclear magnetic resonance (NMR). Tests for water sorption and solubility, the shear-bond strengths to dentin and enamel, and cytotoxicity were performed. The newly-blended experimental group showed the lowest thickness and water sorption and solubility values. The shear bond strength of enamel and dentin were comparable to control groups (the three other products were ClearfilTM, UniFil®, and AdheSE®). All test groups showed 60% of cell viability. In this study, the properties of the newly-synthesized adhesive are comparable with the others. The fundamental goal of this study is to get the MDP patent released, as it is intended for domestic production. For this purpose, this dentin adhesive was developed and compared with the commercial product.

Titanium nitride (TiN) was deposited on the surface of a cobalt−chromium (Co−Cr) alloy by a hot-wall type chemical vapor deposition (CVD) reactor at 850 °C, and the coating characteristics were compared with those of a physical vapor deposition (PVD) TiN coating deposited on the same alloy at 450 °C. Neither coating showed any reactions at the interface. The face-centered cubic (fcc) structure of the alloy was changed into a hexagonal close-packed (hcp) phase, and recrystallization occurred over at 10 μm of depth from the surface after CVD coating. Characteristic precipitates were also generated incrementally depending on the depth, unlike the precipitates in the matrix of the as-cast alloy. On the other hand, the microstructure and phase of the PVD-coated alloy did not change. Depth-dependent nano-hardness measurements showed a greater increase in hardness in the recrystallization zone of the CVD-coated alloy than in the bulk center of the alloy. The CVD coating showed superior adhesion to the PVD coating in the progressive scratch test. The as-cast, PVD-coated, and CVD-coated alloys all showed negative cytotoxicity. Within the limitations of this study, CVD TiN coating to biomedical Co−Cr alloy may be considered a promising alternative to PVD technique.

Although a cobalt⁻chromium (Co⁻Cr) blank in a pre-sintered state has been developed, there are few data on the optimal temperature for the alloy in terms of the desired mechanical properties. A metal block (Soft Metal, LHK, Chilgok, Korea) was milled to produce either disc-shaped or dumbbell-shaped specimens. All the milled specimens were post-sintered in a furnace at 1250, 1350 or 1450 °C. The microstructures, shrinkage and density of the three different alloys were investigated using the disc-shaped specimens. The mechanical properties were investigated with a tensile test according to ISO 22674 (n = 6). The number and size of the pores in the alloys decreased with increased temperature. The shrinkage and density of the alloys increased with temperature. In the 1250 °C alloy, the formation of the ε (hexagonal close-packed) phase was more predominant than that of the γ (face-centered cubic) phase. The 1350 °C and 1450 °C alloys showed γ phase formation more predominantly. Carbide formation was increased along with temperature. The 1450 °C group showed the largest grain size among the three groups. In general, the 1350 °C group exhibited mechanical properties superior to the 1250 °C and 1450 °C groups. These findings suggest that 1350 °C was the most optimal post-sintering temperature for the pre-sintered blank.

Metal additive manufacturing (AM), especially selective laser melting (SLM), has been receiving particular attention because metallic functional structures with complicated configurations can be effectively fabricated using the technique. However, there still exist some future challenges for the fabrication of high-quality SLM products for dental applications. First, the surface quality of SLM products should be further improved by standardizing the laser process parameters or by appropriately post-treating the surface. Second, it should be guaranteed that dental SLM restorations have good dimensional accuracy and, in particular, a good marginal fit. Third, a definitive standard regarding building and scanning strategies, which affect the anisotropy, should be established to optimize the mechanical properties and fatigue resistance of SLM dental structures. Fourth, the SLM substructure’s bonding and support to veneering ceramic should be further studied to facilitate the use of esthetic dental restorations. Finally, the biocompatibility of SLM dental alloys should be carefully examined and improved to minimize the potential release of toxic metal ions from the alloys. Future research of SLM should focus on solving the above challenges, as well as on fabricating dental structures with “controlled” porosity.

Selective laser melting (SLM), used to fabricate metallic objects with high geometrical complexity, is currently of increasing interest to the fields of medicine and dentistry. SLM-fabricated products should have highly smooth surfaces to minimize the use of post-processing procedures such as finishing and polishing. This study investigated the effect of various laser process parameters (laser power, scan rate, and scan-line spacing) on the surface roughness of a Co–Cr dental alloy that was three-dimensionally (3D) constructed via SLM. Initially, a single-line formation test was used to determine the optimal laser power (200 W) and scan rate (128.6 mm/s) that resulted in beads with an optimal profile. During subsequent multi-layer formation tests, the 3D Co–Cr body with the smoothest surface was produced using a scan-line spacing of 100 μm. The findings of this study show that laser process parameters have crucial effects on the surface quality of SLM-fabricated Co–Cr dental alloys.