Nai Chia Teng

A novel accelerator for improving the handling properties of dental filling materials.

INTRODUCTION Mineral trioxide aggregate (MTA) fulfills many of the ideal properties of a root end filling material and repair material for furcal perforation. However, its low cohesive property often makes it difficult to handle. To improve the handling properties of MTA root canal filling materials, MTA-like cement was made, and calcium lactate gluconate (CLG) aqueous solution was used to shorten the setting time and enhance the paste viscosity. METHODS CLG solution was prepared by mixing lactic acid, glucono delta lactone, and calcium oxide by wet process. The crystalline property of the CLG powder was characterized by x-ray diffraction. The MTA-like cements were prepared by mixing Portland cement/bismuth oxide/gypsum (75/20/5); ProRoot white MTA (Dentsply Tulsa Dental, Tulsa, OK) was used as a control group. The influence of various liquid phases on initial setting time, handling properties, and pH value were investigated by a Vicat needle, questionnaire of operational hand feel, and pH meter, respectively. RESULTS By using 23.1 wt% CLG solutions as a liquid phase, the setting time of white MTA was significantly decreased from 155.5 +/- 5.0 to 12.3 +/- 2.5 minutes. The pH values for hydrated white MTA with deionized water and 23.1 wt% CLG solutions were 12.29 +/- 0.02 and 11.81 +/- 0.04 at 72 hours. CONCLUSIONS The results suggest that the addition of amorphous CLG-based liquid phase provides improvement in sealing ability as well as clinical manageability of dental filling materials.

In vivo evaluation of resorbable bone graft substitutes in beagles: Histological properties

Calcium phosphate cement (CPC) is a promising material for use in minimally invasive surgery for bone defect repairs due to its bone-like apatitic final setting product, biocompatibility, bioactivity, self-setting characteristics, low setting temperature, adequate stiffness, and easy shaping into complicated geometrics. However, even though CPC is stable in vivo, the resorption rate of this bone cement is very slow and its long setting time poses difficulties for clinical use. Calcium sulfate dehydrate (CSD) has been used as a filler material and/or as a replacement for cancellous bone grafts due to its biocompatibility. However, it is resorbed too quickly to be optimal for bone regeneration. This study examines the invivo response of a hydroxyapatite (HA), [apatitic phase (AP)]/calcium sulfate (CSD) composite using different ratios in the mandibular premolar sockets of beagles. The HA (AP)/CSD composite materials were prepared in the ratios of 30/70, 50/50, and 70/30 and then implanted into the mandibular premolar sockets for terms of 5 and 10 weeks. The control socket was left empty. The study shows better new bone morphology and more new bone area in the histological and the histomorphometric study of the HA (AP)/CSD in the 50/50 ratio.

Effects of a Novel Hydration Accelerant on the Biological and Mechanical Properties of White Mineral Trioxide Aggregate

INTRODUCTION The objective of this study was to investigate the antibacterial, biocompatibility, and mechanical properties of mineral trioxide aggregate (MTA) set using a calcium lactate gluconate (CLG) solution. METHODS ProRoot white MTA (WMTA) (Dentsply Tulsa Dental, Tulsa, OK) was used as the control group; MTA-like cement was prepared by mixing Portland cement/bismuth oxide/calcium sulfate (75/20/5) as the experiment group. A solution of 23.1 wt% CLG was used as a hydration accelerant and was compared with deionized water (DDW). Changes in pH values, antibacterial properties, in vitro cell viability, and diametral tensile strength (DTS) of the hydrated cements were assessed. RESULTS Like WMTA, pH values for the MTA-like cement set using DDW and the CLG solution showed minor but statistically significant differences (P < .05). The antibacterial effects of hydrated specimens set by DDW and CLG against Streptococcus mutans assessed with an in vitro tube dilution test showed a significant difference in the early hydration time but no significant difference after 60 minutes (P > .05). A mouse osteoblastic cell (MC3T3-E1)-based MTT assay revealed that WMTA set using CLG had significantly higher cell viability than that set using DDW (P < .05). The DTS test for hydrated MTA-like cement with different liquids showed a significant difference on day 1 but no statistical difference on day 21. CONCLUSIONS The results suggest that using a CLG solution as the hydration accelerant may enhance the biocompatibility but not compromise WMTAs antibacterial and mechanical properties.

Surface Analysis of Titanium Biological Modification with Glow Discharge

BACKGROUND Glow discharge plasma (GDP) technology has been used to graft various proteins to the titanium surface, including albumin, type I collagen, but without fibronectin. PURPOSE The aim of this study was to evaluate and analyze the physical properties of fibronectin-grafted titanium surfaces after GDP treatment. MATERIALS AND METHODS Grade II titanium discs after cleaning and autoclaving were considered as original specimens, thus divided into four groups. The groups were different upon two treatments (GDP only and fibronectin grafting after GDP) and two storage temperature (4°C and 25°C). The implant surface morphology was characterized by scanning electron microscopy (SEM), roughness measurement, and wettability evaluation. The concentration relationship of fibronectin was by fluorescein isothiocyanate (FITC) labeling. RESULTS SEM images showed that regular planar texture revealed on the surface of GDP-treated group, and irregular-folding protein was found on the fibronectin-grafted discs. Fibronectin-grafted groups had higher hydrophilicity and greater surface roughness than GDP-treated specimens. The storage temperature did not make obvious difference on the surface topography, wettability, and roughness. The number of fibronectin dots on the titanium surface labeling by FITC had positive relationship with the concentration of fibronectin solution used. CONCLUSIONS Biologically modified titanium surface is more hydrophilic and rougher than GDP-treated ones. GDP treatment combined with fibronectin grafting increased the surface hydrophilicity and surface roughness of titanium discs, which may attribute to the affinity of cell adhesion, migration, proliferation, and differentiation.

Radiopacity and cytotoxicity of Portland cement containing zirconia doped bismuth oxide radiopacifiers.

INTRODUCTION This study evaluates the radiopacity and cytotoxicity of Portland cements containing a radiopacifier of bismuth oxide (Bi2O3) with yttria-stabilized zirconia (YSZ) dopant. METHODS Various radiopacifier powders of Bi2O3 with 0%, 15%, 30%, and 100% YSZ dopant were prepared by solid-state reaction at 700°C for 12 hours and characterized by x-ray diffraction. Portland cement/radiopacifier/calcium sulfate (75/20/5) were mixed and set by deionized water. Changes in radiopacity and in vitro cell viability of the hydrated cements were assessed. An average of 6 measured equivalent thickness of aluminum (N = 6) capable of producing similar radiographic density was recorded. The cytotoxicity of each material was determined in MC3T3 E1 cell-based methyl-thiazol-tetrazolium assay. RESULTS The x-ray diffraction patterns of YSZ doped Bi2O3 are different from those of pure Bi2O3 and YSZ. The cement-containing radiopacifier of Bi2O3/YSZ (85/15) presented significantly greater radiopacity (P < .05) compared with pure Bi2O3. The mouse osteoblastic cell (MC3T3-E1) viabilities of these 2 groups were statistically similar (P < .05). CONCLUSIONS The radiopacifier of Bi2O3/YSZ (85/15) reveals higher radiopacity but similar cell viability when compared with pure Bi2O3. It shows potential use as an alternative radiopacifier in root-end filling materials.

Er:YAG Laser-Roughened Enamel Promotes Osteoblastic Differentiation

OBJECTIVE The aim of this study was to test whether Er:YAG laser-etched enamel of human teeth could act as a biologically active scaffold for tissue regeneration. BACKGROUND DATA Hydroxylapatite (HA) with rough surface created by acid etching treatment has been used as a scaffold for tissue engineering. However, whether tooth HA can be a scaffold for osteoblastic cell seeding is still unclear. MATERIALS AND METHODS Enamel samples from human teeth were pretreated with an Er:YAG laser to create a rough surface. Then the surface of the laser-treated enamel was examined using a surface roughness profilometer and a scanning electron microscope. In addition, static water contact angles of the Er:YAG laser-treated enamel samples were measured using goniometry. To observe the effects of cell behavior on an Er:YAG laser-roughened enamel surface, we cultured MG63 osteoblast-like cells on the surface-modified enamel samples. Alkaline phosphatase activity, a marker of cell proliferation and differentiation, was monitored and compared with that in untreated control and acid-etched enamel samples. RESULTS Er:YAG laser treatment significantly improved the surface roughness of the enamel samples. Furthermore, MG63 osteoblast-like cells cultured on the Er:YAG laser-roughened enamel surface expressed more alkaline phosphatase activity and exhibited greater degrees of cellular differentiation than did cells that had been cultured on untreated enamel samples. CONCLUSIONS These results demonstrate that Er:YAG laser-roughened enamel promotes osteoblastic differentiation. This finding suggests that Er:YAG laser-roughened enamel surfaces can potentially serve as a scaffold for tissue engineering.

Structural Analysis of Cyclic-loaded Nickel-Titanium Rotary Instruments by Using Resonance Frequency as a Parameter

INTRODUCTION The aim of this study was to investigate the relationship between fatigue life and resonance frequency (RF) of various types of nickel-titanium (NiTi) rotary instruments. In addition, the influence of NiTi instruments with different manufacturing methods on cyclic loading was evaluated by using RF as a parameter. METHODS Twenty-eight ProFile instruments and 10 Twisted File instruments were subjected to cyclic fatigue-loading until fracture by repeated preparation with simulated root canals made of clear resin. The RF of each sample was recorded immediately after the simulated canal block was prepared. For each sample, the microscopic images on the fracture surface, change in lengthening deformation, number of canal blocks prepared, and corresponding RF changes were recorded. RESULTS For all the tested instruments, RF values decreased gradually before breakdown when the fatigue failure of the instruments was associated with plastic deformation. In addition, there was a linear relationship between the RF change and the corresponding deformation of the failed instruments. CONCLUSIONS These results demonstrate that the RF analysis has potential as a tool for structural analysis in NiTi instruments.

In vivo evaluation of resorbable bone graft substitutes in mandibular sockets of the beagle

Hydroxyapatite (Ca(10)(PO(4))(6)(OH)(2)), with its high biocompatibility and good bioaffinity, stimulates osteoconduction and is slowly replaced by the host bone after implantation. However, clinical use of HA as a bone substitute has proved problematic. It is difficult to prevent dispersion of the HA granules and to mold the granules into the desired shape. Calcium sulfate as a bone graft substitute is rapidly resorbed in vivo releasing calcium ions, but fails to provide a long-term, three-dimensional framework to support osteoconduction. The setting properties of calcium sulfate, however, allow it to be applied in a slurry form, making it easier to handle and apply in different situations. This study examines the in vivo response of a (Hydroxyapatite, apatitic phase)/calcium sulfate dehydrate (CSD) composite using different ratios in the mandibular premolar sockets of the beagle. The HA (AP)/CSD composite materials prepared in ratios of 30/70, 50/50, and 70/30 were implanted into the mandibular premolar sockets for 5 and 10 weeks. The control socket was empty. The authors compared the radiographic properties and the changes in height and width of the mandibular premolar sockets in the beagle. The composite graft in the 30/70 ratio had the best ability to form new bones.

Effect of stereocomplex formation in d-lactide-containing plla on thermal behaviors and mechanical property changes using the ageing degradation test

Introduction: The formation of a stereocomplex between PLLA and PDLA has been studied intensively because it increases the mechanical performance and thermal/hydrolytic resistance of polylactide-based materials; however, few studies have investigated the stereocomplex formation between PLLA and the (D-lactide)-containing PLLA copolymer. To investigate the effect of the D-lactide content of PLLA on the thermal behaviors and mechanical properties, (5D/95L) polylactide [(5D/95L)PLA], which contains a molar ratio of 5% of the D-form and 95% of the L-form of the monomer, and (15D/85L) polylactide [(15D/85L)PLA], which contains a molar ratio of 15% of the D-form and 85% of the L-form of the monomer, were used in a series of specimens. For the hydrolytic degradation test, the specimens were placed in 20-mL vials, which were filled with phosphate-buffered solution; the vials were allowed to stand at 57°C for 91 days in accordance with the ASTM F1635-95 (2000) standard test method for in vitro studies. The mechanical properties, thermal properties and crystallization behaviors were investigated using DSC and MTS, respectively. Results: The initial bending strength of the (5D/95L)PLA and (15D/85L)PLA were 35.4 and 31.1 N, respectively. After 1 week, the binding strength of the (5D/95L)PLA increased by 9.8%, and the binding strength of the (15D/85L)PLA decreased by 26%. In addition, the DSC curve of the (5D/95L)PLA demonstrated a higher melting temperature in the 1st week, and this Tc was observed in the DSC curve of the (5D/95L)PLA only during this time. The DSC curve of the (15D/85L)PLA was irregular. Discussion & Conclusions: In the (5D/95L)PLA, the recrystallization that occurred during the hydrolysis process was confirmed by the Tc and the increase in the bending strength. The stereocomplex crystallites may be formed in the (15D/85L)PLA during the degradation process. Because of the increase in the D-form monomer, the stereocomplexes were generated more easily and acted as nucleation sites. The PLLA crystal near the stereocomplex crystallites exhibited an incomplete structure, which led to a faster decrease in the bending strength. The low D-lactide content in the matrix of the PLLA did not form a stereocomplex crystallite because the surface area was not large enough to act as a nucleation site. However, the higher D-lactide-containing fraction formed a large stereocomplex crystallite. The (5D/95L)PLA demonstrated better thermal/hydrolytic resistance and mechanical stability than the (15D/85L)PLA.