Initial oral biofilm formation on titanium implants with different surface treatments: An in vivo study

ObjectiveThe aim of this study was to examine in vivo the initial bacterial adhesion on titanium implants with different surface treatments.DesignTen subjects wore oral splints containing machined pure titanium disks (Ti-M), acid-etched titanium (Ti-AE) and anodized and laser irradiated disks (Ti-AL) for 24 h. After this period, disks were removed from the splints and adherent bacteria were quantified by an enzymatic assay to assess total viable bacteria and by Real Time PCR to evaluate total bacteria and Streptococcus oralis levels. Additionally, the initial adherent microorganisms were visualized by scanning electron microscopy (SEM). Titanium surface morphology was verified using SEM, and roughness was evaluated by profilometer analysis.ResultsRegarding titanium surface roughness, Ti-AL (1.423 ± 0.397) showed significantly higher Ra values than did Ti-M (0.771 ± 0.182) and Ti-AE (0.735 ± 0.196) (p < 0.05, ANOVA – Tahame). Ti-AE and Ti-AL presented roughened micro-structure surfaces characterized by open pores, whereas Ti-M showed long grooves alternating with planed areas. Comparing the Ti-M, Ti-AE and Ti-AL groups for viable bacteria (MTT assay), total bacteria and S. oralis quantification (qPCR), no significant differences were observed among these three groups (p > 0.05, ANOVA – Tahame). SEM images showed similar bacterial adhesion on the three titanium surfaces, predominantly characterized by cocci and several bacilli, indicating an initial colonization of the oral biofilm.ConclusionIn conclusion, roughness and microtopography did not stimulate initial biofilm formation on titanium surfaces with different surface treatments.     

Experimental peri-implant mucositis around titanium and zirconia implants in comparison to a natural tooth: part 1—host-derived immunological parameters

The purpose of this study was to assess host-derived parameters around dental zirconia and titanium implants and natural teeth during the occurrence of mucositis. After 4 weeks of perfect oral hygiene, 16 clinically profiled patients were asked to refrain from oral hygiene for 2 weeks, resulting in experimental plaque accumulation. This was followed by 4 weeks of perfect oral hygiene to reverse the inflammation. Immunological samples were analyzed for interleukin 6 (IL-6), tumour necrosis factor alpha (TNF-α), and interleukin 1β (IL-1β). Immunological parameters were measured each week, starting at week 4 (session 2) and ending at week 10 (session 8). There were significant differences in IL-6 between the groups (zirconia vs. tooth and titanium vs. tooth), with unfavourable values for the tooth unit (P < 0.05). After reinstitution of oral hygiene, there was a significant increase in TNF-α values for the tooth but not for the zirconia and titanium implants. There were significant differences in IL-1β between the groups (zirconia vs. titanium and titanium vs. tooth), with higher IL-1β levels around titanium implants (P < 0.05). The soft tissue around titanium implants developed a stronger inflammatory response to experimental plaque accumulation in terms of IL-1β values, whereas the teeth presented an increase in IL-6 and TNF-α values.     

Aesthetic aspects of adjacent maxillary single-crown implants—influence of zirconia and titanium as implant materials

The purpose of this retrospective survey was to assess the esthetic aspects of adjacent zirconia and titanium implants in the anterior maxillary area. A total of 40 patients and 109 adjacent implants (17 patients with 47 titanium implants and 23 patients with 62 zirconia implants) was included. The primary aim of this survey was to assess the papillary fill (Jemt score). Additionally, further esthetic aspects were assessed. Papillae were fully present (Jemt score 3) around 39.1% of adjacent zirconia implants and 17.4% of adjacent titanium implants (p < 0.01). The papilla deficit was significantly higher 1.64 mm (SD 1.35) around titanium compared to zirconia implants 0.92 mm (SD 0.94, p < 0.01). The evaluation of the soft tissue recessions revealed no differences between implant materials, whereas titanium implants presented more visible implant shadows (p < 0.01). Zirconia implants had more implants with papillae that filled the entire proximal space compared to titanium implants. Furthermore, titanium implants had a greater frequency of visible implant shadowing than the zirconia implants. Esthetic rules such as the interdental contact area and golden percentage rules did not differ significantly between the titanium and zirconia implants.     

The effect of fatigue loading on the screw joint stability of zirconium abutment

PurposeThis study evaluated the effect of fatigue loading on the screw joint stability of a zirconium abutment connected to an external hexagon implant in vitro.Materials and methodsFifteen titanium and 15 zirconia abutments of 3 different heights (5, 8, and 11 mm) were connected to external titanium implants with titanium screws. A torque gauge was used to measure the reverse torque values before and after loading. An air cylindrical loading device was used to simulate mastication at a 45-degree angle to the longitudinal axis of the implant.ResultsThere were significant differences (P < 0.05) before and after the loading of titanium (5 mm) and zirconia (5, 8, and 11 mm) abutments.ConclusionZirconia abutments for external hexagon implants had durability rates similar to those of titanium abutments after repeating load on the reverse torque of the abutment screw, indicating that the zirconia abutment could be reliably used instead of the titanium abutment.     

Experimental peri-implant mucositis around titanium and zirconia implants in comparison to a natural tooth: part 2—clinical and microbiological parameters

The aim of this study was to assess the clinical and microbiological parameters around dental zirconia and titanium implants compared with natural teeth during experimental plaque accumulation. Clinical parameters were evaluated (gingival index, plaque index, bleeding on probing, and probing pocket depth). Microbiological samples were analyzed for total bacterial cell counts, as well as Tannerella forsythia and Prevotella intermedia counts. A statistically significant difference over time was observed in the groups in terms of the gingival index (P < 0.001), plaque index (P < 0.001), and bleeding on probing (P = 0.039). The lowest mean total number of bacterial cells was measured around the teeth, followed by the zirconia implants; the highest values were found around the titanium implants. T. forsythia and P. intermedia values showed significant changes over time and sessions around the titanium implants. Compared to the soft tissues around zirconia implants and the teeth, those around titanium implants developed a stronger inflammatory response to experimental plaque accumulation in terms of the total number of bacterial cells and T. forsythia and P. intermedia values.     

Comparative effectiveness of NiCl2, Ni- and NiO-NPs in controlling oral bacterial growth and biofilm formation on oral surfaces

ObjectiveOral ailments are often treated with antibiotics, which are rendered ineffective as bacteria continue to develop resistance against them. It has been suggested that the nanoparticles (NPs) approach may provide a safer and viable alternative to traditional antibacterial agents. Therefore, nickel (Ni)- and nickel oxide (NiO)-NPs were synthesized, characterized and assessed for their efficacy in reducing oral bacterial load in vitro. Also, the effects of bulk compound NiCl₂ (Ni ions), along with the Ni- and NiO-NPs on bacterial exopolysaccharide (EPS) production and biofilm formation on the surface of artificial teeth, and acrylic dentures, were investigated.MethodsTotal bacteria from a healthy male were collected and adjusted to 4 × 109 cells/ml for all the tests. Effect of the NPs on growth, biofilm formation, EPS production and acid production from glucose was tested using standard protocols.ResultsData revealed that the Ni-NPs (average size 41.23 nm) exhibited an IC50 value of 73.37 μg/ml against total oral bacteria. While, NiO-NPs (average size 35.67 nm) were found less effective with much higher IC50 value of 197.18 μg/ml. Indeed, the Ni ions exhibited greater biocidal activity with an IC50 value of 70 μg/ml. Similar results were obtained with biofilm inhibition on the surfaces of dental prostheses. The results explicitly suggested the effectiveness of tested Ni compounds on the growth of oral bacteria and biofilm formation in the order as NiCl₂ > Ni-NPs > NiO-NPs.ConclusionThe results elucidated that Ni-NPs could serve as effective nanoantibiotics against oral bacteria.     

A dual energy micro-CT methodology for visualization and quantification of biofilm formation and dentin demineralization

ObjectiveThe aim of this study was to induce artificial caries in human sound dentin by means of a microcosm model using human saliva as source of bacteria and to apply a novel dual-energy micro-CT technique to quantify biofilm formation and evaluate its demineralization potential.DesignEight sound third molars had the occlusal enamel removed by cutting with a diamond disk and five cylindrical cavities (±2 mm diameter; ±1.5 mm depth) were prepared over the dentin surface in each specimen (n = 40 cavities). After sterilization, each specimen received the bacterial salivary inoculum obtained from individuals without any systemic diseases presenting dentin caries lesions and were incubated in BHI added of with 5% sucrose for 96 h to allow biofilm formation. After that, two consecutive micro-CT scans were acquired from each specimen (40kv and 70kv). Reconstruction of the images was performed using standardized parameters. After alignment, registration, filtering and image calculations, a final stack of images containing the biofilm volume was obtained from each prepared cavity. Dentin demineralization degree was quantified by comparison with sound dentin areas. All data were analyzed using Shapiro-Wilk test and Spearman correlation using α=5%.ResultsDual-energy micro-CT technique disclosed biofilm formation in all cavities. Biofilm volume inside each cavity varied from 0.30 to 1.57 mm³. A positive correlation between cavity volume and volume of formed biofilm was obtained (0.77, p < 0.01). The mineral decrease obtained in dentin was high (± 90%) for all cavities and all demineralized areas showed mineral density values lower than a defined threshold for dentin caries (1.2 g/cm³).ConclusionDual-energy micro-CT technique was successful in the quantification of a microcosm human bacterial biofilm formation and to quantify its demineralization potential in vitro.     

Tensile bond strength between tooth-colored porcelain and sandblasted zirconia framework

PurposeThe purpose of this study was to examine the bond strength between tooth-colored porcelain and sandblasted zirconia framework.MethodsThe surfaces of zirconia specimens that had been cut into a size suitable for a bending test were sandblasted at three different pressures (0.2, 0.4 and 0.6 MPa). The surface roughness of each specimen was measured and then a 3-point bending test was performed. After that, other zirconia specimens simulating a crown framework were fabricated and their surfaces were sandblasted. Three types of tooth-colored porcelain were fired onto the surface of those zirconia specimens, and the tensile bond strength between the two substances was examined.ResultsWhen the sandblasting pressure was increased, the surface roughness of zirconia specimens tended to become, but the flexural strength remained unchanged. The specimens simulating a zirconia framework had a higher strength of bond when sandblasted at 0.4 or 0.6 MPa than when blasted at 0.2 MPa. The zirconia specimens sandblasted at a pressure of 0.4 MPa had a bond strength to tooth-colored porcelain of 37.7–49.5 MPa.ConclusionWhen sandblasted at a pressure of 0.4 MPa, the zirconia specimens developed a strong bond with the tooth-colored porcelain, regardless of the type of porcelain.     

Adhesion of Porphyromonas gingivalis and Tannerella forsythia to dentin and titanium with sandblasted and acid etched surface coated with serum and serum proteins – An in vitro study

ObjectiveTo evaluate the adhesion of selected bacterial strains incl. expression of important virulence factors at dentin and titanium SLA surfaces coated with layers of serum proteins.MethodsDentin- and moderately rough SLA titanium-discs were coated overnight with human serum, or IgG, or human serum albumin (HSA). Thereafter, Porphyromonas gingivalis, Tannerella forsythia, or a six-species mixture were added for 4 h and 24 h. The number of adhered bacteria (colony forming units; CFU) was determined. Arg-gingipain activity of P. gingivalis and mRNA expressions of P. gingivalis and T. forsythia proteases and T. forsythia protease inhibitor were measured.ResultsCoating specimens never resulted in differences exceeding 1.1 log10 CFU, comparing to controls, irrespective the substrate. Counts of T. forsythia were statistically significantly higher at titanium than dentin, the difference was up to 3.7 log10 CFU after 24 h (p = 0.002). No statistically significant variation regarding adhesion of the mixed culture was detected between surfaces or among coatings. Arg-gingipain activity of P. gingivalis was associated with log10 CFU but not with the surface or the coating. Titanium negatively influenced mRNA expression of T. forsythia protease inhibitor at 24 h (p = 0.026 uncoated, p = 0.009 with serum).ConclusionsThe present findings indicate that: a) single bacterial species (T. forsythia) can adhere more readily to titanium SLA than to dentin, b) low expression of T. forsythia protease inhibitor may influence the virulence of the species on titanium SLA surfaces in comparison with teeth, and c) surface properties (e.g. material and/or protein layers) do not appear to significantly influence multi-species adhesion.     

Salivary pellicles equalise surfaces’ charges and modulate the virulence of Candida albicans biofilm

IntroductionNumerous environmental factors influence the pathogenesis of Candida biofilms and an understanding of these is necessary for appropriate clinical management.AimsTo investigate the role of material type, pellicle and stage of biofilm development on the viability, bioactivity, virulence and structure of C. albicans biofilms.MethodsThe surface roughness (SR) and surface free energy (SFE) of acrylic and titanium discs was measured. Pellicles of saliva, or saliva supplemented with plasma, were formed on acrylic and titanium discs. Candida albicans biofilms were then generated for 1.5 h, 24 h, 48 h and 72 h. The cell viability in biofilms was analysed by culture, whilst DNA concentration and the expression of Candida virulence genes (ALS1, ALS3 and HWP1) were evaluated using qPCR. Biofilm metabolic activity was determined using XTT reduction assay, and biofilm structure analysed by Scanning Electron Microscopy (SEM).ResultsWhilst the SR of acrylic and titanium did not significantly differ, the saliva with plasma pellicle increased significantly the total SFE of both surface. The number of viable microorganisms and DNA concentration increased with biofilm development, not differing within materials and pellicles. Biofilms developed on saliva with plasma pellicle surfaces had significantly higher activity after 24 h and this was accompanied with higher expression of virulence genes at all periods.ConclusionInduction of C. albicans virulence occurs with the presence of plasma proteins in pellicles, throughout biofilm growth. To mitigate such effects, reduction of increased plasmatic exudate, related to chronic inflammatory response, could aid the management of candidal biofilm-related infections.     

Effects of ageing on surface textures of veneering ceramics for zirconia frameworks

ObjectivesTo evaluate the effects of ageing on surface textures of veneering ceramics for zirconia frameworks.MethodsFive different veneering ceramics for zirconia frameworks, Vintage ZR (ZR), Cerabien ZR (CZR), VitaVM9 (VM9), Cercon ceram KISS (KISS), and IPS e.max ceram (e.max), and one veneering ceramic with metal frameworks, Vintage MP (MP), were evaluated. Twenty specimens were fabricated from each veneering ceramic. All specimens were divided into two groups, one of which was subjected to accelerated ageing. The other was used as the control. Accelerated ageing was performed on the distilled water for 5 h at 200 °C and 2 atm. Surface textures were examined using laser profilometry, X-ray diffraction (XRD), scanning electron microscopy (SEM), and energy dispersive spectroscopy (EDS).ResultsCompared to unaged specimens, surface roughness parameters (Ra, Rp, Rv) of all aged specimens except e.max were significantly greater (P = 0.000). Compared to the unaged specimens, sodium and potassium on the surfaces of all the aged specimens significantly decreased (P < 0.05). However, oxygen levels increased significantly (P < 0.05). Silicon showed a tendency to decrease in all aged specimens, and that of ZR, KISS and e.max have a significant decrease (P < 0.01). Numerous ruffled cracks were observed on the surfaces of all aged specimens, as shown by SEM. The peaks of all crystalline phases on the surfaces of all specimens changed after accelerated ageing.ConclusionSurface textures of all examined veneering ceramics were changed by the accelerated ageing test.     

Novel technique using cold atmospheric plasma coupled with air-polishing for the treatment of titanium discs grown with biofilm: An in-vitro study

ObjectivesThe aim of the present study was to assess the decontamination efficacy and titanium surface alterations of erythritol based air abrasion (AA) and cold atmospheric plasma (CAP) targeting a human complex biofilm.MethodsSaliva collected from a peri-implantitis patient was used to develop in vitro human biofilm over titanium discs with machined (group A) and moderately rough (group B) surface. The discs were treated with AA, experimental CAP or a combination of both treatments (COM). The amount of biofilm on the discs was measured by crystal violet (CV). Surface features and roughness before and after treatment were assessed by SEM and laser profilometry, respectively. The data were statistically analyzed using Kruskal Wallis followed by Dunn's multiple comparison test after being checked for normality by Shapiro-Wilk test.ResultsAll the discs in group A performed better to treatments compared to group B. In both groups, CV data showed significantly lower amount of biofilm after AA treatment compared to CAP (p < 0.05). Cleaning efficacy revealed relevant decontamination of both the surfaces following AA and COM treatments and almost complete biofilm removal after AA application on group A (99.92%). SEM analysis demonstrated no post-treatment alterations on the discs and laser profilometry did not show statistically significant changes in S_a and S_dr values.SignificanceDecontamination with AA delivering erythritol with or without CAP is highly effective in biofilm removal from different titanium surfaces. All the tested treatments, including CAP showed no noticeable alterations of the titanium discs surface features. Further in vivo studies are necessary to understand the potential of CAP technology in implant surface decontamination.     

High-translucent yttria-stabilized zirconia ceramics are wear-resistant and antagonist-friendly

ObjectivesTo evaluate two-body wear of three zirconia ceramics stabilized with 3, 4 and 5 mol% yttria and to compare their wear behavior with that of a lithium-disilicate glass-ceramic.MethodsSixteen rectangular-shaped specimens made from three grades of zirconia ceramics and a lithium-disilicate glass-ceramic were polished and dynamically loaded in a chewing simulator (2 kg vertical load, 2.1 Hz) under water at 90 °C for 1.2 × 10⁶ cycles (about 7 days) in the ball-on-plate mode against steatite antagonists. Surface roughness was measured before and after wear testing. Wear tracks were scanned with a non-contact 3D profilometer and super-impositions were used to determine wear loss of the antagonists. Wear surfaces were imaged by SEM. XRD and micro-Raman spectroscopy were used to characterize phase transformation and stress status in the worn and unworn areas of the zirconia ceramics.ResultsIndependent of fracture toughness, strength and aging-susceptibility, the three zirconia ceramics showed a similar and limited amount of wear (∼10 μm in depth) and were more wear-resistant than the lithium-disilicate glass-ceramic (∼880 μm in depth). Abrasive wear without obvious cracks was observed for all investigated zirconias, whereas the glass-ceramic with a lower fatigue threshold and high susceptibility to surface dissolution exhibited significant abrasion, fatigue and corrosion wear. All three zirconia ceramics yielded a lower antagonist wear than the glass-ceramic and no significant differences were found between the zirconia ceramics.SignificanceIn the context of this study, high-translucent zirconia ceramics stabilized with a higher yttria content, recently introduced in the dental field, were as wear-resistant and antagonist-friendly as conventional high-strength zirconia and suitable for monolithic restorations.     

Electrochemical evaluation of the hydrogen peroxide- and fluoride-induced corrosive property and its recovery on the titanium surface

PurposeThis study aimed to elucidate the effects of hydrogen peroxide (H₂O₂) and sodium fluoride (NaF) on titanium surfaces under conditions mimicking those encountered during dental treatment.MethodsTitanium samples were immersed in artificial saliva (AS), 1 M H₂O₂, 1 M H₂O₂ with catalase, 1000 ppmF NaF, 1 M H₂O₂ with 1000 ppmF NaF, or 9000 ppmF NaF (9000 ppmF NaF: pH 5.3, other solutions: pH 6.5) for 3 min. The electrochemical properties of the titanium samples were analyzed before and after the immersion procedures using a potentiostat. The amounts of titanium eluted into each solution were measured using inductively coupled plasma mass spectrometry. The post-immersion color changes (ΔE*ab) and gloss values of the titanium samples were determined using spectrophotometry. Moreover, the solution-treated titanium samples were subsequently immersed in AS and analyzed electrochemically at 1, 2, 3, 4, 6, 8, and 24 h.ResultsThe immersion of titanium in any of the solutions except 1000 ppmF NaF caused significant increases in corrosive and passive currents and significant reductions in polarization resistance. No titanium elution or color changes were observed, except when 9000 ppmF NaF was used. After immersion in AS, the electrochemical properties of all of the titanium samples, except the 9000 ppmF NaF-treated samples, recovered within 24 h.ConclusionsOne M H₂O₂ and 1000 ppmF NaF can be used alone or in combination in the clinical setting without causing significant titanium corrosion because the corrosive properties they induce is reversible. However, highly concentrated acidic fluorides can cause irreversible corrosion.     

Influence of surface treatments and resin cement selection on bonding to densely-sintered zirconium-oxide ceramic

ObjectivesTo evaluate the effect of surface conditioning on the microtensile bond strength of zirconium-oxide ceramic to dual-cured resin cements.MethodsEighteen cylinder-shaped zirconium-oxide ceramic blocks (Cercon^® Zirconia, Dentsply) were treated as follows: (1) Sandblasting with 125 μm aluminum-oxide (Al₂O₃) particles; (2) tribochemical silica coating using 50 μm Al₂O₃ particles modified by silica; (3) no treatment. Each ceramic cylinder was duplicated in composite resin (Tetric Evo Ceram, Ivoclar-Vivadent) using a silicon mold. Composite cylinders were bonded to conditioned ceramics using: (1) Calibra (Densply Caulk); (2) Clearfil Esthetic Cement (Kuraray); (3) Rely × Unicem (3 M ESPE). After 24 h bonded specimens were cut into microtensile sticks that were loaded in tension until failure. Data were analyzed using two-way ANOVA and Student–Newman–Keuls test for multiple comparisons (p < 0.05). Failure mode was recorded and the interfacial morphology of debonded specimens was observed using a scanning electron microscope (SEM). Surface topography and ceramic average surface roughness were analyzed under an atomic force microscope (AFM).ResultsSignificant changes in zirconia surface roughness occurred after sandblasting (p < 0.001). Bond strength of Clearfil cement to zirconia was significantly higher than that of Rely × Unicem and Calibra, regardless of the surface treatment (p < 0.001). When using Calibra, premature failures occurred in non-treated and silica coated zirconia surfaces.SignificanceThe phosphate monomer-containing luting system (Clearfil Esthetic Cement) is recommended to bond zirconia ceramics and surface treatments are not necessary.     

Effect of water aging on microtensile bond strength of dual-cured resin cements to pre-treated sintered zirconium-oxide ceramics

ObjectivesTo evaluate the hydrolytic stability of different dual-cure resin cements when luted to zirconia ceramic.MethodsEighteen cylinder-shaped zirconia blocks (Cercon Zirconia, Dentsply) were conditioned with: Group 1, no treatment; Group 2, sandblasting (125 μm alumina–Al₂O₃-particles); Group 3, tribochemical silica coating (50 μm silica-modified Al₂O₃ particles). Ceramic blocks were duplicated in composite resin (Tetric Evo Ceram, Ivoclar-Vivadent). Composite disks were luted to pre-treated ceramic surfaces using: (1) Clearfil Esthetic Cement (CEC; Kuraray); (2) Rely X Unicem (RXU; 3M ESPE); (3) Calibra (CAL; Dentsply Caulk). After 24 h, bonded samples were cut into microtensile sticks (1 mm²). Half of the sticks were loaded in tension until failure (cross-head speed of 0.5 mm/min). The remaining half was tested after 6 months of water storage at 37 °C. Data was analyzed with three-way ANOVA and Tukey’s test (P <0.05). Fractographic analysis was performed by SEM.ResultsAfter 24 h, bond strength of CEC to zirconia was significantly higher than that of RXU and CAL, independently from the ceramic pre-treatment (P <0.001). Using CAL, all samples failed prematurely except when luting to sandblasted surfaces. After 6 months of water aging, bond strength of CEC significantly decreased. RXU did not significantly alter bond strengths. Adhesion of sandblasted specimens luted with CAL fell over time. Micromorphological alterations were evident after water storage.SignificanceResin–ceramic interfacial longevity depended on cement selection rather than on surface pre-treatments. CEC and RXU were both suitable for luting zirconia. Water aging played an important role in the durability of zirconia-to-composite chemical bonds.     

The influence of light-curing time on the bacterial colonization of resin composite surfaces

ObjectivesBacterial colonization of composite surfaces represents the main factor in the etiology of secondary caries around adhesive restorations. The authors’ aim was to evaluate the influence of light-curing time on mutans streptococci colonization (MS) of a resin composite material.MethodsSpecimens obtained from a dental resin composite were divided into 12 groups and light-cured with the same light source respectively for 10, 20, 30, 40, 60 or 80 s using two different curing-power levels: 400 and 800 mW/cm². A wild strain of MS was isolated and a 24-h-monospecific biofilm, adherent to the surfaces of the samples, was obtained. A colorimetric technique (MTT assay), based on the reduction of a yellow tetrazolium salt to a purple formazan, was used to evaluate the biomass adherent to the specimen surfaces. ANOVA and Scheffé’s tests were used to statistically analyze the results.ResultsTwo-way ANOVA demonstrated there was no interaction between curing-time factor and curing-power factor (p = 0.970); one-way ANOVA was used to analyze separately the data obtained from each curing-power level. Both levels showed highly significant differences (p < 0.0001) among the different curing time groups. The non-parametric test for trend showed in both levels the existence of a highly significant trend (p < 0.0001) for bacterial colonization reduction as curing time increases.SignificanceA reduced curing time seems to be responsible for increased in vitro colonization of composite surfaces by MS; this phenomenon is likely to be related to the presence of unpolymerized monomers on the material surface.     

Fracture loads of screw-retained implant-supported zirconia prostheses after thermal and mechanical stress

PurposeThe objective of the present study was to evaluate fracture loads of screw-retained implant-supported zirconia prostheses after artificial aging.MethodsFour types of screw-retained implant-supported prostheses were fabricated (n = 11 each); porcelain-veneered zirconia prosthesis (PVZ), indirect composite-veneered zirconia prosthesis (IVZ), porcelain-fused-to-metal prosthesis (PFM), and monolithic zirconia prosthesis (ML). The specimens were subjected to 10,000 thermocycles and cyclic loading for 1.2 million cycles. Fracture loads were measured, and the data were analyzed with the Kruskal–Wallis and Steel–Dwass tests (α = 0.05).ResultsAll specimens survived the artificial aging procedures. The fracture loads for the PVZ (1.52 kN), IVZ (1.62 kN), and PFM groups (1.53 kN) did not significantly differ; however, the fracture load for the ML group (6.61 kN) was significantly higher than those for the other groups. The fracture load for the IVZ group was comparable to those for the PVZ and PFM groups.ConclusionsThe monolithic zirconia prostheses exhibited significantly higher fracture loads than the bilayered prostheses. All the investigated types of screw-retained implant-supported zirconia prostheses appear sufficient to resist posterior masticatory forces during long-term clinical use.     

A systematic review and meta-analysis on the clinical outcome of zirconia implant–restoration complex

Purpose

This systematic review evaluates the clinical outcome of zirconia implant-associated survival and success rates, marginal bone loss, and implant–restoration complex integrity.

Effect of bovine lactoferrin on enamel demineralization and acid fermentation by Streptococcus mutans

The purpose of this study was to evaluate the effects of bovine lactoferrin on acid fermentation and enamel demineralization using Streptococcus mutans in a culture system and an artificial mouth model system. The antibacterial activity of bovine lactoferrin (bLF) against S. mutans was analyzed by a radial diffusion assay. In the culture system, the effect of bLF on the synthesis and adherence of water insoluble glucan (WIG) and the adherence of S. mutans to a glass surface was examined by a batch culture. In the artificial mouth model system, cell suspension of S. mutans, heart infusion broth supplemented with sucrose, and PBS or lactoferrin solution were supplied separately and constantly for 21 hours. The following parameters were determined for evaluation: the amount of artificial biofilm, the changes in pH underneath the biofilm; and the changes in enamel microhardness measured by a Vicker's hardness tester. The antibacterial activity of bLF against S. mutans was observed. The amounts of bacterial cells in the total adherent fractions were inhibited by bLF in a dose dependent manner. The amounts of WIG in a firm-adherent fraction were significantly inhibited by 0.1–1.0% bLF. The changes in microhardness on enamel slabs in the bLF group (2.4 ± 0.8) showed significantly less hardness reduction than those in the control group (22.3 ± 2.5) (P < 0.001). The artificial biofilm accumulation was not reduced by bLF. The results of this study suggest that bLF might have inhibitory effects against acid fermentation and demineralization of enamel by S. mutans.