Pub Date : 2025-11-08DOI: 10.1016/j.dental.2025.11.002
Stevan M. Čokić , Jef Vleugels , Bart Van Meerbeek , Fei Zhang
Objectives
To evaluate the effect of different speed-sintering cooling rates on the phase composition, microstructure, optical and mechanical properties of monolithic zirconia.
Methods
Speed-sintered ZirCAD LT (Ivoclar) (LT_1200; 5 min at 1480 °C; oven-door opening and air-cooling: 1200 °C) and Katana STML (Kuraray Noritake) (STML_800; 30 min at 1560 °C; oven-door opening and air-cooling: 800 °C) were compared to speed-sintered ZirCAD LT and Katana STML with a steady cooling rate and oven-door opening at 300 °C (LT_300 and STML_300, respectively). Density was measured by Archimedes’ principle; composition by XRF; phase by XRD; grain size by SEM; translucency parameter by spectrophotometry. Vickers hardness, indentation fracture toughness, and biaxial strength were also assessed.
Results
Regardless of the cooling rate, ZirCAD LT and Katana STML revealed similar density, chemical composition and grain size. Both 3Y-TZP ZirCAD LT_1200/300 zirconia had lower cubic ZrO2-phase content, and lower Y2O3 content in the remaining tetragonal ZrO2 phases compared to 5Y-PSZ Katana STML_800/300 zirconia. In contrast to 3Y-TZP, 5Y-PSZ contained a high amount of metastable t’-phase. TP of ZirCAD LT and Katana STML were not affected by the cooling rate. The hardness and fracture toughness of both 3Y-TZP and 5Y-PSZ were not influenced by cooling rate variations. Steady cooling significantly diminished flexural strength and mechanical reliability of Katana STML_300, while it did not have any effect on the ZirCAD LT zirconia grades.
Significance
Steady cooling during speed-sintering did not significantly influence the performance of 3Y-TZP but can negatively influence flexural strength and mechanical reliability of 5Y-PSZ zirconia ceramics.
{"title":"Effect of cooling rate on the microstructural and mechanical properties of speed-sintered monolithic zirconia","authors":"Stevan M. Čokić , Jef Vleugels , Bart Van Meerbeek , Fei Zhang","doi":"10.1016/j.dental.2025.11.002","DOIUrl":"10.1016/j.dental.2025.11.002","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the effect of different speed-sintering cooling rates on the phase composition, microstructure, optical and mechanical properties of monolithic zirconia.</div></div><div><h3>Methods</h3><div>Speed-sintered ZirCAD LT (Ivoclar) (LT_1200; 5 min at 1480 °C; oven-door opening and air-cooling: 1200 °C) and Katana STML (Kuraray Noritake) (STML_800; 30 min at 1560 °C; oven-door opening and air-cooling: 800 °C) were compared to speed-sintered ZirCAD LT and Katana STML with a steady cooling rate and oven-door opening at 300 °C (LT_300 and STML_300, respectively). Density was measured by Archimedes’ principle; composition by XRF; phase by XRD; grain size by SEM; translucency parameter by spectrophotometry. Vickers hardness, indentation fracture toughness, and biaxial strength were also assessed.</div></div><div><h3>Results</h3><div>Regardless of the cooling rate, ZirCAD LT and Katana STML revealed similar density, chemical composition and grain size. Both 3Y-TZP ZirCAD LT_1200/300 zirconia had lower cubic ZrO<sub>2</sub>-phase content, and lower Y<sub>2</sub>O<sub>3</sub> content in the remaining tetragonal ZrO<sub>2</sub> phases compared to 5Y-PSZ Katana STML_800/300 zirconia. In contrast to 3Y-TZP, 5Y-PSZ contained a high amount of metastable <em>t’</em>-phase. TP of ZirCAD LT and Katana STML were not affected by the cooling rate. The hardness and fracture toughness of both 3Y-TZP and 5Y-PSZ were not influenced by cooling rate variations. Steady cooling significantly diminished flexural strength and mechanical reliability of Katana STML_300, while it did not have any effect on the ZirCAD LT zirconia grades.</div></div><div><h3>Significance</h3><div>Steady cooling during speed-sintering did not significantly influence the performance of 3Y-TZP but can negatively influence flexural strength and mechanical reliability of 5Y-PSZ zirconia ceramics.</div></div>","PeriodicalId":298,"journal":{"name":"Dental Materials","volume":"42 3","pages":"Pages 412-419"},"PeriodicalIF":6.3,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145480465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-08DOI: 10.1016/j.dental.2025.11.004
Laura Carolina Kepler , Paula Benetti , Vitor Trancoso Britto , Alvaro Della Bona , Yu Zhang , Marcia Borba
Objectives
Even though improvements in CAD/CAM technology have allowed the milling protocol to be modified according to specific treatment requirements, it remains unclear how different protocols affect the surface quality and mechanical properties of the final restoration. This study aims to evaluate the effect of the CAD/CAM milling protocol on the topography, flexural strength, and reliability of 3 mol% yttria partially stabilized zirconia (3Y-PSZ).
Methods
Disc-shaped specimens (∅12 mm×1.2 mm) were fabricated using three different CAD/CAM dry-milling protocols (n = 20): slow (S), normal (N), and fast (F). Control polished specimens were fabricated by cutting pre-sintered CAD/CAM blocks using a cutting machine and polishing with silicon carbide papers, in wet (Pwet) and dry (Pdry) conditions (n = 20). Surface topography was evaluated using an optical profilometer (n = 3). Specimens were subjected to a piston-on-three-balls flexural strength test using a universal testing machine. Fractographic analysis was performed using optical and scanning electron microscopes. The characteristic flexural strength (σ0), Weibull modulus (m), and the 90 % confidence intervals (90 % CI) were estimated. XRD was used to identify the tetragonal, cubic, and monoclinic phases.
Results
Distinct topographies were observed for polished and CAD/CAM-milled specimens. Surface roughness parameters (Sa and Sz) followed a decreasing order: F > N > S > P (Pwet and Pdry) There was no difference for σ0 and m values among the three CAD/CAM milling protocols. Pdry had similar σ0 and m to CAD/CAM-milled groups, while Pwet resulted in lower values.
Significance
Distinct CAM-milling protocols produce apparent differences in the topography of 3Y-PSZ while preserving flexural strength and reliability.
尽管CAD/CAM技术的改进使得铣削方案可以根据具体的处理要求进行修改,但不同的方案如何影响最终修复体的表面质量和机械性能仍然不清楚。本研究旨在评估CAD/CAM铣削方案对3 mol%氧化钇部分稳定氧化锆(3Y-PSZ)的形貌、抗弯强度和可靠性的影响。方法:采用三种不同的CAD/CAM干铣削方案(n = 20):慢(S),正常(n),快速(F),制作盘形标本(∅12 mm×1.2 mm)。在湿(Pwet)和干(Pdry)条件下(n = 20),使用切割机切割预烧结CAD/CAM块,并用碳化硅纸抛光,制备对照抛光样品。使用光学轮廓仪评估表面形貌(n = 3)。用万能试验机对试件进行活塞-三球抗弯强度试验。用光学显微镜和扫描电镜进行断口分析。估计了特征抗弯强度(σ0)、威布尔模量(m)和90 %置信区间(90 % CI)。采用XRD对其进行了四方相、立方相和单斜相的表征。结果:对抛光和CAD/ cam铣削的标本观察到不同的地形。表面粗糙度参数(Sa和Sz)依次递减:F > N > S > P (Pwet和Pdry) 3种CAD/CAM铣削方案的σ0和m值没有差异。Pdry组的σ0和m值与CAD/ cam组相似,Pwet组的σ0和m值较低。意义:不同的cam -铣削方案在保持弯曲强度和可靠性的同时,会产生3Y-PSZ形貌的明显差异。
{"title":"Effect of CAD/CAM milling protocols on surface topography and mechanical behavior of polycrystalline zirconia","authors":"Laura Carolina Kepler , Paula Benetti , Vitor Trancoso Britto , Alvaro Della Bona , Yu Zhang , Marcia Borba","doi":"10.1016/j.dental.2025.11.004","DOIUrl":"10.1016/j.dental.2025.11.004","url":null,"abstract":"<div><h3>Objectives</h3><div>Even though improvements in CAD/CAM technology have allowed the milling protocol to be modified according to specific treatment requirements, it remains unclear how different protocols affect the surface quality and mechanical properties of the final restoration. This study aims to evaluate the effect of the CAD/CAM milling protocol on the topography, flexural strength, and reliability of 3 mol% yttria partially stabilized zirconia (3Y-PSZ).</div></div><div><h3>Methods</h3><div>Disc-shaped specimens (∅12 mm×1.2 mm) were fabricated using three different CAD/CAM dry-milling protocols (n = 20): slow (S), normal (N), and fast (F). Control polished specimens were fabricated by cutting pre-sintered CAD/CAM blocks using a cutting machine and polishing with silicon carbide papers, in wet (P<sub>wet</sub>) and dry (P<sub>dry</sub>) conditions (n = 20). Surface topography was evaluated using an optical profilometer (n = 3). Specimens were subjected to a piston-on-three-balls flexural strength test using a universal testing machine. Fractographic analysis was performed using optical and scanning electron microscopes. The characteristic flexural strength (σ<sub>0</sub>), Weibull modulus (<em>m</em>), and the 90 % confidence intervals (90 % CI) were estimated. XRD was used to identify the tetragonal, cubic, and monoclinic phases.</div></div><div><h3>Results</h3><div>Distinct topographies were observed for polished and CAD/CAM-milled specimens. Surface roughness parameters (Sa and Sz) followed a decreasing order: F > N > S > P (P<sub>wet</sub> and P<sub>dry)</sub> There was no difference for σ<sub>0</sub> and <em>m</em> values among the three CAD/CAM milling protocols. P<sub>dry</sub> had similar σ<sub>0</sub> and <em>m</em> to CAD/CAM-milled groups, while P<sub>wet</sub> resulted in lower values.</div></div><div><h3>Significance</h3><div>Distinct CAM-milling protocols produce apparent differences in the topography of 3Y-PSZ while preserving flexural strength and reliability.</div></div>","PeriodicalId":298,"journal":{"name":"Dental Materials","volume":"42 3","pages":"Pages 420-430"},"PeriodicalIF":6.3,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145476568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-07DOI: 10.1016/j.dental.2025.10.013
Tahar Sif eddine Bouchema , Johanna Saunier , Lucas Mollier , Jessica Mauriello , Brice Savard , Najet Yagoubi
Objectives
Photo-polymerizable resins can be used to print clear orthodontic aligners with several advantages compared to thermoformed ones. However, the safety of these new printed devices, their efficacy, and the impact of aging on safety and performance are still insufficiently known. This study aims to evaluate several 3D printing resins used in dentistry to produce clear gutters, regarding biocompatibility, leached compounds (release kinetics), surface state, and thermo-mechanical properties before and after simulated intra-oral aging. The impact of post-curing time on their behavior was also evaluated.
Methods
Three resins - NextDent Ortho Flex, Freeprint Ortho Detax, and Graphy TC-85DAC - were tested using a standardized approach that included the same printer and a standard post-polymerization process. Chemical modifications were analyzed by ATR-FTIR, surface morphology by SEM, thermal properties by TGA and DSC, and cytotoxicity by MTT tests. Mechanical properties were characterized through tensile tests, and substance release in a salivary simulant based on PBS was monitored by HPLC. Aging in simulated saliva was followed for 15 days, corresponding to the duration of use of one aligner.
Results
The results showed good biocompatibility for the printed materials, except for the insufficiently post-cured materials. In addition, significant differences in release kinetics and physical properties were observed as a function of the resin used and the post-polymerization time. Intra-oral aging impacts all the properties of the materials tested, particularly the thermo-mechanical (maximum force and Tg) and surface properties, and leads to a release of residual resin and degradation products into the simulant which increases cytotoxicity.
Significance
This study highlights the importance of strictly standardizing post-polymerization protocols to ensure the safety and performance of 3D-printed dental devices and underlines the risk of the cumulative effect of leached compounds for the patient’s health, even if measured cell viability and photo-initiator exposure dose were within acceptable limits. Moreover, whatever the resin, aging leads to a decrease in thermo-mechanical properties that may affect the device's performance.
{"title":"Comparison of three dental resins for 3D printing of orthodontic appliances: Comparison of leaching, biocompatibility, and thermo-mechanical properties after post-curing and aging","authors":"Tahar Sif eddine Bouchema , Johanna Saunier , Lucas Mollier , Jessica Mauriello , Brice Savard , Najet Yagoubi","doi":"10.1016/j.dental.2025.10.013","DOIUrl":"10.1016/j.dental.2025.10.013","url":null,"abstract":"<div><h3>Objectives</h3><div>Photo-polymerizable resins can be used to print clear orthodontic aligners with several advantages compared to thermoformed ones. However, the safety of these new printed devices, their efficacy, and the impact of aging on safety and performance are still insufficiently known. This study aims to evaluate several 3D printing resins used in dentistry to produce clear gutters, regarding biocompatibility, leached compounds (release kinetics), surface state, and thermo-mechanical properties before and after simulated intra-oral aging. The impact of post-curing time on their behavior was also evaluated.</div></div><div><h3>Methods</h3><div>Three resins - NextDent Ortho Flex, Freeprint Ortho Detax, and Graphy TC-85DAC - were tested using a standardized approach that included the same printer and a standard post-polymerization process. Chemical modifications were analyzed by ATR-FTIR, surface morphology by SEM, thermal properties by TGA and DSC, and cytotoxicity by MTT tests. Mechanical properties were characterized through tensile tests, and substance release in a salivary simulant based on PBS was monitored by HPLC. Aging in simulated saliva was followed for 15 days, corresponding to the duration of use of one aligner.</div></div><div><h3>Results</h3><div>The results showed good biocompatibility for the printed materials, except for the insufficiently post-cured materials. In addition, significant differences in release kinetics and physical properties were observed as a function of the resin used and the post-polymerization time. Intra-oral aging impacts all the properties of the materials tested, particularly the thermo-mechanical (maximum force and T<sub>g</sub>) and surface properties, and leads to a release of residual resin and degradation products into the simulant which increases cytotoxicity.</div></div><div><h3>Significance</h3><div>This study highlights the importance of strictly standardizing post-polymerization protocols to ensure the safety and performance of 3D-printed dental devices and underlines the risk of the cumulative effect of leached compounds for the patient’s health, even if measured cell viability and photo-initiator exposure dose were within acceptable limits. Moreover, whatever the resin, aging leads to a decrease in thermo-mechanical properties that may affect the device's performance.</div></div>","PeriodicalId":298,"journal":{"name":"Dental Materials","volume":"42 3","pages":"Pages 381-402"},"PeriodicalIF":6.3,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145476545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This randomized clinical trial investigated the 96-month clinical performance of a universal adhesive (Adhese Universal Vivapen, Ivoclar Vivadent) applied in etch-and-rinse (ER) and self-etch (SE) modes in Class II bulk-fill composite restorations.
Materials and methods
Thirty-five patients, each with at least two Class II carious lesions, were enrolled. Using a split-mouth design, cavities were randomly assigned to ER or SE adhesive application. All restorations were placed with a high-viscosity bulk-fill resin composite (Tetric EvoCeram Bulk Fill, Ivoclar Vivadent). In total, 84 restorations were evaluated at baseline and at 12, 24, 36, 48, 60, 72, 84 and 96 months by two calibrated, blinded examiners according to modified USPHS criteria. Statistical analyses were performed with Chi-square, Friedman, Cochran’s Q, and McNemar tests (α=0.05).
Results
At 96 months, 74 restorations in 33 participants were examined. No loss of retention/fractures occurred. Seven restorations were replaced (six due to secondary caries—ER: 1, SE: 5 and one due to unacceptable marginal adaptation—SE), yielding crude cumulative replacement rates of 2.4 % (ER) and 14.3 % (SE). Kaplan–Meier analysis showed significantly higher survival for ER than SE (97.4 % vs 85.2 %, p = 0.049). Marginal discoloration was consistently higher with SE from 36 months onward (p < 0.05), whereas marginal adaptation showed no differences between groups at any recall. Other criteria were comparable, and no postoperative sensitivity was recorded.
Conclusions
Despite a statistically higher incidence of marginal discoloration in the SE approach, both strategies demonstrated comparable long-term outcomes, with no retention loss after 96 months. The ER showed a higher cumulative survival. These findings confirm the clinical acceptability of universal adhesives in Class II bulk-fill composite restorations over extended service periods.
Clinical significance
Universal adhesives demonstrated durable adhesion and predictable performance in posterior bulk-fill restorations with both strategies, while the ER approach provided additional benefits in marginal discoloration and lower cumulative replacement needs over the long term.
{"title":"Etch-and-rinse vs self-etch strategy of a universal adhesive in Class II bulk-fill restorations: A 96-month split-mouth evaluation","authors":"Aybuke Uslu Tekce , Zeynep Bilge Kutuk , Ayse Ruya Yazici","doi":"10.1016/j.dental.2025.11.001","DOIUrl":"10.1016/j.dental.2025.11.001","url":null,"abstract":"<div><h3>Objective</h3><div>This randomized clinical trial investigated the 96-month clinical performance of a universal adhesive (Adhese Universal Vivapen, Ivoclar Vivadent) applied in etch-and-rinse (ER) and self-etch (SE) modes in Class II bulk-fill composite restorations.</div></div><div><h3>Materials and methods</h3><div>Thirty-five patients, each with at least two Class II carious lesions, were enrolled. Using a split-mouth design, cavities were randomly assigned to ER or SE adhesive application. All restorations were placed with a high-viscosity bulk-fill resin composite (Tetric EvoCeram Bulk Fill, Ivoclar Vivadent). In total, 84 restorations were evaluated at baseline and at 12, 24, 36, 48, 60, 72, 84 and 96 months by two calibrated, blinded examiners according to modified USPHS criteria. Statistical analyses were performed with Chi-square, Friedman, Cochran’s Q, and McNemar tests (α=0.05).</div></div><div><h3>Results</h3><div>At 96 months, 74 restorations in 33 participants were examined. No loss of retention/fractures occurred. Seven restorations were replaced (six due to secondary caries—ER: 1, SE: 5 and one due to unacceptable marginal adaptation—SE), yielding crude cumulative replacement rates of 2.4 % (ER) and 14.3 % (SE). Kaplan–Meier analysis showed significantly higher survival for ER than SE (97.4 % vs 85.2 %, <em>p</em> = 0.049). Marginal discoloration was consistently higher with SE from 36 months onward (p < 0.05), whereas marginal adaptation showed no differences between groups at any recall. Other criteria were comparable, and no postoperative sensitivity was recorded.</div></div><div><h3>Conclusions</h3><div>Despite a statistically higher incidence of marginal discoloration in the SE approach, both strategies demonstrated comparable long-term outcomes, with no retention loss after 96 months. The ER showed a higher cumulative survival. These findings confirm the clinical acceptability of universal adhesives in Class II bulk-fill composite restorations over extended service periods.</div></div><div><h3>Clinical significance</h3><div>Universal adhesives demonstrated durable adhesion and predictable performance in posterior bulk-fill restorations with both strategies, while the ER approach provided additional benefits in marginal discoloration and lower cumulative replacement needs over the long term.</div></div>","PeriodicalId":298,"journal":{"name":"Dental Materials","volume":"42 3","pages":"Pages 403-411"},"PeriodicalIF":6.3,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145476533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-04DOI: 10.1016/j.dental.2025.10.016
Merve Uctasli , Roda Seseogullari-Dirihan , Thiago Henrique Scarabello Stape , Mustafa Murat Mutluay , Arzu Tezvergil-Mutluay
Objective
To evaluate the long-term effect of ammonia- and water-based silver fluoride treatments on the degradation of the dentin collagen matrix.
Methods
Dentin beams (0.3x3x7mm) were demineralized (10 % H3PO4), rinsed and randomly distributed into six groups. Groups (n = 10 beams/group) were treated with (1) ammonia-based silver fluoride = SDF; (2) SDF + potassium iodide = KI (3) water-based silver fluoride = SF (4) SF + KI (5) KI (6) untreated demineralized dentin beams served as control. Following treatments, dry mass, modulus of elasticity and enzymatic activity were assessed. Dentin beams were incubated in calcium- and zinc-containing artificial saliva up to 6 months. After different incubation periods (1 week, 1 month, 3 months or 6 months), dry mass, modulus of elasticity and enzymatic activity were reevaluated. The aliquots of incubation media were analyzed to determine the solubilized telopeptides of collagen (ICTP and CTX immunoassays), hydroxyproline release and total extractable protein (Bradford assay). Scanning electron microscopy imaging and in situ zymography analyses were conducted. Data were statistically analyzed with ANOVA followed by Tukey test (α=0.05).
Results
Silver fluoride treatments reduced the total enzymatic activity, but increased the solubilized telopeptides of collagen throughout incubation periods (p < 0.05). The addition of KI exacerbated the loss of dry mass, modulus of elasticity, hydroxyproline release and total protein loss (p < 0.05).
Significance
Ammonia- and water-based silver fluoride treatments may reduce long-term degradation of dentin collagen. However, potassium iodide can further increase endogenous protease activity and compromise the structural integrity of dentin’s organic matrix.
目的:评价氨基氟化银和水基氟化银对牙本质胶原基质降解的远期影响。方法:牙本质梁(0.3x3x7mm)脱矿(10 % H3PO4),冲洗后随机分为6组。各组(n = 10束/组)用(1)氨基氟化银= SDF处理;(2) SDF + 碘化钾= KI(3)水基氟化银= SF (4) SF + KI (5) KI(6)未处理脱矿牙本质光束作为对照。处理后,测定其干质量、弹性模量和酶活性。牙本质梁在含钙和含锌的人工唾液中孵育6个月。在不同的孵育期(1周、1个月、3个月或6个月)后,重新评估干质量、弹性模量和酶活性。分析培养液的等分,以测定胶原蛋白的溶解端肽(ICTP和CTX免疫测定)、羟脯氨酸释放量和总可提取蛋白(Bradford测定)。扫描电镜成像和原位酶谱分析。资料采用方差分析和Tukey检验(α=0.05)进行统计学分析。结果:氟化银处理降低了总酶活性,但在整个孵育期间增加了胶原的可溶性端肽(p )。意义:氨和水基氟化银处理可能会减少牙本质胶原的长期降解。然而,碘化钾会进一步增加内源性蛋白酶的活性,损害牙本质有机基质的结构完整性。
{"title":"Long-term effect of ammonia- and water-based silver fluoride on dentin collagen matrix","authors":"Merve Uctasli , Roda Seseogullari-Dirihan , Thiago Henrique Scarabello Stape , Mustafa Murat Mutluay , Arzu Tezvergil-Mutluay","doi":"10.1016/j.dental.2025.10.016","DOIUrl":"10.1016/j.dental.2025.10.016","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the long-term effect of ammonia- and water-based silver fluoride treatments on the degradation of the dentin collagen matrix.</div></div><div><h3>Methods</h3><div>Dentin beams (0.3x3x7mm) were demineralized (10 % H<sub>3</sub>PO<sub>4</sub>), rinsed and randomly distributed into six groups. Groups (n = 10 beams/group) were treated with (1) ammonia-based silver fluoride = SDF; (2) SDF + potassium iodide = KI (3) water-based silver fluoride = SF (4) SF + KI (5) KI (6) untreated demineralized dentin beams served as control. Following treatments, dry mass, modulus of elasticity and enzymatic activity were assessed. Dentin beams were incubated in calcium- and zinc-containing artificial saliva up to 6 months. After different incubation periods (1 week, 1 month, 3 months or 6 months), dry mass, modulus of elasticity and enzymatic activity were reevaluated. The aliquots of incubation media were analyzed to determine the solubilized telopeptides of collagen (ICTP and CTX immunoassays), hydroxyproline release and total extractable protein (Bradford assay). Scanning electron microscopy imaging and <em>in situ</em> zymography analyses were conducted. Data were statistically analyzed with ANOVA followed by Tukey test (α=0.05).</div></div><div><h3>Results</h3><div>Silver fluoride treatments reduced the total enzymatic activity, but increased the solubilized telopeptides of collagen throughout incubation periods (<em>p</em> < 0.05). The addition of KI exacerbated the loss of dry mass, modulus of elasticity, hydroxyproline release and total protein loss (<em>p</em> < 0.05).</div></div><div><h3>Significance</h3><div>Ammonia- and water-based silver fluoride treatments may reduce long-term degradation of dentin collagen. However, potassium iodide can further increase endogenous protease activity and compromise the structural integrity of dentin’s organic matrix.</div></div>","PeriodicalId":298,"journal":{"name":"Dental Materials","volume":"42 4","pages":"Pages 533-544"},"PeriodicalIF":6.3,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145450388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Monomer leaching from resin-based restorations is a concern due to possible adverse effects on the oral environment. This study evaluated a validated artificial saliva model and a multi-instrument analytical workflow to characterize two liquid resins for 3D-printing, compare findings with manufacturers’ SDSs, and determine leachable profiles from test specimens incubated in artificial saliva.
Methods
Liquid resins (Saremco print CROWNTEC, SCT; FREEPRINT® temp, FPT) were analyzed by UHPLC–HRMS and GC–MS. Disc-shaped specimens were 3D-printed and, as control, milled from Temp Premium Flexible (TPF) (n = 6). Samples were immersed in artificial saliva (surface area-to-volume ratio 1.2 cm²/mL, 37 °C). Aliquots were analyzed for methacrylate monomers and photoinitiators after 1 h, 24 h, 1 week, and 3 months using quantitative LC–MS/MS. Specimens incubated for 24 h and 3 months were further examined by untargeted UHPLC–HRMS.
Results
SDSs identified BisEMA as the main methacrylate in both resins, confirmed by UHPLC–HRMS. FPT also contained nondisclosed UDMA. Targeted analysis showed significantly higher concentrations of leachables (P < 0.05) from FPT than SCT or TPF at all time points. Untargeted analysis supported this, revealing the greatest number of leachables in FPT incubations, with at least 67 putative compounds.
Significance
Most residual methacrylate monomers elute within 24 h after 3D-printing. However, untargeted results suggest different leaching dynamics for other substances, highlighting the importance of broader analytical approaches in assessing biocompatibility.
{"title":"Resin materials for 3D-printing and milling of indirect restorations – Composition and leachables using an artificial saliva model","authors":"Mina Aker Sagen , Silvio Uhlig , Heidi Vanessa Holm , Lene Grutle , Lina Stangvaltaite-Mouhat , Marika Koutsouri Hæreid , Aida Gacic Mulic","doi":"10.1016/j.dental.2025.10.017","DOIUrl":"10.1016/j.dental.2025.10.017","url":null,"abstract":"<div><h3>Objective</h3><div>Monomer leaching from resin-based restorations is a concern due to possible adverse effects on the oral environment. This study evaluated a validated artificial saliva model and a multi-instrument analytical workflow to characterize two liquid resins for 3D-printing, compare findings with manufacturers’ SDSs, and determine leachable profiles from test specimens incubated in artificial saliva.</div></div><div><h3>Methods</h3><div>Liquid resins (Saremco print CROWNTEC, SCT; FREEPRINT® temp, FPT) were analyzed by UHPLC–HRMS and GC–MS. Disc-shaped specimens were 3D-printed and, as control, milled from Temp Premium Flexible (TPF) (n = 6). Samples were immersed in artificial saliva (surface area-to-volume ratio 1.2 cm²/mL, 37 °C). Aliquots were analyzed for methacrylate monomers and photoinitiators after 1 h, 24 h, 1 week, and 3 months using quantitative LC–MS/MS. Specimens incubated for 24 h and 3 months were further examined by untargeted UHPLC–HRMS.</div></div><div><h3>Results</h3><div>SDSs identified BisEMA as the main methacrylate in both resins, confirmed by UHPLC–HRMS. FPT also contained nondisclosed UDMA. Targeted analysis showed significantly higher concentrations of leachables (P < 0.05) from FPT than SCT or TPF at all time points. Untargeted analysis supported this, revealing the greatest number of leachables in FPT incubations, with at least 67 putative compounds.</div></div><div><h3>Significance</h3><div>Most residual methacrylate monomers elute within 24 h after 3D-printing. However, untargeted results suggest different leaching dynamics for other substances, highlighting the importance of broader analytical approaches in assessing biocompatibility.</div></div>","PeriodicalId":298,"journal":{"name":"Dental Materials","volume":"42 3","pages":"Pages 370-380"},"PeriodicalIF":6.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145429757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to evaluate the biomechanical effects of deep margin elevation (DME) and restorative material selection for overlays in maxillary molars with mesio-occluso-distal (MOD) subgingival defects via in vitro deformation analysis, fracture resistance tests, and 3D finite element analysis (FEA).
Methods
Three MOD overlay models (Model 1, Model 2, and Model 3) were created for maxillary molars by positioning the mesial and distal margins 1 mm above, at, and 1 mm below the cementoenamel junction (CEJ), respectively. Model 3 underwent DME modification, generating Models 4 (1 mm supragingival) and 5 (CEJ). The five models were restored with two materials (E: IPS e.max CAD; L: Lava Ultimate), yielding 10 test groups (E1–E5/L1–L5). The CEJ deformation, load resistance, and restoration failure modes were evaluated using deformation analysis and fracture resistance tests. 3D FE modeling was used to quantify the von Mises stress (VMS) distributions in the restorations, bonding, and DME layers, which were validated by cross-method correlation with experimental data.
Results
Deformation analysis revealed consistent mesial microstrains greater than distal microstrains, with E-groups having lower values than L-groups. Fracture resistance tests revealed that Model 3 (subgingival margin) was the weakest, with higher catastrophic failure rates than the supragingival designs. Compared with the non-DME group, the L4 (2-mm DME) group presented the best biomechanical performance with a greater load capacity. FE analysis demonstrated that E1 and L1 achieved optimal stress dispersion and that E3/L3 developed critical stress increases. The post-DME groups (E4/E5/L4/L5) exhibited homogeneous VMS distributions compared with the E3/L3 stress increases. DME layers concentrated VMS mesially, and FEA–in vitro correlation showed strong method concordance across all parameters.
Significance
As the subgingival defect depth increases, restorations progressively degrade. For sub-CEJ defects, the use of the 2-mm DME method to increase margins to 1 mm supragingival along with Lava Ultimate resulted in optimized stress distributions and improved biomechanical performance, resulting in greater longevity than non-DME methods. Thus, this protocol is recommended.
{"title":"Biomechanical evaluation of deep margin elevation-assisted overlays for Mesio-Occluso-Distal and sub-CEJ defects in maxillary molars: A 3D finite element analysis and in vitro study","authors":"Yuxuan Zhao , Hui Li , Yuting Huang, Kehuan Hong, Liecong Lin, Qianzhou Jiang","doi":"10.1016/j.dental.2025.10.009","DOIUrl":"10.1016/j.dental.2025.10.009","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate the biomechanical effects of deep margin elevation (DME) and restorative material selection for overlays in maxillary molars with mesio-occluso-distal (MOD) subgingival defects via in vitro deformation analysis, fracture resistance tests, and 3D finite element analysis (FEA).</div></div><div><h3>Methods</h3><div>Three MOD overlay models (Model 1, Model 2, and Model 3) were created for maxillary molars by positioning the mesial and distal margins 1 mm above, at, and 1 mm below the cementoenamel junction (CEJ), respectively. Model 3 underwent DME modification, generating Models 4 (1 mm supragingival) and 5 (CEJ). The five models were restored with two materials (E: IPS e.max CAD; L: Lava Ultimate), yielding 10 test groups (E1–E5/L1–L5). The CEJ deformation, load resistance, and restoration failure modes were evaluated using deformation analysis and fracture resistance tests. 3D FE modeling was used to quantify the von Mises stress (VMS) distributions in the restorations, bonding, and DME layers, which were validated by cross-method correlation with experimental data.</div></div><div><h3>Results</h3><div>Deformation analysis revealed consistent mesial microstrains greater than distal microstrains, with E-groups having lower values than L-groups. Fracture resistance tests revealed that Model 3 (subgingival margin) was the weakest, with higher catastrophic failure rates than the supragingival designs. Compared with the non-DME group, the L4 (2-mm DME) group presented the best biomechanical performance with a greater load capacity. FE analysis demonstrated that E1 and L1 achieved optimal stress dispersion and that E3/L3 developed critical stress increases. The post-DME groups (E4/E5/L4/L5) exhibited homogeneous VMS distributions compared with the E3/L3 stress increases. DME layers concentrated VMS mesially, and FEA–in vitro correlation showed strong method concordance across all parameters.</div></div><div><h3>Significance</h3><div>As the subgingival defect depth increases, restorations progressively degrade. For sub-CEJ defects, the use of the 2-mm DME method to increase margins to 1 mm supragingival along with Lava Ultimate resulted in optimized stress distributions and improved biomechanical performance, resulting in greater longevity than non-DME methods. Thus, this protocol is recommended.</div></div>","PeriodicalId":298,"journal":{"name":"Dental Materials","volume":"42 3","pages":"Pages 359-369"},"PeriodicalIF":6.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145429749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-31DOI: 10.1016/j.dental.2025.10.015
Kyoungjin Seo , HongXin Cai , Seung-Ho Shin , Ji-Won Choi , Young-Bin Seo , Jong-Eun Kim , Kwang-Man Kim , Heng Bo Jiang , Jae-Sung Kwon
Objective
Although the accuracy of scanning technologies has been extensively explored, a research gap still exists concerning the scanning results of dental impression materials, particularly regarding their color and gloss characteristics. This study aims to evaluate and compare the scanning capabilities of blue-light scanners for various dental impression materials characterized by different colors and gloss levels.
Methods
Blue (B), green (G), red (R), and yellow (Y) dental impression materials were selected for this study. Colorimetric analyses were conducted using a spectrophotometer. The gloss levels of the samples were quantified using a gloss meter. The accuracy and surface detail reproduction of a blue-light scanner were analyzed by scanning impression materials in four different colors. The four-unit crown-bridge model for accuracy analysis was based on International Standardization Organization (ISO) standard 12836. The data measured by the coordinate measuring machine (CMM) served as the gold standard and were used for parameter comparison (height, angle, and distance) and 3D fitting with the scanned files.
Results
Surface detail reproduction analyses revealed significant differences among the various groups. Notably, Group B consistently demonstrated superior scanning accuracy across all measurements, indicating its effectiveness as a dental impression material in blue-light scanning applications. Significant differences were observed in the rate of surface detail, angle parameters, and corner height across the various groups (p < 0.05). Additionally, the root–mean–square error values pertaining to trueness exhibited significant disparities in all the specimens (p < 0.05).
Significance. The absence of significant gloss differences across all color variations indicates that color should be evaluated alongside other critical factors when employing blue-light scanners for measurement accuracy.
{"title":"Evaluation of blue-light model scanner trueness, precision, and surface detail reproduction with different rubber impression material colors","authors":"Kyoungjin Seo , HongXin Cai , Seung-Ho Shin , Ji-Won Choi , Young-Bin Seo , Jong-Eun Kim , Kwang-Man Kim , Heng Bo Jiang , Jae-Sung Kwon","doi":"10.1016/j.dental.2025.10.015","DOIUrl":"10.1016/j.dental.2025.10.015","url":null,"abstract":"<div><h3>Objective</h3><div>Although the accuracy of scanning technologies has been extensively explored, a research gap still exists concerning the scanning results of dental impression materials, particularly regarding their color and gloss characteristics. This study aims to evaluate and compare the scanning capabilities of blue-light scanners for various dental impression materials characterized by different colors and gloss levels.</div></div><div><h3>Methods</h3><div>Blue (B), green (G), red (R), and yellow (Y) dental impression materials were selected for this study. Colorimetric analyses were conducted using a spectrophotometer. The gloss levels of the samples were quantified using a gloss meter. The accuracy and surface detail reproduction of a blue-light scanner were analyzed by scanning impression materials in four different colors. The four-unit crown-bridge model for accuracy analysis was based on International Standardization Organization (ISO) standard 12836. The data measured by the coordinate measuring machine (CMM) served as the gold standard and were used for parameter comparison (height, angle, and distance) and 3D fitting with the scanned files.</div></div><div><h3>Results</h3><div>Surface detail reproduction analyses revealed significant differences among the various groups. Notably, Group B consistently demonstrated superior scanning accuracy across all measurements, indicating its effectiveness as a dental impression material in blue-light scanning applications. Significant differences were observed in the rate of surface detail, angle parameters, and corner height across the various groups (p < 0.05). Additionally, the root–mean–square error values pertaining to trueness exhibited significant disparities in all the specimens (p < 0.05).</div><div><em>Significance.</em> The absence of significant gloss differences across all color variations indicates that color should be evaluated alongside other critical factors when employing blue-light scanners for measurement accuracy.</div></div>","PeriodicalId":298,"journal":{"name":"Dental Materials","volume":"42 3","pages":"Pages 351-358"},"PeriodicalIF":6.3,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145420726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-29DOI: 10.1016/j.dental.2025.10.014
K. Shemtov-Yona , Y. Miara , D. Rittel
Titanium-based biomaterials show a high success rate and excellent biocompatibility due to their properties, that can be partly attributed to the titanium’s ability to form a protective oxide layer. As such they are widely used, mostly Ti6Al4V, to manufacture dental implants and prosthetic devices. Unfortunately, implant failures can arise during implant use and are mainly due to peri-implant diseases involving bacterial infection and inflammatory stimuli. This study performs a systematic nano-structural evaluation of the contribution of inflammatory-simulating conditions (H2O2 and lactic acid), aside with room air and saline solution, combined with repeated mechanical loading, to the damage generated on the titanium surface and to the titanium oxide integrity. By using an array of high-resolution characterization techniques, such as ToF-SIMS and TEM, the synergy between mechanical loads and chemical reactions was unraveled.
In the more aggressive environments (e.g. lactic acid and H2O2), a clear increase in the titanium oxide’s thickness was observed compared to inert environments, such as air and saline. The effect of the mediums was more pronounced in the presence of loads. The TEM analysis observations revealed the porous and permeable nature of the oxide layer, affecting its neutrality and hence its biocompatibility.
{"title":"Investigating the integrity of titanium-oxide nanolayers of Ti6Al4V under chemo-mechanical stress","authors":"K. Shemtov-Yona , Y. Miara , D. Rittel","doi":"10.1016/j.dental.2025.10.014","DOIUrl":"10.1016/j.dental.2025.10.014","url":null,"abstract":"<div><div>Titanium-based biomaterials show a high success rate and excellent biocompatibility due to their properties, that can be partly attributed to the titanium’s ability to form a protective oxide layer. As such they are widely used, mostly Ti6Al4V, to manufacture dental implants and prosthetic devices. Unfortunately, implant failures can arise during implant use and are mainly due to peri-implant diseases involving bacterial infection and inflammatory stimuli. This study performs a systematic nano-structural evaluation of the contribution of inflammatory-simulating conditions (H<sub>2</sub>O<sub>2</sub> and lactic acid), aside with room air and saline solution, combined with repeated mechanical loading, to the damage generated on the titanium surface and to the titanium oxide integrity. By using an array of high-resolution characterization techniques, such as ToF-SIMS and TEM, the synergy between mechanical loads and chemical reactions was unraveled.</div><div>In the more aggressive environments (<em>e.g.</em> lactic acid and H<sub>2</sub>O<sub>2</sub>), a clear increase in the titanium oxide’s thickness was observed compared to inert environments, such as air and saline. The effect of the mediums was more pronounced in the presence of loads. The TEM analysis observations revealed the porous and permeable nature of the oxide layer, affecting its neutrality and hence its biocompatibility.</div></div>","PeriodicalId":298,"journal":{"name":"Dental Materials","volume":"42 2","pages":"Pages 342-349"},"PeriodicalIF":6.3,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-29DOI: 10.1016/j.dental.2025.10.011
Nuria Pérez-Guzmán , Paula García-Rios , Francisco J. Rodríguez-Lozano , David García-Bernal , Ali El Yahyaoui , Sergio López-García
Objectives
This study was conducted to examine the biocompatibility, regenerative potential, and immunomodulatory effects of three formulated calcium silicate-containing sealers (CSCS)—TotalFill BC Sealer (TFbc), NeoSEALER Flo (NS Flo), and NeoSEALER EZ Flo (NS EZ Flo)—on human periodontal ligament stem cells (hPDLSCs).
Materials and Methods
Third molars extracted from healthy patients (n = 15) were used to isolate hPDLSCs. Dilutions of 1:1, 1:2, and 1:4 were prepared, along with set sample discs of TFbc, NS Flo, and NS EZ Flo. The following assays were conducted: cell phenotyping, metabolic activity assessment (MTT assay), evaluation of cell attachment and morphology (scanning electron microscopy, SEM), cell migration analysis (wound-healing assay), cytoskeletal organization (phalloidin staining), proinflammatory cytokine release (IL-6 and IL-8, via ELISA), expression of differentiation markers (RT-qPCR), and assessment of cellular mineralization (Alizarin Red S staining). Statistical significance was set at p < 0.05.
Results
The metabolic activity assay demonstrated that cell viability increased over time with the use of bioceramic sealers.These sealers also promoted remarkable cell confluence and a higher number of focal adhesion complexes, as evidenced by the phalloidin assay. Furthermore, they demonstrated enhanced cell adhesion and anti-inflammatory effects compared to the negative control group (untreated cells), with the latter effect being more pronounced in the case of TotalFill BC Sealer. NS Flo, followed by NS EZ Flo, were the bioceramic sealers that most significantly promoted mineralized nodule formation, comparable to the positive control (Osteodiff), thus contributing to osteogenic and cementogenic differentiation.
Conclusion
This study demonstrates that all the bioceramic sealers investigated exhibit adequate cytocompatibility. NS Flo and NS EZ Flo demonstrate a strong ability to induce differentiation of hPDLSCs into osteogenic and cementogenic phenotypes. NS Flo significantly supports extracellular matrix mineralization. However, TFbc had a less substantial impact on these processes than the sealers. The effect was comparable during the first three days but decreased thereafter. In addition, the calcium silicate-containing sealers investigated exhibited relevant anti-inflammatory effects, offering potential therapeutic benefits in the field of regenerative endodontics.
目的:研究三种配方硅酸钙密封剂(CSCS)——totalfill BC Sealer (TFbc)、NeoSEALER Flo (NS Flo)和NeoSEALER EZ Flo (NS EZ Flo)对人牙周韧带干细胞(hPDLSCs)的生物相容性、再生潜能和免疫调节作用。材料与方法:采用健康患者第三磨牙(n = 15)分离hPDLSCs。分别配制1:1、1:2和1:4的稀释液,并分别配制TFbc、NS Flo和NS EZ Flo样品盘。进行以下检测:细胞表型、代谢活性评估(MTT法)、细胞附着和形态评估(扫描电镜,SEM)、细胞迁移分析(伤口愈合法)、细胞骨架组织(phalloidin染色)、促炎细胞因子释放(IL-6和IL-8, ELISA法)、分化标志物表达(RT-qPCR)和细胞矿化评估(茜素红S染色)。结果:代谢活性测定表明,随着使用生物陶瓷密封剂,细胞活力随着时间的推移而增加。这些封口剂也促进了显著的细胞融合和更多的局灶黏附复合物的数量,如阳杆菌素测定所证明的那样。此外,与阴性对照组(未经处理的细胞)相比,它们表现出增强的细胞粘附和抗炎作用,后者的效果在TotalFill BC Sealer的情况下更为明显。与阳性对照(Osteodiff)相比,NS Flo和NS EZ Flo是最显著促进矿化结节形成的生物陶瓷密封剂,从而有助于成骨和骨质分化。结论:本研究表明所研究的生物陶瓷密封材料具有良好的细胞相容性。NS Flo和NS EZ Flo具有诱导hPDLSCs向成骨和骨质增生表型分化的强大能力。NS Flo显著支持细胞外基质矿化。然而,与封口剂相比,TFbc对这些过程的影响较小。前三天的效果相当,但之后就下降了。此外,所研究的含硅酸钙密封剂显示出相关的抗炎作用,在再生牙髓学领域提供潜在的治疗益处。
{"title":"Ultrastructural and immunobiological responses of human periodontal ligament stem cells to novel tricalcium silicate sealers","authors":"Nuria Pérez-Guzmán , Paula García-Rios , Francisco J. Rodríguez-Lozano , David García-Bernal , Ali El Yahyaoui , Sergio López-García","doi":"10.1016/j.dental.2025.10.011","DOIUrl":"10.1016/j.dental.2025.10.011","url":null,"abstract":"<div><h3>Objectives</h3><div>This study was conducted to examine the biocompatibility, regenerative potential, and immunomodulatory effects of three formulated calcium silicate-containing sealers (CSCS)—TotalFill BC Sealer (TFbc), NeoSEALER Flo (NS Flo), and NeoSEALER EZ Flo (NS EZ Flo)—on human periodontal ligament stem cells (hPDLSCs).</div></div><div><h3>Materials and Methods</h3><div>Third molars extracted from healthy patients (n = 15) were used to isolate hPDLSCs. Dilutions of 1:1, 1:2, and 1:4 were prepared, along with set sample discs of TFbc, NS Flo, and NS EZ Flo. The following assays were conducted: cell phenotyping, metabolic activity assessment (MTT assay), evaluation of cell attachment and morphology (scanning electron microscopy, SEM), cell migration analysis (wound-healing assay), cytoskeletal organization (phalloidin staining), proinflammatory cytokine release (IL-6 and IL-8, via ELISA), expression of differentiation markers (RT-qPCR), and assessment of cellular mineralization (Alizarin Red S staining). Statistical significance was set at p < 0.05.</div></div><div><h3>Results</h3><div>The metabolic activity assay demonstrated that cell viability increased over time with the use of bioceramic sealers.These sealers also promoted remarkable cell confluence and a higher number of focal adhesion complexes, as evidenced by the phalloidin assay. Furthermore, they demonstrated enhanced cell adhesion and anti-inflammatory effects compared to the negative control group (untreated cells), with the latter effect being more pronounced in the case of TotalFill BC Sealer. NS Flo, followed by NS EZ Flo, were the bioceramic sealers that most significantly promoted mineralized nodule formation, comparable to the positive control (Osteodiff), thus contributing to osteogenic and cementogenic differentiation<strong>.</strong></div></div><div><h3>Conclusion</h3><div>This study demonstrates that all the bioceramic sealers investigated exhibit adequate cytocompatibility. NS Flo and NS EZ Flo demonstrate a strong ability to induce differentiation of hPDLSCs into osteogenic and cementogenic phenotypes. NS Flo significantly supports extracellular matrix mineralization. However, TFbc had a less substantial impact on these processes than the sealers. The effect was comparable during the first three days but decreased thereafter. In addition, the calcium silicate-containing sealers investigated exhibited relevant anti-inflammatory effects, offering potential therapeutic benefits in the field of regenerative endodontics.</div></div>","PeriodicalId":298,"journal":{"name":"Dental Materials","volume":"42 2","pages":"Pages 331-341"},"PeriodicalIF":6.3,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}