Biomaterial investigations in dentistry最新文献

Purpose: This systematic review and meta-analysis aimed to compare the clinical success rates of Platelet-Rich Fibrin (PRF) and Mineral Trioxide Aggregate (MTA) when used in pulp-capping and pulpotomy.

Materials and methods: A systematic search of PubMed, Scopus, Embase, and Web of Science was performed. Randomized and non-randomized clinical trials with a minimum 6-month follow-up were included. The risk of bias was assessed using RoB-2 and ROBINS-I tools, and the certainty of evidence was evaluated using GRADE.

Results: Nine studies were included in the qualitative and quantitative synthesis. The meta-analysis at 6 months (7 studies, 436 treated teeth) showed no significant difference between PRF and MTA (odds ratio [OR] 0.72, 95% confidence interval [CI]: 0.29-1.78; P= 0.4799). At 12 months (7 studies, 352 treated teeth), the results also indicated no statistically significant difference (OR 1.50, 95% CI: 0.93-2.43; P= 0.0962), though the point estimate favored PRF.

Conclusion: Within the limitations of this study, PRF and MTA demonstrate broadly similar clinical success rates in pulp-capping and pulpotomy over 6 and 12 months. The low certainty of evidence underscores the need for well-designed, larger randomized controlled trials with extended follow-up to more definitively establish their comparative long-term efficacy.

Aim: The present study aimed to evaluate and compare the sealing ability of Biodentine, zirconia reinforced glass ionomer cement (GIC), and Mineral Trioxide Aggregate (MTA) as furcation repair materials.

Materials and methods: A total of 50 extracted permanent maxillary molars were collected and divided into three experimental groups and one control group. Group I - Biodentine (n = 15), Group II - zirconia reinforced GIC (n = 15), Group III - MTA Angelus (n = 15), and unrepaired, control group (n = 5). Crowns of teeth in experimental groups were sectioned 3 mm above the cementoenamel junction and roots 3 mm below the furcation. Standardised endodontic access openings were prepared, canal orifices and root ends were sealed with sticky wax. After coating with nail varnish, a 1 mm furcation perforation was created at a standardised location using a round carbide bur. Samples were flushed, dried, and incubated at 37°C for 24 h to simulate clinical conditions. All samples were subjected to orthograde and retrograde methylene blue dye challenge followed by dye extraction with a concentration of 65% nitric acid. Samples were then analysed using 550 ultraviolet-visible spectrophotometers.

Statistical analysis: The results were analysed statistically by one-way analysis of variance (ANOVA) and Tukey's multiple comparison tests.

Result: No statistically significant difference in sealing ability was observed between Biodentine, zirconia reinforced GIC, and MTA when used as a furcation perforation repair material.

Conclusion: Within the limitations of this study, it can be concluded that Biodentine, zirconia reinforced GIC, and MTA showed sealing ability comparable to each other.

Background: Shape memory polymers (SMPs) are gaining traction in orthodontics, particularly in clear aligners, due to their stimulus-responsive behavior and potential to improve treatment outcomes. However, their use in biomedical devices raises questions about biocompatibility and environmental sustainability.

Objectives: This scoping review aims to map current evidence on the health and environmental risks of SMPs used in orthodontic aligners, identify knowledge gaps, and guide future research.

Search methods: A systematic search of PubMed, Scopus, Web of Science, Embase, ProQuest, and Cochrane databases was conducted, focusing on studies from the past decade. Search terms included SMPs, orthodontic aligners, toxicity, biodegradability, and environmental impact.

Selection criteria: Eligible studies involved original in vitro, in vivo, clinical, or environmental research related to SMPs in orthodontic applications.

Data collection and analysis: Key information from each study was extracted using a standardized Excel spreadsheet by one reviewer (SA) and validated by another (MKN). Extracted data included study design, polymer type, health and environmental risks, and conclusions. Due to heterogeneity, results were synthesized narratively.

Results: Sixteen studies met the inclusion criteria. Evidence on SMP biocompatibility is emerging but limited. Certain SMP formulations released residual monomers and degradation products with potential cytotoxic or systemic effects. Environmental concerns included low degradability, accumulation of polymer waste, and lack of recycling strategies. Notably, there was a lack of long-term clinical data and environmental life-cycle analyses.

Conclusions: While SMPs offer promise in orthodontics, their safety and environmental impacts are insufficiently studied. Future research should focus on standardized toxicological testing, long-term evaluations, and sustainable material development.

Registration and conflicts: This scoping review was prospectively registered in PROSPERO (ID: CRD42022308725). The authors report no conflicts of interest.

Objective: This study evaluated the antibacterial efficacy of chlorhexidine-chlorine dioxide (CHX-CDO) mouthwash formulations against major halitosis-related pathogens: Porphyromonas gingivalis (Pg), Aggregatibacter actinomycetemcomitans (Aa), Fusobacterium nucleatum (Fn), Prevotella intermedia (Pi), and Eikenella corrodens (Ec).

Materials and methods: Five bacterial strains were cultured anaerobically. Experimental mouthwashes with varying concentrations of CHX (0.01-0.2%) and CDO (0.05-0.1%), labeled solution A-J, were tested. Agar diffusion assays measured inhibition zones. MICs were determined by broth microdilution with 24 h anaerobic incubation and OD600 measurement. The time-kill test quantified CFUs from serial dilutions at time points (0, 1, 3, 6, 12, and 24 h).

Results: All CHX-CDO mouthwash combinations inhibited bacterial growth, with A (0.05% CHX + 0.05% CDO), C (0.2% CHX + 0.05% CDO), F (0.2% CHX + 0.1% CDO), and J (CHX 0.02/CDO 0.1) showing the largest inhibition zones and G (CHX 0.01/CDO 0.05) and H (CHX 0.02/CDO 0.05) exhibiting the most favorable MIC values. Time-kill assays confirmed sustained bactericidal effects for low concentration-CHX/0.05% CDO formulations. Significant differences in antibacterial activity were observed among the formulations (p < 0.05).

Conclusion: Low-dose CHX combined with 0.05% CDO mouthwash maintains antibacterial efficacy against halitosis-associated pathogens, suggesting a promising CHX dose reduction while preserving effectiveness.

Biocompatible high-performance polymer (BioHPP), a high-performance polymer derived from polyetheretherketone (PEEK) and reinforced with ceramic fillers, has emerged as a promising alternative to conventional metal and ceramic framework materials in prosthetic dentistry. With an elastic modulus (~4 GPa) comparable to that of cortical bone, BioHPP promotes physiological stress distribution and reduces stress shielding, thereby supporting peri-implant bone preservation. Its excellent chemical inertness and low bacterial affinity minimize mucosal inflammation and reduce the risk of peri-implant disease. However, the material's low surface energy and hydrophobicity pose challenges to long-term adhesive stability, necessitating specific surface modification techniques and specialized adhesive systems. Clinically, BioHPP has been successfully applied in single crowns, fixed partial dentures, full-arch hybrid prostheses (e.g. All-on-Four), bar-retained overdentures, maxillofacial frameworks, customized abutments, and provisional restorations. Despite its favorable biomechanical and biological profile, limitations such as inherent opacity, restricted fracture toughness, and the scarcity of long-term clinical data highlight the need for further interdisciplinary research and material innovation. This narrative review comprehensively evaluates the mechanical, biological, and adhesive characteristics of BioHPP, compares its performance with traditional framework materials, and discusses its clinical applications and future perspectives in prosthetic rehabilitation.

Aim: This systematic review appraised clinical trials that evaluated the efficacy of various protective liners on preserving pulp vitality after selective caries removal.

Methods: This systematic review adhered to the Preferred Reporting Items for Systematic Review and Meta-analysis principles. The Population, Intervention, Comparison, Outcome and Study Design (PICOS)strategy was intended to encompass individuals with deep carious lesions in permanent teeth. Studies comparing the efficacy of calcium hydroxide with glass ionomer cement (GIC) or resin-modified glass ionomer (RMGIC) or mineral trioxide aggregate (MTA) or Biodentine or Theracal on pulp vitality after selective caries removal having 1 year of follow-up were included.

Results: After full-text analysis, eight studies (n = 8 trials, 678 teeth) were included. The results of meta-analysis of seven studies indicated that there was no statistically significant difference between RMGIC and calcium hydroxide (risk ratio [RR] = 0.98; 95% Confidence limits (CL) = 0.92 to 1.06; P = 0.68), Biodentine and calcium hydroxide (RR = 1.05; 95% CL = 0.94 to 1.18; P = 0.40), Theracal and calcium hydroxide (RR = 1.02 ; 95% CL = 0.97 to 1.07; P = 0.48) and MTA and calcium hydroxide (RR = 1.13; 95% CL = 0.95 to 1.34; P = 0.17). Sensitivity analysis also showed no significant difference between Theracal and calcium hydroxide. Heterogeneity was moderate for comparison between MTA and calcium hydroxide (I² = 54%). Two studies were with low risk of bias, and six studies were classified as having some concerns. Evidence ranged from very low to moderate.

Conclusion: There were no differences in clinical outcomes between RMGIC and calcium hydroxide, Biodentine and calcium hydroxide, Theracal and calcium hydroxide and MTA and calcium hydroxide. Thus, the findings suggest that treatment success is not significantly influenced by the type of protective liner employed.

Objective: Resin composite restorations typically last 6-10 years but often fail due to mechanical fatigue, hydrolytic breakdown, and degradation at the interface. These failures result in frequent replacements, leading to significant clinical and environmental impacts. Extending restoration durability is essential for both patient care and sustainability. This review examines recent advances in self-healing dental biomaterials, emphasising the underlying chemical and physical mechanisms, their integration into resin composites, cements, and adhesives, and their relevance to sustainable restorative practice.

Materials and methods: A narrative review methodology was employed to synthesise the current evidence. Studies on self-healing mechanisms, including extrinsic (capsule- or reservoir-based) and intrinsic (dynamic covalent, supramolecular, or shape-memory polymer) systems, were critically evaluated with emphasis on evidence relevant to dental resin composites, cements, and adhesives. Parallel insights from polymer and material sciences were included where dental-specific research was limited. Supplementary searches were conducted on Google Scholar for additional peer-reviewed articles, books, and preprints.

Results: Experimental resin composites and cements incorporating microcapsule-based self-healing systems exhibited fracture toughness recovery between 65% and 77%, maintaining structural integrity after 6 months of water storage in deionised water at 37°C. Disulfide and Diels-Alder dynamic networks, though mostly investigated in polymer science, show potential for repeatable healing under mild triggers, while supramolecular hydrogen-bonding and bioactive fillers offer adaptive repair and remineralisation at adhesive interfaces. Self-healing strategies align with the four pillars of green dentistry, that is pollution prevention, water conservation, energy efficiency, and waste reduction by potentially halving procedural resource consumption through extended restoration lifespan.

Conclusion: Self-healing biomaterials designed and developed in accordance with sustainability principles have the potential to transform restorative dentistry by facilitating autonomous repair, prolonging restoration lifespan, and minimising the environmental footprint through reduced material usage and clinical waste generation.

Objective: This systematic review aimed to systematically map and synthesize the available evidence from in vitro studies on the modification of Glass Ionomer Cements (GICs) with plant extracts, with a specific focus on evaluating their effects on the material's antibacterial, physicochemical, and mechanical properties.

Materials and methods: The review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. The search strategy, based on the Population Intervention, Comparison, and Outcome (PICO) framework, was applied to four major databases (PubMed, Embase, Scopus, and Web of Science), yielding 2,614 initial records. The Quality Assessment Tool for In Vitro Studies (QUINN Tool) was used to evaluate the risk of bias. Data regarding plant species, GIC types, modification methods, and outcome measures were extracted and synthesized narratively due to methodological heterogeneity.

Results: The analysis of the 14 included studies revealed that Salvadora persica was the most frequently used plant species (6 studies). The primary outcome was a significant enhancement of the antibacterial activity of GICs against Streptococcus mutans without negatively affecting fluoride release. Most studies reported maintained or improved mechanical properties, such as compressive strength, at low extract concentrations (typically below 5%). However, the review identified significant limitations: a lack of methodological detail in extract incorporation, a near absence of cytotoxicity assessments, and insufficient investigation into ion release profiles beyond fluoride.

Conclusions: The incorporation of plant extracts presents a promising strategy for improving the antibacterial performance of GICs while preserving their beneficial properties. However, the current body of evidence is constrained by methodological inconsistencies and critical gaps in safety and long-term efficacy evaluation. Future research must prioritize standardized protocols, comprehensive biocompatibility testing, and analyses under conditions that better simulate the oral environment to ensure clinical translatability.

Red marine seaweeds, particularly those belonging to the genus Rhodophyta, possess a robust structural framework and are rich in biologically active compounds such as carrageenan, agar, collagen, and alginate. These natural resources are abundant and have attracted significant attention for their therapeutic potential in oral healthcare. This review highlights the applications of red marine seaweeds in dentistry, focusing on their roles in maintaining oral health, facilitating wound healing, exhibiting antibacterial properties, and contributing to tooth remineralization. Notably, their anti-inflammatory activity supports the management of conditions such as gingivitis, periodontitis, and oral ulcerations, while their antibacterial and antifungal actions effectively inhibit oral pathogens such as Streptococcus mutans, a primary contributor to dental caries. Furthermore, carrageenan-based biodegradable films derived from red seaweeds demonstrate promising potential as controlled drug delivery systems and tissue-regenerative biomaterials within the oral cavity. Beyond clinical applications, seaweeds can also serve as sustainable sources for formulating naturally derived oral hygiene products - including mouthwashes, toothpastes, and gels - offering eco-friendly alternatives to synthetic chemicals. However, despite these advances, broader clinical adoption requires comprehensive and well-designed clinical trials to validate efficacy and safety. Overall, this review underscores the emerging potential of red marine seaweeds as sustainable, bioactive resources for innovative dental therapeutics, while emphasizing the need for continued translational and clinical research.

The stability and functionality of complete dentures depend on various clinical and material factors, such as retention, adaptation, color change, microhardness, and surface roughness. Relining aims to re-establish the fit of the prosthesis to the supporting tissues, and it is carried out using materials such as acrylic resins. This study aimed to evaluate the color, microhardness and roughness properties of three relining acrylic resins: Kooliner (GC America, USA), TDV-Cold (TDV, Brazil), and Ufi Gel Hard C (VOCO, Germany), after combined use with three different adhesives (Corega, Fixodent - Haleon, UK; and Poligrip - P&G, USA) for 2 months, followed by aging by thermocycling (5.000 cycles). Color, microhardness, and roughness were analyzed on 120 samples at times T0 (initial), T1 (after 2 months), and T2 (after thermocycling). Additionally, characterization by energy-dispersive X-ray spectroscopy and scanning electron microscopy was performed at T0 and T2. The results showed that time had a significant influence on all the properties evaluated, with an increase in microhardness and roughness over time. Ufi Gel Hard C showed greater color stability and microhardness, even after aging, a behavior associated with the presence of elements such as silicon and barium in its composition. Roughness was also more evident in this relining acrylic resin, as confirmed by the SEM data and images. The reliners analyzed showed distinct behavior in response to aging and thermocycling, with Ufi Gel Hard C standing out for its greater stability. Time was the main factor influencing color, microhardness, and roughness properties.