Faculty Bibliography

Integration between implant and bone is an essential concept for osseous healing requiring hardware placement. A novel approach to hardware implantation, termed osseodensification, is described here as an effective alternative. 12 sheep averaging 65kg had fixation devices installed in their C2, C3, and C4 vertebral bodies; each device measured 4mm diameterx10mm length. The left-sided vertebral body devices were implanted using regular surgical drilling (R) while the right-sided devices were implanted using osseodensification drilling (OD). The C2 and C4 vertebra provided the t=0 in vivo time point, while the C3 vertebra provided the t=3 and t=6 week time points, in vivo. Structural competence of hardware was measured using biomechanical testing of pullout strength, while the quality and degree of new bone formation and remodeling was assessed via histomorphometry. Pullout strength demonstrated osseodensification drilling to provide superior anchoring when compared to the control group collapsed over time with statistical significance (p<0.01). On Wilcoxon rank signed test, C2 and C4 specimens demonstrated significance when comparing device pullout (p=0.031) for both, and C3 pullout tests at 3 and 6 weeks collapsed over time had significance as well (p=0.027). Percent bone-to-implant contact (%BIC) analysis as a function of drilling technique demonstrated an OD group with significantly higher values relative to the R group (p<0.01). Similarly, percent bone-area-fraction-occupancy (BAFO) analysis presented with significantly higher values for the OD group compared to the R group (p=0.024). As a function of time, between 0 and 3 weeks, a decrease in BAFO was observed, a trend that reversed between 3 and 6 weeks, resulting in a BAFO value roughly equivalent to the t=0 percentage, which was attributed to an initial loss of bone fraction due to remodeling, followed by regaining of bone fraction via production of woven bone. Histomorphological data demonstrated autologous bone chips in the OD group with greater frequency relative to the control, which acted as nucleating surfaces promoting new bone formation around the implants, providing superior stability and greater bone density. This alternative approach to a critical component of hardware implantation encourages assessment of current surgical approaches to hardware implantation.

PURPOSE: This study aimed to quantify polymerization shrinkage of one conventional and three bulk-fill composites, under bonded and unbonded conditions, in Class II preparations using 3D microcomputed tomography (muCT) and report its location. MATERIALS AND METHODS: Preparations (2.5 mm occlusal depth x 4 mm wide x 4 mm mesial box and 1 mm beyond the CEJ distal box depth) were made in 48 human extracted molars (n = 6). Four composites were tested, one regular (Vitalescence/VIT) and three bulk-fill: SureFil SDR Flow (SDR), Tetric EvoCeram Bulk Fill (TET), and Filtek flowable Bulk Fill (FIL). Teeth were divided into four groups according to restorative material used and subdivided into two subgroups, according to the presence of an adhesive system (XP Bond) application (bonded [-B]) or its absence (unbonded [-U]). Each tooth was scanned three times: (1) after cavity preparation, (2) before and (3) after composite light-curing. Acquired muCT images were imported into 2D and 3D software for analysis. RESULTS: Significantly different volumetric shrinkage between bonded and unbonded conditions was observed only for TET group (p < 0.05), unbonded presenting significantly higher volumetric shrinkage. Among the bonded groups, TET-B presented significantly lower shrinkage than both SDR-B and FIL-B but not significantly different from VIT-B. Generally, shrinkage occurred at occlusal and distal surfaces. CONCLUSIONS: When applied to bonded Class II cavities, TET exhibited significantly lower volumetric shrinkage compared to the other bulk-fill composites. However, it also exhibited the highest difference of volumetric shrinkage values between unbonded and bonded cavities. CLINICAL SIGNIFICANCE: Volumetric polymerization shrinkage occurred with all composites tested, regardless of material type (conventional or bulk-fill) or presence or absence of bonding. However, volumetric shrinkage has been reduced or at least maintained when bulk-fill composites were used compared to a conventional composite resin, which makes them a potential time saving alternative for clinicians. (J Esthet Restor Dent, 2016).

Loss-of-function mutations in stromal interaction molecule 1 (STIM1) impair the activation of Ca2+ release-activated Ca2+ (CRAC) channels and store-operated Ca2+ entry (SOCE), resulting in a disease syndrome called CRAC channelopathy that is characterized by severe dental enamel defects. The cause of these enamel defects has remained unclear given a lack of animal models. We generated Stim1/2K14cre mice to delete STIM1 and its homolog STIM2 in enamel cells. These mice showed impaired SOCE in enamel cells. Enamel in Stim1/2K14cre mice was hypomineralized with decreased Ca content, mechanically weak, and thinner. The morphology of SOCE-deficient ameloblasts was altered, showing loss of the typical ruffled border, resulting in mislocalized mitochondria. Global gene expression analysis of SOCE-deficient ameloblasts revealed strong dysregulation of several pathways. ER stress genes associated with the unfolded protein response were increased in Stim1/2-deficient cells, whereas the expression of components of the glutathione system were decreased. Consistent with increased oxidative stress, we found increased ROS production, decreased mitochondrial function, and abnormal mitochondrial morphology in ameloblasts of Stim1/2K14cre mice. Collectively, these data show that loss of SOCE in enamel cells has substantial detrimental effects on gene expression, cell function, and the mineralization of dental enamel.

PURPOSE: This study evaluated whether simplified drilling protocols would provide comparable histologic and histomorphometric results to conventional drilling protocols at a low rotational speed. MATERIALS AND METHODS: A total of 48 alumina-blasted and acid-etched Ti-6Al-4V implants with two diameters (3.75 and 4.2 mm, n = 24 per group) were bilaterally placed in the tibiae of 12 dogs, under a low-speed protocol (400 rpm). Within the same diameter group, half of the implants were inserted after a simplified drilling procedure (pilot drill + final diameter drill), and the other half were placed using the conventional drilling procedure. After 3 and 5 weeks, the animals were euthanized, and the retrieved bone-implant samples were subjected to nondecalcified histologic sectioning. Histomorphology, bone-to-implant contact (BIC), and bone area fraction occupancy (BAFO) analysis were performed. RESULTS: Histology showed that new bone was formed around implants, and inflammation or bone resorption was not evident for both groups. Histomorphometrically, when all independent variables were collapsed over drilling technique, no differences were detected for BIC and BAFO; when drilling technique was analyzed as a function of time, the conventional groups reached statistically higher BIC and BAFO at 3 weeks, but comparable values between techniques were observed at 5 weeks; 4.2-mm implants obtained statistically higher BAFO relative to 3.75-mm implants. CONCLUSION: Based on the present methodology, the conventional technique improved bone formation at 3 weeks, and narrower implants were associated with less bone formation.

In this work, two solutions were developed: the first, rich in Ca2+, PO43- ions and the second, rich in Ca2+, PO43- and Mg2+, defined as Mg-modified precursor solution. For each Mg-modified precursor solution, the concentrations of Mg2+ ions were progressively increased by 5%, 10% and 15%wt. The aims of this research were to investigate the influence of magnesium ions substitution in calcium phosphate coatings on titanium surface and to evaluate these coatings by bioactivity assay in McCoy culture medium. The obtained coatings were characterized by X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR) analysis, and the presence of Mg ions was confirmed by the inductively coupled plasma atomic emission spectroscopy (ICP) analysis. In vitro bioactivity assay in McCoy culture medium showed bioactivity after 14days in incubation for the HA and 10% Mg-monetite coatings. The high chemical stability of Mg-HA coatings was verified by the bioactivity assays, and no bone-like apatite deposition, characteristic of bioactivity, was observed for Mg-HA coatings, for the time period used in this study.

The present study aimed to characterize the pattern and volume of polymerization shrinkage of flowable resin composites, including one conventional, two bulk fill, and one self-adhesive. Standardized class I preparations (2.5 mm depth x 4 mm length x 4 mm wide) were performed in 24 caries-free human third molars that were randomly divided in four groups, according to the resin composite and adhesive system used: group 1 = Permaflo + Peak Universal Bond (PP); group 2 = Filtek Bulk Fill + Scotchbond Universal (FS); group 3 = Surefil SDR + XP Bond (SX); and group 4 = Vertise flow self-adhering (VE) (n=6). Each tooth was scanned three times using a microcomputed tomography (muCT) apparatus. The first scan was done after the cavity preparation, the second after cavity filling with the flowable resin composite before curing, and the third after it was cured. The muCT images were imported into three-dimensional rendering software, and volumetric polymerization shrinkage percentage was calculated for each sample. Data were submitted to one-way analysis of variance and post hoc comparisons. No significant difference was observed among PP, FS, and VE. SX bulk fill resin composite presented the lowest values of volumetric shrinkage. Shrinkage was mostly observed along the occlusal surface and part of the pulpal floor. In conclusion, polymerization shrinkage outcomes in a 2.5-mm deep class I cavity were material dependent, although most materials did not differ. The location of shrinkage was mainly at the occlusal surface.

Nowadays, bioactive coatings or modifications on titanium surface have been tested in vitro and in vivo. In this study, two types of calcium phosphate coatings were produced by a chemical deposition method and their bioactivity assay in cell culture medium were investigated. The calcium phosphate coatings were characterized by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and scanning electron microscopy with field emission gun (FEG-SEM) analyses. Titanium substrate was successfully coated with brushite using chemical deposition method and, after a second step of conversion, the hydroxyapatite coating was obtained. The hydroxyapatite coating showed a bioactivity property after 14 days' incubation in McCoy medium culture

PURPOSE:To examine the effect of mechanical fatigue on the bond strength of resin composite cemented to silica-coated yttria-tetragonal zirconia polycrystal ceramic (Y-TZP). MATERIALS AND METHODS:Ten Y-TZP blocks were polished down to 600-grit silicon carbide paper. Specimens were silica coated by airborne-particle abrasion with 30-μm silica-modified Al2O3 particles. Blocks were cleaned in an ultrasonic bath, and a dental adhesive was applied and light cured for 20 s. Pre-cured composite blocks were luted to treated Y-TZP surfaces with a dual-curing resin cement. Half of the samples (n = 5) were subjected to mechanical fatigue before trimming (fatigue group) and the other half tested 24 h after bonding procedures (control group). Forty-five beam-shaped samples with an approximately 1 mm2 cross-sectional area were prepared for each group and tested in microtensile mode at 0.5 mm/min. Fractographic analysis was performed by optical and scanning electron microscopy. Only specimens that failed at the interface area were considered for statistical analysis. Weibull distribution (95% confidence bounds) was used to determine the characteristic strength (σ0 in MPa) and Weibull modulus (m) for each group. Probability of survival was calculated over the range of loads until specimens failed. RESULTS:The control group showed σ0 = 45.91 MPa and m = 7.98, and the fatigue group σ0 = 43.94 MPa and m = 6.44 (p > 0.05). The probability of survival did not differ significantly between groups. CONCLUSIONS:Fatigue did not affect the bond strength between silica-treated Y-TZP intaglio surfaces and composite cement under these experimental conditions.

The increasing interest in the use of brushite and monetite as resorbable calcium phosphate cements or graft materials is related to the fact of these phases being metastable under physiological environment, with higher solubility than hydroxyapatite phase. In this study, X-ray diffraction (XRD) and scanning electron microscopy with field emission gun (FEG-SEM) analyses were performed in order to assess the temperature influence on the production of calcium phosphate coatings by a chemical deposition method. Titanium substrates were successfully coated with brushite and monetite by a chemical deposition method and a brushite-monetite transformation was assessed with the increasing temperature. Brushite deposition was kinetically favored at low temperatures, whereas monetite was the major phase at higher temperatures