Proteins, Pathogens, and Failure at the Composite-Tooth Interface

In the United States, composites accounted for nearly 70% of the 173.2 million composite and amalgam restorations placed in 2006 (Kingman et al., 2012), and it is likely that the use of composite will continue to increase as dentists phase out dental amalgam. This trend is not, however, without consequences. The failure rate of composite restorations is double that of amalgam (Ferracane, 2013). Composite restorations accumulate more biofilm, experience more secondary decay, and require more frequent replacement. In vivo biodegradation of the adhesive bond at the composite-tooth interface is a major contributor to the cascade of events leading to restoration failure. Binding by proteins, particularly gp340, from the salivary pellicle leads to biofilm attachment, which accelerates degradation of the interfacial bond and demineralization of the tooth by recruiting the pioneer bacterium Streptococcus mutans to the surface. Bacterial production of lactic acid lowers the pH of the oral microenvironment, erodes hydroxyapatite in enamel and dentin, and promotes hydrolysis of the adhesive. Secreted esterases further hydrolyze the adhesive polymer, exposing the soft underlying collagenous dentinal matrix and allowing further infiltration by the pathogenic biofilm. Manifold approaches are being pursued to increase the longevity of composite dental restorations based on the major contributing factors responsible for degradation. The key material and biological components and the interactions involved in the destructive processes, including recent advances in understanding the structural and molecular basis of biofilm recruitment, are described in this review. Innovative strategies to mitigate these pathogenic effects and slow deterioration are discussed.

Evaluation of tensile tetention of Y-TZP crowns after long-term aging: Effect of the core substrate and crown surface conditioning

This study evaluated the effect of the core substrate type (dentin and composite resin) on the retention of crowns made of yttrium oxide stabilized tetragonal zirconia polycrystal (Y-TZP), submitted to three inner surface conditionings. For this purpose, 72 freshly extracted molars were embedded in acrylic resin, perpendicular to the long axis, and prepared for full crowns: 36 specimens had crown preparations in dentin; the remaining 36 teeth had the crowns removed, and crown preparations were reconstructed with composite resin plus fiber posts with dimensions identical to the prepared dentin. The preparations were impressed using addition silicone, and 72 Y-TZP copings for the tensile test were produced. Cementation was performed with a dual-cured cement containing phosphate monomers. For cementation, the crown preparation (dentin or resin) was conditioned with the adhesive system, and the ceramic was subjected to one of three surface treatments: isopropyl alcohol, tribochemical silica coating, or thin low-fusing glassy porcelain layer application plus silanization. After 24 hours, all specimens were submitted to thermocycling (6000 cycles) and placed in a special tensile testing device in a universal testing machine to determine failure loads. The failure modes of all samples were analyzed under a stereomicroscope. Two-way analysis of variance showed that the surface treatment and substrate type (alpha=0.05) affected the tensile retention results. The dentin substrate presented the highest tensile retention values, regardless of the surface treatment. When the substrate was resin, the tribochemical silica coating and low-fusing glaze application plus silanization groups showed the higher retention values.

Avaliação da adesão de Staphylococcus spp. em resina acrílica específica para prótese ocular e alteração de cor de botões de íris artificiais, variando a cor e as técnicas de obtenção, ambos após desinfecção química

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Air abrasion before and/or after zirconia sintering: surface characterization, flexural strength, and resin cement bond strength

The purpose of this in vitro study was to evaluate the effect of air-abrasion/zirconia sintering order on the yttria partially stabilized tetragonal zirconia polycrystal (Y-TZP) surface characterization (roughness, morphology, and phase transformation), flexural strength (FS), and shear bond strength (SBS) to a resin cement. Y-TZP specimens were air abraded with 50-μm Al2O3 particles after (AS), before (BS), or before and after zirconia sintering (BAS). For roughness (Ra), 30 block specimens (12×12×3.0 mm; n=10) had their surfaces analyzed by a profilometer. Next, on the air-abraded surfaces of these specimens, composite resin discs (n=30) were bonded with RelyX ARC. The bonded specimens were stored for 24 hours in distilled water at 37°C before shear testing. Failure mode was determined with a stereomicroscope (20×). The surface morphology (n=2) was evaluated by SEM (500×). For the four-point flexural strength test (EMIC DL2000), 39 bar-shaped specimens (20×4.0×1.2 mm; n=13) were air abraded according to the three conditions proposed, and an additional group (nonabraded) was evaluated (n=13). The quantitative analysis of phase transformation (n=1) was completed with Rietveld refinement with X-ray diffraction data. Ra (μm) and SBS (MPa) data were analyzed by one-way analysis of variance (ANOVA) and the Tukey test (α=0.05). Pearson correlation analysis was used to determine if there was a correlation between roughness and SBS. For FS (MPa) data, one-way ANOVA and the Dunnett C-test (α=0.05) were used. The air-abrasion/zirconia sintering order influenced significantly (p<0.001) Ra, SBS, and FS. The BS and AS groups presented the highest (1.3 μm) and the lowest (0.7 μm) Ra. The highest SBS (7.0 MPa) was exhibited by the BAS group, followed by the AS group (5.4 MPa) and finally by the BS group (2.6 MPa). All groups presented 100% adhesive failure. A weak correlation (r=−0.45, p<0.05) was found between roughness and SBS. The air-abrasion/zirconia sintering order provided differences in the surface morphology. The nonabraded (926.8 MPa) and BS (816.3 MPa) groups exhibited statistically similar FS values but lower values than the AS (1249.1 MPa) and BAS (1181.4 MPa) groups, with no significant difference between them. The nonabraded, AS, BS, and BAS groups exhibited, respectively, percentages of monoclinic phase of 0.0 wt%, 12.2 wt%, 0.0 wt%, and 8.6 wt%. The rougher surface provided by the air-abrasion before zirconia sintering may have impaired the bonding with the resin cement. The morphological patterns were consistent with the surface roughness. Considering the short-term SBS and FS, the BAS group exhibited the best performance. Air abrasion, regardless of its performance order, provides tetragonal to monoclinic transformation, while sintering tends to zero the monoclinic phase content.

Effect of surface treatments on the shear bond strength of luting cements to Y-TZP ceramic

Statement of problem Because zirconia is a glass-free material, alternative surface treatments such as airborne-particle abrasion or silica coating should be used for long-term bonding. However, these surface treatments in combination with different bonding agents and luting cements have not yet been studied. Purpose The purpose of the study was to evaluate the effect of surface treatments on the shear bond strength (SBS) of luting cements to Y-TZP ceramic. Material and methods Zirconia disks (N=240) were airborne-particle abraded with the following particles (n=48): 50 μm Al2O3; 120 μm Al2O3; 30 μm silica-coated Al2O3 (Rocatec Soft); 120 μm Al2O3+110 μm silica-coated Al2O3 (Rocatec Plus); and Rocatec Plus. After silanization of the zirconia surface, composite resin disks were bonded with (n=12) RelyX Luting 2; RelyX ARC; RelyX U100; and Panavia F. The bonded specimens were thermocycled (10 000 cycles) and tested for SBS. Failure mode was determined with a stereomicroscope (×20). The morphology and elemental composition of airborne-particle abraded surfaces were evaluated with scanning electron microscopy (×500) and energy-dispersive x-ray spectroscopy (×50). Results Surface treatments, cements, and their interaction were significant (P<.001). For RelyX ARC, Rocatec Soft and Rocatec Plus provided the highest SBS. In general, surface treatments did not influence the SBS of RelyX U100 and Panavia F. Regardless of the cement, no significant difference was found between 50 μm and 120 μm Al2O3 particles, between Rocatec Soft and Rocatec Plus, or between Rocatec Plus and 120 μm Al2O3 particles+Rocatec Plus. All groups showed adhesive failures. Different particle sizes provided differences in morphological patterns. The elemental composition comprised Al and Al/Si for alumina and silica-abraded zirconia. Conclusions Particle size did not influence the SBS of the groups abraded exclusively with alumina or silica-coated particles. RelyX ARC was more surface-treatment dependent than RelyX U100 or Panavia F.

Repair of composites: Effect of laser and different surface treatments

Objectives: This study investigated the repairs of resin composite restorations after using different surface treatments.Design: Eighty four truncated cones of Filtek Z350 were prepared and thermo-cycled (20,000 cycles). Surfaces were roughened with diamond bur and etched with 37% phosphoric acid. Those cones were divided into 7 groups (N=12): 1) Prime&Bond 2.1; 2) aluminum oxide sandblasting+Prime&Bond 2.1; 3) Er:YAG laser treatment+Prime&Bond 2.1; 4) 9.6% hydrofluoric acid for 2 min-Fsilane coupling agent.; 5) silane coupling agent; 6) auto-polymerized acrylic monomer+Prime&Bond 2.1; 7) Adper Scothbond SE. Teflon device was used to fabricate inverted truncated cones of repair composite over the surface-treated. The bonded specimens were stressed to failure under tension. The data were analyzed with oneway ANOVA and Tukey tests.Results: Mean repair strengths (SD, in MPa) were, Group-2: 18.8a; Group-1: 18.7a; Group-6: 13.4ab; Group-7: 9.5bc; Group-3: 7.5bcd; Group-4: 5.2cd; Group-5: 2.6d.Conclusions: The use of diamond bur and a conventional adhesive and the use of aluminum oxide sandblasting prior to adhesive provided a simple and cost-effective solutions to composite repair. Er:YAG laser, silane alone, 9.6% hydrofluoric acid plus silane or a self-etching adhesive results in inferior composite repair strengths. (C) 2015 Elsevier Ltd. All rights reserved.

Erosive cola-based drinks affect the bonding to enamel surface: an in vitro study

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

KCNQ Channels Determine Serotonergic Modulation of Ventral Surface Chemoreceptors and Respiratory Drive

Chemosensitive neurons in the retrotrapezoid nucleus (RTN) regulate breathing in response to CO2/H+ changes. Their activity is also sensitive to neuromodulatory inputs from multiple respiratory centers, and thus they serve as a key nexus of respiratory control. However, molecular mechanisms that control their activity and susceptibility to neuromodulation are unknown. Here, we show in vitro and in vivo that KCNQ channels are critical determinants of RTN neural activity. In particular, we find that pharmacological block of KCNQ channels (XE991, 10 mu M) increased basal activity and CO2 responsiveness of RTN neurons in rat brain slices, whereas KCNQ channel activation (retigabine, 2-40 mu M) silenced these neurons. Interestingly, we also find that KCNQ and apamin-sensitive SK channels act synergistically to regulate firing rate of RTN chemoreceptors; simultaneous blockade of both channels led to a increase in CO2 responsiveness. Furthermore, we also show that KCNQ channels but not SK channels are downstream effectors of serotonin modulation of RTN activity in vitro. In contrast, inhibition of KCNQ channel did not prevent modulation of RTN activity by Substance P or thyrotropin-releasing hormone, previously identified neuromodulators of RTN chemoreception. Importantly, we also show that KCNQ channels are critical for RTN activity in vivo. Inhibition of KCNQ channels lowered the CO2 threshold for phrenic nerve discharge in anesthetized rats and decreased the ventilatory response to serotonin in awake and anesthetized animals. Given that serotonergic dysfunction may contribute to respiratory failure, our findings suggest KCNQ channels as a new therapeutic avenue for respiratory complications associated with multiple neurological disorders.

Evaluation of a nanometer roughness scale resorbable media-processed surface: a study in dogs

Objectives: This study compared the biomechanical fixation and bone-to-implant contact (BIC) of implants with different surfaces treatment (experimental resorbable blasting media-processed nanometer roughness scale surface, and control dual acid-etched) in a dog model. Material and methods: Surface characterization was made in six implants by means of scanning electron microscopic imaging, atomic force microscopy to evaluate roughness parameters, and X-ray photoelectron spectroscopy (XPS) for chemical assessment. The animal model comprised the bilateral placement of control (n = 24) and experimental surface (n = 24) implants along the proximal tibiae of six mongrel dogs, which remained in place for 2 or 4 weeks. Half of the specimens were biomechanically tested (torque), and the other half was subjected to histomorphologic/ morphometric evaluation. BIC and resistance to failure measures were each evaluated as a function of time and surface treatment in a mixed model ANOVA. Results: Surface texturing was significantly higher for the experimental compared with the control surface. The survey XPS spectra detected O, C, Al, and Ti at the control group, and Ca (similar to 0.2-0.9%) and P (similar to 1.7-4.1%) besides O, C, Al, and Ti at experimental surfaces. While no statistical difference in BIC was found between experimental and control surfaces or between 2 and 4 weeks in vivo, both longer time and use of experimental surface significantly increased resistance to failure. Conclusions: The experimental surface resulted in enhanced biomechanical fixation but comparable BIC relative to control, suggesting higher bone mechanical properties around the experimental implants.

Periodontopathogens around the surface of mini-implants removed from orthodontic patients

Objective: To verify if mini-implant mobility is affected by the presence of periodontopathogens, frequently associated with peri-implantitis. Materials and Methods: The surfaces of 31 mini-implants used for skeletal anchorage in orthodontic patients were evaluated. Polymerase chain reaction was used for identification of the presence of DNA from three different periodontopathogens (P. intermedia [Pi], A. actinomycetemcomitans [Aa], and P. gingivalis [Pg]) in 16 mini-implants without mobility (control group) and 15 mini-implants with mobility (experimental group). Results: The results showed that Pi was present in 100% of the samples, from both groups: Aa was found in 31.3% of the control group and in 13.3% of the experimental group. Pg was detected in 37.4% of the control group and in 33.3% of the experimental group. The Fisher exact test and the odds ratio (OR) values for Aa and Pg (OR = 0.34; 95% confidence interval [CI]: 0.05-2.10 and OR = 0.61; 95% Cl: 0.13-2.79, respectively) showed no significant association (P > .05) between the periodontopathogens studied and the mobility of the mini-implants. Conclusions: It can be concluded that the presence of Aa, Pi, and Pg around mini-implants is not associated with mobility. (Angle Orthod. 2012;82:591-595.)

Evaluation of Chemical Treatment on Zirconia Surface with Two Primer Agents and an Alkaline Solution on Bond Strength

Objectives: This study evaluated the effect of an alkaline solution and two 10-methacryloyloxydecyl dihydrogen phosphate (MDP)-based primer agents on bond strength to zirconia (yttria-stabilized tetragonal zirconium polycrystal [Y-TZP]) through the shear bond strength (SBS) test. Materials and Methods: Sixty square-shaped Y-TZP samples were embedded in an acrylic resin mold, polished, and randomly assigned to one of six groups (n=10) according to treatment surface: group CR, no treatment (control); group NaOH, 0.5 M NaOH; group AP, Alloy Primer; group ZP, Z-Primer Plus; group NaOH-AP, 0.5 M NaOH + Alloy Primer; and group NaOH-ZP, 0.5 M NaOH + Z-Primer Plus. The resin cement (Rely X U100) was applied inside a matrix directly onto the Y-TZP surface, and it was light-cured for 40 seconds. The samples were stored in distilled water at 37 C for 24 hours prior to the test, which was performed in a universal machine at a crosshead-speed of 0.5 mm/min. The data were analyzed by one-way analysis of variance and Tukey tests (p<0.05). Light stereomicroscopy and scanning electron microscopy were used to assess the surface topography and failure mode. Results: The SBS was significantly affected by the chemical treatment (p<0.0001). The AP group displayed the best results, and the use of NaOH did not improve SBS results relative to either AP or ZP. The samples treated with Alloy Primer displayed mainly mixed failures, whereas those conditioned with Z-Primer Plus or with 0.5 M NaOH presented a balanced distribution of adhesive and mixed failure modes. Conclusions: The use of a NaOH solution may have modified the reactivity of the Y-TZP surface, whereas the employment of a MDP/6-4-vinylbenzyl-n-propyl amino-1,3,5-triazine2,4-dithione-based primer enhanced the Y-TZP bond strength.

Comportamento tribologico di materiali per componenti di interesse industriale: Failure analysis e prove tribologiche in laboratorio

L’attività di ricerca della presente tesi di dottorato ha riguardato sistemi tribologici complessi di interesse industriale per i quali sono stati individuati, mediante failure analysis, i meccanismi di usura dominanti. Per ciascuno di essi sono state studiate soluzioni migliorative sulla base di prove tribologiche di laboratorio. Nella realizzazione di maglie per macchine movimentazione terra sono ampiamente utilizzati i tradizionali acciai da bonifica. La possibilità di utilizzare i nuovi microlegati a medio tenore di carbonio, consentirebbe una notevole semplificazione del ciclo produttivo e benefici in termini di costi. Una parte della tesi ha riguardato lo studio del comportamento tribologico di tali acciai. E’ stato anche affrontato lo studio tribologico di motori idraulici, con l’obiettivo di riuscire a migliorarne la resistenza ad usura e quindi la vita utile. Sono state eseguite prove a banco, per valutare i principali meccanismi di usura, e prove di laboratorio atte a riprodurre le reali condizioni di utilizzo, valutando tecniche di modificazione superficiale che fossero in grado di ridurre l’usura dei componenti. Sono state analizzate diverse tipologie di rivestimenti Thermal Spray in termini di modalità di deposizione (AFS-APS) e di leghe metalliche depositate (Ni,Mo,Cu/Al). Si sono infine caratterizzati contatti tribologici nel settore del packaging, dove l’utilizzo di acciai inox austenitici è in alcuni casi obbligatorio. L’acciaio inossidabile AISI 316L è ampiamente utilizzato in applicazioni in cui siano richieste elevate resistenze alla corrosione, tuttavia la bassa resistenza all’usura, ne limitano l’impiego in campo tribologico. In tale ambito, è stata analizzata una problematica tribologica relativa a macchine automatiche per il dosaggio di polveri farmaceutiche. Sono state studiate soluzioni alternative che hanno previsto sia la completa sostituzione dei materiali della coppia tribologica, sia l’individuazione di tecniche di modificazione superficiale innovative quali la cementazione a bassa temperatura anche seguita dalla deposizione di un rivestimento di carbonio amorfo idrogenato a-C:H

Effect of substrate surface roughening and cold spray coating on the fatigue life of AA2024 specimens

The effects of cold spray coating and substrate surface preparation on crack initiation under cyclic loading have been studied on Al2024 alloy specimens. Commercially pure (CP) aluminum feedstock powder has been deposited on Al2024-T351 samples using a cold-spray coating technique known as high velocity particle consolidation. Substrate specimens were prepared by surface grit blasting or shot peening prior to coating. The fatigue behavior of both coated and uncoated specimens was then tested under rotating bend conditions at two stress levels, 180 MPa and 210 MPa. Scanning electron microscopy was used to analyze failure surfaces and identify failure mechanisms. The results indicate that the fatigue strength was significantly improved on average, up to 50% at 180 MPa and up to 38% at 210 MPa, by the deposition of the cold-sprayed CP-Al coatings. Coated specimens first prepared by glass bead grit blasting experienced the largest average increase in fatigue life over bare specimens. The results display a strong dependency of the fatigue strength on the surface preparation and cold spray parameters

Aquatic therapies in patients with compromised left ventricular function and heart failure

With water immersion, gravity is partly eliminated, and the water exerts a pressure on the body surface. Consequently there is a blood volume shift from the periphery to the central circulation, resulting in marked volume loading of the thorax and heart. This paper presents a selection of published literature on water immersion, balneotherapy, aqua exercises, and swimming, in patients with left ventricular dysfunction (LVD) and/or stable chronic heart failure (CHF). Based on exploratory studies, central hemodynamic and neurohumoral responses of aquatic therapies will be illustrated. Major findings are: 1. In LVD and CHF, a positive effect of therapeutic warm-water tub bathing has been observed, which is assumed to be from afterload reduction due to peripheral vasodilatation caused by the warm water. 2. In coronary patients with LVD, at low-level water cycling the heart is working more efficiently than at lowlevel cycling outside of water. 3. In patients with previous extensive myocardial infarction, upright immersion to the neck resulted in temporary pathological increases in mean pulmonary artery pressure (mPAP) and mean pulmonary capillary pressures (mPCP). 4. Additionally, during slow swimming (20-25m/min) the mPAP and/or PCP were higher than during supine cycling outside water at a 100W load. 5. In CHF patients, neck- deep immersion resulted in a decrease or no change in stroke volume. 6. Although patients are hemodynamically compromised, they usually maintain a feeling of well-being during aquatic therapy. Based on these findings, clinical indications for aquatic therapies are proposed and ideas are presented to provoke further research.

Effect of zirconia surface treatments on the shear strength of zirconia/veneering ceramic composites

Aim of the investigation was to assess the effect of different surface treatments on the bond strength of veneering ceramics to zirconia. In a shear test, the influences of polishing, sandblasting, and silica-coating of the zirconia surface on bonding were assessed with five different veneering ceramics. In addition the effect of liner application was examined. With one veneering ceramic, the impact of regeneration firing of zirconia was also evaluated. Statistical analysis was performed with one-way ANOVA and post hoc Scheffé's test. Failure in every case occurred in the veneering ceramic adjacent to the interface with a thin layer of ceramic remaining on the zirconia surface, indicating that bond strength was higher than the cohesive strength of the veneering ceramic. Shear strength ranged from 23.5 +/- 3.4 MPa to 33.0 +/- 6.8 MPa without explicit correlation to the respective surface treatment. Regeneration firing significantly decreased the shear strength of both polished and sandblasted surfaces. Findings of this study revealed that bonding between veneering ceramics and zirconia might be based on chemical bonds. On this note, sandblasting was not a necessary surface pretreatment to enhance bond strength and that regeneration firing was not recommended.