Due to the rising demand for zirconia (Zr) based implant systems, it is important to understand the impact of Zr and titanium (Ti) implants and particularly their topography on soft tissue healing. As human gingival fibroblasts (hGFs) are the predominant cells in peri-implant soft tissue, we focused on examining the effect of implant material and surface roughness on hGFs’ initial attachment, growth and the expression of proteins involved in the focal adhesion. hGFs isolated from eight healthy donors were cultured on the following surfaces: smooth titanium machined surface (TiM), smooth zirconia machined surface (ZrM), moderately rough titanium surface (SLA), or moderately rough zirconia surface (ZLA) for up to 14 days. The initial attachment of hGFs was evaluated by scanning electron microscopy. Cell proliferation/viability was assessed by cell counting kit 8. Focal adhesion and cytoskeleton were visualized by a focal adhesion staining kit. The gene expression of focal adhesion kinase (FAK), α-smooth muscle actin (α-SMA), and integrin subunits ITG-β1, ITG-β4, ITG-α4, ITG-α5, ITG-α6, was evaluated by qPCR. Cell proliferation/viability was slightly decreased by moderately rough surfaces, whereas no effect of surface material was observed. Cell morphology was strikingly different between differently treated surfaces: on machined surfaces, cells had elongated morphology and were attached along the grooves, whereas on moderately rough surfaces, cells were randomly attached. Surface roughness had a more pronounced effect on the gene expression compared to the surface material. The expression of FAK, α-SMA, ITG-β4, ITG-α5, and ITG-α6 was enhanced by moderately rough surfaces compared to smooth surfaces. Within the limitations of this in vitro study, it can be concluded that the behavior of primary hGFs is primarily affected by surface structure, whereas no apparent advantage of Zr over Ti could be observed.

Invisalign aligners have been widely used to correct malocclusions, but their effect on oral cells is poorly known. Previous research evaluated the impact of aligners’ eluates on various cells, but the cell behavior in direct contact with aligners is not yet studied. In the present study, we seeded oral epithelial cells (cell line Ca9-22) directly on Invisalign SmartTrack material. This material is composed of polyurethane and co-polyester and exhibit better mechanical characteristics compared to the predecessor. Cell morphology and behavior were investigated by scanning electron microscopy and an optical cell moves analyzer. The effect of aligners on cell proliferation/viability was assessed by cell-counting kit (CCK)-8 and 3,4,5-dimethylthiazol-2-yl-2,5-diphenyl tetrazolium bromide (MTT) assay and live/dead staining. The expression of inflammatory markers and proteins involved in epithelial barrier function was measured by qPCR. Cells formed cluster-like structures on aligners. The proliferation/viability of cells growing on aligners was significantly lower (p < 0.05) compared to those growing on tissue culture plastic (TCP). Live/dead staining revealed a rare occurrence of dead cells on aligners. The gene expression level of all inflammatory markers in cells grown on aligners’ surfaces was significantly increased (p < 0.05) compared to cells grown on TCP after two days. Gene expression levels of the proteins involved in barrier function significantly increased (p < 0.05) on aligners’ surfaces after two and seven days of culture. Aligners’ material exhibits no cytotoxic effect on oral epithelial cells, but alters their behavior and the expression of proteins involved in the inflammatory response, and barrier function. The clinical relevance of these effects has still to be established.

To reveal the impact of titanium dioxide-based scanning powder for intraoral digital impression on the biological activity of oral fibroblasts. Murine L929 cells and human periodontal ligament (PDLF) and gingival fibroblasts (GF) were treated with ten-fold serial dilutions of scanning powder and the corresponding conditioned medium (filtrate of overnight incubation of powder in medium) starting with 30mg/ml. Bicinchoninic acid protein assay, formazan- and resazurin-based toxicity assays, live/dead and annexin V/propidium iodide (PI) staining and immunoassays for interleukin (IL)-6 and IL-8 were performed. Powder composition was analyzed using energy dispersive X-ray spectroscopy (EDS). Formazan and resazurin conversion was lesser in L929 cells than PDLF and GF in the presence of scanning powder. Induction of cell death was caused by 30mg/ml of powder in L929 cells but not in PDLF and GF. No pronounced impact of the conditioned medium was seen in cytotoxicity assays or live/dead-, and annexin V/PI staining. In PDLF and GF IL-6 expression was increased by the powder, while there was a decrease in IL-8. Powder particles did not deplete protein from medium. EDS showed a heterogeneous mixture consisting predominantly of titanium dioxide. Scanning powder decreased cell activity and induced cell death in L929 cells at high concentrations. Human oral fibroblasts showed an increase in IL-6 levels but more resistance to the cytotoxicity of the powder. Within the limitations of an in vitro study our results suggest that proper cleaning after scanning is of clinical relevance to avoid potential unwanted effects of the powder.

Objectives: The use of lasers for debonding adhesively luted ceramic restorations is a rather recent oral laser application in dentistry. The removal of all-ceramic restorations in the mouth can often be a troublesome task. A novel method for the debonding of ceramic restorations without damaging the restorations is Er:YAG laser irradiation. The aim of this study was to evaluate the Er:YAG laser for debonding procedures of different dental ceramics and to identify appropriate laser settings. Material and methods: Lithium disilicate, zirconium-reinforced lithium silicate, feldspatic ceramic, and zirconium dioxide were investigated. Ten ceramic rectangular-shaped specimens with 1 and 2 mm thickness were produced from each material. All specimens were irradiated with four different power settings 1.5; 2.5; 3.5; 4.5 W, pulse duration 50 μs, laser repetition rate 10 Hz, time of irradiation 10 s. The transmitted energy was measured with a powermeter. Additionally the suitability of the Er:YAG laser to remove the adhesively bonded ceramic and the time until loss of retention was evaluated. Results: The transmission rate for 1 and 2 mm platelets was determined for zirconium-reinforced lithium silicate at 54.6%/35.6%, lithium disilicate at 53.2%/35.7%, zirconium dioxide at 40.6%/32.4%, and for the feldspathic ceramic at 19.4%/10.1%. For zirconium-reinforced lithium silicate and zirconium dioxide 2.5 W (250 mJ/10 Hz) was an appropriate energy level for effective debonding. Whereas for lithium disilicate and for feldspathic ceramic, 4.5 W (450 mJ/10 Hz) is required for efficient debonding. Conclusions: There are differences regarding transmission rates between ceramic types for the Er:YAG laser light and additionally depending on the type of ceramic different energy settings should be used for adequate debonding. Based on our in-vitro experiments we recommend 2.5 W for zirconium-reinforced lithium silicate and zirconium dioxide and 4.5 W for lithium disilicate and feldspatic ceramic. Transmission rates of different ceramic types and varying influences of thicknesses and bonding materials should be considered to adjust the laser parameters during laser debonding of adhesively luted all-ceramic restorations.

Background: Diode-assisted endodontics is nowadays utilized for pulp space disinfection, but little is known on the bonding potential of this lased root dentin when the tooth is restored with an intracanal polymer post. Objectives: to investigate the influence of diode laser irradiation settings, in laser-assisted endodontics, on the intraradicular bonding of composite materials. Methods: Sixteen two-rooted, maxillary first premolars were collected, prepared up to F4 (Protaper Universal. Dentsply-Maillefer, Ballaigues, Switzerland), and randomly assigned in two groups: group A (chopped mode or short pulse), diode irradiated according to protocol, pulse 25 ms, power 2.5 W, and group B (microchopped mode or ultrashort pulse), pulse 25 μs, peak power 12 W (both groups GentleRay. KaVo Dental, Biberach an der Riss, Germany). Buccal canals were irradiated, palatal ones served as controls. Canals were then obturated, post space was created in all canals, and quartz-fiber posts (ICE light Danville. Danville Materials, San Ramon, CA, USA) were cemented by self-etch self-curing cement (Max Cem Elite. Kerr, West Collins Orange, CA, USA) (Max Cem Elite. Kerr, Brea, CA, USA). A week later, teeth were sectioned horizontally in 1 mm increments. Push-out test was conducted in a Zwick testing machine (Zwick Roell, Ulm, Germany) at 1 mm/min speed, and the force required to dislodge the post from each specimen (F-max) was recorded. Weibull regression models were applied for statistical analyses. Results: Differences in F-max by group (control vs. chopped mode vs. microchopped mode) and height (meaning the apical-to-coronal position of each specimen along the root) were statistically significant (p < 0.05 in all cases). Conclusions: Short pulses (or chopped mode) had a profound positive effect on the quality of intraradicular bonding, while Ultrashort pulses (or microchopped mode) affected it negatively. In addition, apically positioned bonding proved weaker compared with more coronally located specimens.

Background: Reduced bond strengths in hypmineralised enamel have been reported with increased restorative failures. This study aimed to investigate the shear bond strengths of resin composite to hypomineralised enamel and dentin bonded with two different adhesive systems and pre-treatments. Methods: Thirty-six freshly extracted first permanent molars with MIH and 17 sound third molars were used for shear bond strength tests in enamel and dentin. Specimens of control groups were bonded to resin composite using Scotchbond^TM Universal Plus and Adper^TM Scotchbond 1XT. MIH-affected enamel specimens of six test groups were pre-treated with various chemical agents, such as 35% phosphoric acid, 5% NaOCl, resin infiltration with ICON^®, or a combination of these agents prior to bonding with composite resin using Scotchbond^TM Universal Plus. Bonded specimens were subsequently sheared at a crosshead speed of 1.0 mm/min, after which their fracture modes were recorded. The mean bond strengths of all groups were compared using a one-way analysis of variance test (ANOVA) and a Bonferroni–Holm analysis was performed for pairwise comparison between the groups. The association between modes of failure was examined with Pearson’s chi-square test. Results: Mean shear bond strength values were highest for sound dentin specimens (Group SD 2) bonded with Scotchbond^TM Universal Plus (23.76 ± 7.68 MPa). Sound enamel specimens (Group SE 2) exhibited significantly higher mean bond strength values than MIH-enamel specimens (Group HE 2) when bonded with Scotchbond^TM Universal Plus (19.68 ± 6.25 vs. 11.53 ± 3.29 MPa, p < 0.001). Oxidative pre-treatment followed by resin infiltration significantly improved bond strengths to hypomineralised enamel (Group HE 6) (17.84 ± 2.98 MPa, p < 0.05). Bond strengths to sound and hypomineralised enamel and dentin did not differ significantly for both adhesives. Conclusions: Within the limitations of an in vitro study, oxidative pre-treatment in combination with resin infiltration seems to be beneficial when planning adhesive restorations with composite in hypomineralised enamel. Both Scotchbond^TM Universal Plus and Adper^TM Scotchbond 1XT can be used for bonding of resin composite to MIH-affected enamel and dentin.