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OBJECTIVES: This study aimed to investigate the antimicrobial properties of three dimensionally-printed dental polymers (3DPs) incorporated with microencapsulated phytochemicals (MPs) and to assess their surface characteristics and cytotoxicity. METHODS: MPs derived from phytoncide oil and their specific chemical components were introduced into suspensions of three microbial species: Streptococcus gordonii, Streptococcus oralis, and Candida albicans. Optical density was measured to determine the microbial growth in the presence of MPs for testing their antimicrobial activity. MPs at 5% (w/w) were mixed with dental polymers and dispersants to 3DP discs. These microbial species were then seeded onto the discs and incubated for 24 h. The antibacterial and antifungal activities of MP-containing 3DPs were evaluated by counting the colony-forming units (n = 3). The biofilm formation on the 3DP was assessed by crystal violet staining assay (n = 3). Microbial viability was determined using a live-dead staining and CLSM observation (n = 3). Surface roughness and water contact angle were assessed (n = 10). Cytotoxicity of MP-containing 3DPs for human gingival fibroblast was evaluated by MTT assay. RESULTS: MPs, particularly (-)-α-pinene, suppressed the growth of all tested microbial species. MP-containing 3DPs significantly reduced the colony count (P ≤ 0.001) and biofilm formation (P ≤ 0.009), of all tested microbial species. Both surface roughness (P < 0.001) and water contact angle (P < 0.001) increased. The cytotoxicity remained unchanged after incorporating MPs to the 3DPs (P = 0.310). CONCLUSIONS: MPs effectively controlled the microbial growth on 3DPs as evidenced by the colony count, biofilm formation, and cell viability. Although MPs modified the surface characteristics, they did not influence the cytotoxicity of 3DPs. CLINICAL SIGNIFICANCE: Integration of MPs into 3DPs could produce dental prostheses or appliances with antimicrobial properties. This approach not only provides a proactive solution to reduce the risk of oral biofilm-related infection but also ensures the safety and biocompatibility of the material, thereby improving dental care.

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Statement of problem: Biomaterials, including polymethyl methacrylate (PMMA) and bisacrylate, have been widely used as conventional interim materials and may exhibit cytotoxicity or systemic toxicity. Purpose: This study was designed to compare the mechanical properties of polylactic acid (PLA) as an alternative to conventional dental polymers for computer-aided design and manufacturing (CAD/CAM). Material and methods: Four groups (n = 20 per group) of CAD/CAM polymers were assessed. Specimens of PLA (PLA Mill) and PMMA (PMMA Mill) for subtractive manufacturing, PLA for fused deposition modeling (PLA FDM), and bisphenol for additive manufacturing by stereolithography (Bisphenol SLA) were fabricated into 2-mm-wide, 2-mm-thick and 25-mm-long specimens using a milling machine, an FDM printer, and an SLA printer, respectively.The flexural strength (FS) and elastic modulus (EM) were calculated. The surface roughness and Shore D hardness were analyzed with a 3D optical surface roughness analyzer and a Shore durometer, respectively. Results: PLA Mill showed the lowest FS (64.9 ± 8.28), followed by PLA FDM (104.27 ± 4.42 MPa), PMMA Mill (139.2 ± 20.95 MPa), and Bisphenol SLA (171.56 ± 15.38 MPa), with statistically significant differences. PLA FDM showed the highest EM, followed by PLA Mill, Bisphenol SLA, and PMMA Mill. Significant differences were observed not only between PMMA Mill and Bisphenol SLA but also between PLA FDM and PLA Mill. The lowest Shore D hardness was observed for PLA FDM, followed by PLA Mill, PMMA Mill, and Bisphenol SLA, which showed the highest value among the 4 groups, with significance. The highest values for the surface roughness parameters were observed for PLA Mill, and the lowest were observed for Bisphenol SLA. Conclusions: Among the tested CAD/CAM polymers, Bisphenol SLA was the most durable material, and the mechanical properties of PLA FDM were within the clinically acceptable range.

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PURPOSE: To investigate antifungal and mechanical properties after the impregnation of Dimethyl Amino-ethyl Hexa-decyl Di-methacrylate (DMAHDM) alone or in combination with Nystatin in polymethylmethacrylate. METHODOLOGY: The control group was fabricated by mixing powder and liquid of PMMA at the ratio of 2.5:1 g/mL. The DMAHDM was added to PMMA liquid and were mixed with PMMA powder. The Nystatin (500,000 International Units (IU)) was mixed with PMMA powder, whereby the composite powder was mixed with the DMAHDM-based liquid. The prepared specimens were tested for fungal adhesion testing (at days 1 and 30), impact strength and flexural strength. Oneway ANOVA post-hoc Tukey's test were used for statistical analysis. RESULTS: Statistical analysis for the adhesion assay revealed that the antifungal activities of unaged and aged specimens in experimental groups were statistically significant as compared to control group A. The groups containing DMAHDM with Nystatin have shown statistically reduced flexural strength. The impact strength test revealed that groups containing 20% DMAHDM alone and DMAHDM with Nystatin showed statistically reduced impact strength compared to the control group. CONCLUSION: Antifungal activities of experimental PMMA resin was increased. The addition of DMAHDM alone in PMMA resin has no deleterious effects on impact and flexural strength, however, at higher concentration values were reduced.

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PURPOSE: Polymers are used in dentistry on a daily basis due to their mechanical, functional and aesthetic properties. However, such biomaterials are subject to deterioration in the oral environment. Thus, this study aimed to evaluate the structural properties of five commonly used dental polymers to determine their best clinical indications. METHODS: Four hundred-fifty samples of five dental polymers (polyethylenterephthalat - glycol modified (PG), polymethyl methacrylate (PA), ethylene vinyl acetate(E), polycarbonate (PC), polyetheretherketone (PK) were prepared to investigate their thermal, structural and chemical characteristics using energy dispersive spectroscopy (EDS), Fourier transform infrared analysis(FTIR), scanning electron microscopy (SEM), differential scanning calorimetry(DSC), thermogravimetric analysis(TGA), X-ray diffraction(XRD), and Shore D hardness test. Data were analyzed using one-way ANOVA, Tukey's HSD, and Levene's tests (α=0.05). RESULTS: PK (87.2) and PA (82.4) displayed the highest hardness values and smooth surfaces, as observed with SEM (p<0.001). Silica was detected in PK, PA, and E by EDS and XRD. The highest glass transition temperature was recorded for PC (145.00±2.00°C) and PK (143.00±1.87°C), while the lowest value was measured for E (50.00±2.12°C)(p<0.001).The highest mass loss was detected for PG (91.40±1.40%) by TGA. CONCLUSIONS: PA and PK polymers can be used for stress-containing treatments due to their mechanical properties. These two materials are also advantageous in terms of plaque accumulation as these polymers reveal smoother surfaces than other groups. Insufficient physical and thermal properties require the use of E with caution and only in limited clinical indications.

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Polymers are the most commonly used material for three-dimensional (3D) printing in dentistry; however, the high porosity and water absorptiveness of the material adversely influence biofilm formation on the surface of the 3D-printed dental prostheses. This study evaluated the effects of a newly developed chlorhexidine (CHX)-loaded polydimethylsiloxane (PDMS)-based coating material on the surface microstructure, surface wettability and antibacterial activity of 3D-printing dental polymer. First, mesoporous silica nanoparticles (MSN) were used to encapsulate CHX, and the combination was added to PDMS to synthesize the antibacterial agent-releasing coating substance. Then, a thin coating film was formed on the 3D-printing polymer specimens using oxygen plasma and thermal treatment. The results show that using the coating substance significantly reduced the surface irregularity and increased the hydrophobicity of the specimens. Remarkably, the culture media containing coated specimens had a significantly lower number of bacterial colony formation units than the noncoated specimens, thereby indicating the effective antibacterial activity of the coating.

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Despite the many advantages of poly (methyl methacrylate) (PMMA) as a dental polymer, its antifungal and antibacterial effects remain limited. Here, phytoncide was incorporated into PMMA to inhibit fungal and biofilm accumulation without impairing the basic and biological properties of PMMA. A variable amount of phytoncide (0 wt % to 5 wt %) was incorporated into PMMA, and the basic material properties of microhardness, flexural strength and gloss were evaluated. In addition, cell viability was confirmed by MTT assay. This MTT assay measures cell viability via metabolic activity, and the color intensity of the formazan correlates viable cells. The fungal adhesion and viability on the PMMA surfaces were evaluated using Candida albicans (a pathogenic yeast). Finally, the thickness of saliva-derived biofilm was estimated. The flexural strength of PMMA decreased with increasing phytoncide contents, whereas there were no significant differences in the microhardness and gloss (p > 0.05) and the cell viability (p > 0.05) between the control and the phytoncide-incorporated PMMA samples. The amounts of adherent Candida albicans colony-forming unit (CFU) counts, and saliva-derived biofilm thickness were significantly lower in the phytoncide-incorporated PMMA compared to the control (p < 0.05). Hence, it was concluded that the incorporation of appropriate amounts of phytoncide in PMMA demonstrated antifungal effects while maintaining the properties, which could be a possible use in dentistry application such as denture base resin.

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OBJECTIVES: The aims of this study were to quantify salivary concentrations of bisphenol A (BPA) and to assess if presence of dental composite fillings is associated with higher BPA levels in saliva. MATERIALS AND METHODS: Twenty individuals with six or more tooth surfaces filled with polymer-based dental materials (composite group) and 20 individuals without any polymer-based materials (control group) were included in the study. Saliva was collected in polypropylene tubes and stored at -80 °C before analysis. Concentration of free (unconjugated) and total bisphenol A was determined by liquid chromatography/mass spectrometry (LC/MS). Values below limit of detection (0.1 ng/mL) were set to one-half of the limit of detection. Mann-Whitney U test (one sided; the Exact Tests Option in IBM-SPSS version 21) was used for the statistical analyses. RESULTS: The concentration of BPA in saliva was very low. In the composite group, 8 of 20 samples had detectable concentrations of BPA. In the control group, 3 of 20 samples had detectable concentrations of BPA. Statistical analysis indicated that the concentration of unconjugated BPA was slightly higher in the composite group (p = 0.044) than in the control group. CONCLUSIONS: Presence of dental composites may be associated with slightly higher concentration of unconjugated BPA in saliva. However, additional studies using sensitive analytical methods are needed before firm conclusions can be drawn. Influence from other factors, like food intake and time of the day for saliva sampling, must be considered. CLINICAL RELEVANCE: The relative contribution of existing polymer-based dental fillings to total BPA exposure seems to be low.

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Dental personnel are at risk as they manually handle polymer products containing monomers and additives that cause irritation and induce allergy. Gloves and face masks can be easily penetrated by monomers. A total of 587 dental personnel and a referent group (585) in the 2 most northern regions of Sweden were included in a questionnaire study (response rate 76%). Questions were asked regarding symptoms of atopy, asthma, conjunctivitis, atopic dermatitis, hand dermatitis, and hay fever/rhinitis. The dental personnel were asked to give the name of polymer products used in their practice and the frequency of use. They were also asked to risk evaluate 5 different types of polymer materials on a scale from 1 to 5. Analysis was done to find if the occurrence of a symptom was associated with a high risk evaluation of a polymer material, or with frequent use of a certain polymer product. Significantly more dentists reported symptoms of atopic dermatitis and conjunctivitis compared to referents and chair assistants. Results show that dental personnel with symptoms risk evaluated most materials significantly higher than dental personnel without symptoms. Further, the occurrence of some symptoms was associated with frequent use of 8 polymer products.