Human tissue is structured mainly of self-assembled polymers (proteins) and ceramics (bone minerals), with metals present as trace elements with molecular scale functions. However, metals and their alloys have played a predominant role as structural biomaterials in reconstructive surgery, especially orthopedics, with more recent uses in non-osseous tissues, such as blood vessels. With the successful routine use of a large variety of metal implants clinically, issues associated with long-term maintenance of implant integrity have also emerged. This review focuses on metallic implant biomaterials, identifying and discussing critical issues in their clinical applications, including the systemic toxicity of released metal ions due to corrosion, fatigue failure of structural components due to repeated loading, and wearing of joint replacements due to movement. This is followed by detailed reviews on specific metallic biomaterials made from stainless steels, alloys of cobalt, titanium and magnesium, as well as shape memory alloys of nickel–titanium, silver, tantalum and zirconium. For each, the properties that affect biocompatibility and mechanical integrity (especially corrosion fatigue) are discussed in detail. Finally, the most critical challenges for metallic implant biomaterials are summarized, with emphasis on the most promising approaches and strategies.

Metallic implant biomaterials

Hygroscopic and hydrolytic effects in dental polymer networks.

Relationship between bond-strength tests and clinical outcomes

The present review surveys studies on physical-chemical properties and biological response of living tissues to NiTi (Nitinol) carried out recently, aiming at an understanding of the place of this material among the implant alloys in use. Advantages of shape memory and superelasticity are analyzed in respect to functionality of implants in the body. Various approaches to surface treatment, sterilization procedures, and resulting surface conditions are analyzed. A review of corrosion studies conducted both on wrought and as-cast alloys using potentiodynamic and potentiostatic techniques in various corrosive media and in actual body fluids is also given. The parameters of localized and galvanic corrosion are presented. The corrosion behavior is analyzed with respect to alloy composition, phase state, surface treatment, and strain and compared to that of conventional implant alloys. Biocompatibility of porous Nitinol, Ni release and its effect on living cells are analyzed based on understanding of the surface conditions and corrosion behavior. Additionally, the paper offers a brief overview of the comparative toxicity of metals, components of commonly used medical alloys, indicating that the biocompatibility profile of Nitinol is conducive to present in vivo applications.

Surface, corrosion and biocompatibility aspects of Nitinol as an implant material.

Adhesion to tooth structure: A critical review of "micro" bond strength test methods

The aim of this paper was to review in vitro and in situ studies that directly compared the use of bovine teeth as a substitute for human teeth in dental experiments. A PubMed search was conducted for papers published from 1953 to December 30, 2010 using the following keywords: "human bovine enamel" or "human bovine dentin" or "human bovine teeth". The abstracts of the studies resulting from the keyword search were read, and all papers that compared human and bovine teeth were fully read. Only original articles written in English and directly comparing human and bovine substrates were included in the review. The search was supplemented by manual searches of the reference lists from each identified paper. Out of 76 studies initially selected, 68 fulfilled the selection criteria for inclusion. The studies covered seven categories: dental morphology, chemical composition, physical properties, dental caries, dental erosion/abrasion, bonding/adhesive strength, and marginal microleakage. Inconsistent data exist regarding whether bovine teeth can be considered an appropriate substitute for human teeth in dental research. Morphological, chemical compostion and physical property differences between the two substrates must be considered when interpreting results obtained from any experiment using bovine tooth substrate.

/pdf/bovine-teeth-as-substitute-for-human-teeth-in-dental-5g9ko15bq3.pdf

Bovine teeth as substitute for human teeth in dental research: a review of literature.

Clinical Relevance While achieving adequate curing at 4-mm thicknesses, not all bulk-fill composites are characterized by low-shrinkage stress. Clinicians should be cautious with these material selections for high C-factor applications.

Polymerization Shrinkage Stress Kinetics and Related Properties of Bulk-fill Resin Composites

Clinical Relevance Achieving a high degree of cure throughout a 2 mm thickness of light-activated resin composite did not occur for many types and shades of resin composite. Clinicians should check...

Depth of Cure of Dental Resin Composites: ISO 4049 Depth and Microhardness of Types of Materials and Shades

Here we report the synthesis, materials characterization, antimicrobial capacity, and cytocompatibility of novel antibiotic-containing scaffolds. Metronidazole (MET) or Ciprofloxacin/(CIP) was mixed with a polydioxanone (PDS)polymer solution at 5 and 25 wt% and processed into fibers. PDS fibers served as a control. Scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR), tensile testing, and high-performance liquid chromatography (HPLC) were used to assess fiber morphology, chemical structure, mechanical properties, and drug release, respectively. Antimicrobial properties were evaluated against those of Porphyromonas gingivalis/Pg and Enterococcus faecalis/Ef. Cytotoxicity was assessed in human dental pulp stem cells (hDPSCs). Statistics were performed, and significance was set at the 5% level. SEM imaging revealed a submicron fiber diameter. FTIR confirmed antibiotic incorporation. The tensile values of hydrated 25 wt% CIP scaffold were significantly lower than those of all other groups. Analysis of HPLC data confirmed gradual, sustained drug release from the scaffolds over 48 hrs. CIP-containing scaffolds significantly (p < .00001) inhibited biofilm growth of both bacteria. Conversely, MET-containing scaffolds inhibited only Pg growth. Agar diffusion confirmed the antimicrobial properties against specific bacteria for the antibiotic-containing scaffolds. Only the 25 wt% CIP-containing scaffolds were cytotoxic. Collectively, this study suggests that polymer-based antibiotic-containing electrospun scaffolds could function as a biologically safe antimicrobial drug delivery system for regenerative endodontics.

/pdf/bioactive-nanofibrous-scaffolds-for-regenerative-endodontics-5bas5u7oo3.pdf

Jeffrey A. Platt

Papers

Bovine teeth as substitute for human teeth in dental research: a review of literature.

Polymerization Shrinkage Stress Kinetics and Related Properties of Bulk-fill Resin Composites

Depth of Cure of Dental Resin Composites: ISO 4049 Depth and Microhardness of Types of Materials and Shades

Bioactive Nanofibrous Scaffolds for Regenerative Endodontics

Bioactive nanofibrous scaffolds for regenerative endodontics