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Rotatory dental instruments generate atmospheric aerosols that settle on various surfaces, including the dentist's head. The aim of this study was to quantitatively assess bacterial contamination of the dentist's head and to evaluate whether it is affected by using a rubber dam. Senior dental students (n=52) were asked to wear autoclaved headscarves as collection media while performing restorative dental treatment with and without a rubber dam. Four points from each headscarf were swabbed for bacterial culture after 30min of operative work. Bacterial contamination was quantified by counting the colony-forming units. Regardless of the collection point, using a rubber dam was associated with more bacterial colony-forming units than not using a rubber dam (P=0.009). Despite its clinical value, the rubber dam seems to result in significantly higher aerosol levels on various areas of the dentist's head, requiring that dentists cover their heads with suitable protective wear.

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Background Gingival tissue attachment is known to be important for long‐term prognosis of implants. This in vitro study evaluated the gingival attachment to zirconia implants and zirconia implants modified with sol‐gel derived TiO2 coatings. Methods Zirconia endodontic posts (n = 23) were used to function as implants that were inserted into the center of full‐thickness porcine gingival explants (n = 31). The tissue/implant specimens were then individually placed at an air/liquid interface on a stainless‐steel grid in cell culture wells containing a nutrient solution. The tissue cultures were incubated at 37°C in a 5% CO2 environment and at days 7 and 14, the specimens were harvested and analyzed by dynamic mechanical analysis (DMA) measurements under dynamic loading conditions mimicking natural mastication. Specimens were also analyzed by immunohistochemical staining identifying the laminin (Ln) γ2 chain specific for Ln‐332, which is known to be a crucial molecule for the proper attachment of epithelium to tooth/implant surface. Results Tissue attachment to TiO2‐coated zirconia demonstrated higher dynamic modulus of elasticity and higher creep modulus, meaning that the attachment is stronger and more resistant to damage during function over time. Laminin γ2 was identified in the attachment of epithelium to TiO2‐coated zirconia. Conclusions Both DMA and histological analysis support each other, so the gingival tissue is more strongly attached to sol‐gel derived TiO2‐coated zirconia than uncoated zirconia. Immunohistochemical staining showed that TiO2 coating may enhance the synthesis and deposition of Ln‐332 in the epithelial attachment to the implant surface.

The purpose of this study was to evaluate the effect of sol-gel derived bioactive coatings on the biaxial flexural strength and fibroblast proliferation of zirconia, aimed to be used as an implant abutment material. Yttrium stabilized zirconia disc-shaped specimens were cut, ground, sintered, and finally cleansed ultrasonically in each of acetone and ethanol for 5 minutes. Three experimental groups (n = 15) were fabricated, zirconia with sol-gel derived titania (TiO ) coating, zirconia with sol-gel derived zirconia (ZrO ) coating, and non-coated zirconia as a control. The surfaces of the specimens were analyzed through images taken using a scanning electron microscope (SEM), and a non-contact tapping mode atomic force microscope (AFM) was used to record the surface topography and roughness of the coated specimens. Biaxial flexural strength values were determined using the piston-on-three ball technique. Human gingival fibroblast proliferation on the surface of the specimens was evaluated using AlamarBlue assay™. Data were analyzed using a one-way analysis of variance (ANOVA) followed by Tukey's post-hoc test. Additionally, the biaxial flexural strength data was also statistically analyzed with the Weibull distribution. The biaxial flexural strength of zirconia specimens was unaffected (p > 0.05). Weibull modulus of TiO coated and ZrO coated groups (5.7 and 5.4, respectively) were lower than the control (8.0). Specimens coated with ZrO showed significantly lower fibroblast proliferation compared to other groups (p < 0.05). In conclusion, sol-gel derived coatings have no influence on the flexural strength of zirconia. ZrO coated specimens showed significantly lower cell proliferation after 12 days than TiO coated or non-coated control. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2401-2407, 2017.

Prevention of bacterial inflammation around dental implants (peri-implantitis) is one of the keys to success of the implantation and can be achieved by securing the gingival tissue-abutment interface preventing penetration of bacteria. Modern dental practice has adopted zirconia abutments in place of titanium, but the adhesion of gingival tissue to zirconia is inferior to titanium. The aim of this study was to assess and improve the adhesion of mucosal tissues to zirconia posts using sol-gel derived TiO2 coating following dynamic mechanical testing. The posts were cultivated with porcine bone-gingival tissue specimens in vitro for 7 and 14 days and then subjected to dynamic mechanical analysis simulating physiological loading at 1 Hz up to 50 μm amplitude. In parallel in silico analysis of stresses and strains have been made simulating “the worst case” when the fixture fails in osseointegration while the abutment still holds. Results show treatment of zirconia can lead to double interface stiffness (static shear stiffness values from 5–10 to 17–23 kPa and dynamic from 20–50 to 60–125 kPa), invariant viscostiffness (from 5–35 to 45–90 kPa·sα) and material memory values (increased from 0.06–0.10 to 0.17–0.25), which is beneficial in preventing bacterial contamination in dental implants. This suggests TiO2-coated zirconia abutments may have a significant clinical benefit for prevention of the bacterial contamination.

This in vitro study was designed to evaluate the effect of sol-gel derived TiO2coating on blood coagulation, blood protein adsorption, and platelet response on zirconia surfaces. Square-shaped zirconia (n=96) (10x10x2 mm) was cut, ground, sintered, and finally cleansed ultrasonically in each of acetone and ethanol for 5 minutes. Three experimental groups (n=32) were fabricated: (a) zirconia coated with sol-gel derived TiO2, (b) zirconia coated with sol-gel derived TiO2and treated with ultraviolet (UV) irradiation for 1 hour, and (c) non-coated zirconia as control. The coatings were prepared from tetraisopropyl orthotitanate solution by dip-coating. The thrombogenicity of the specimens was evaluated using a whole blood kinetic clotting time method where the extent of blood clotting was evaluated at 10, 20, 30, 40, 50, and 60 minutes (n=4/time point, total n=24/group). Scanning electron microscope images were taken to observe platelet morphologies after 1-hour incubation with platelet-rich plasma (PRP) (n=5/group). Surface characteristics were visualized using atomic force microscopy (n=1/group). Adsorption of plasma proteins and fibronectin on each surface was studied by gel electrophoresis (n=2/group). Significant differences were observed in blood coagulation between the test groups at 20-, 30-, 40-, and 50-minute time points (p<0.005). UV treated TiO2coated specimens showed fastest blood coagulation followed by TiO2coated and non-coated specimens. Furthermore, platelets appeared at a higher activation state on coated specimens. Gel electrophoresis revealed no difference in protein adsorption among the experimental groups. In summary, TiO2coatings promoted blood coagulation, and it was further enhanced by UV treatment, which has the potential to hasten the wound healing process in vivo.