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Functionally graded biomimetic biomaterials in dentistry: an evidence-based update

Qasim SSB, Zafar MS, Niazi FH, Alshahwan M, Omar H, Daood U

J Biomater Sci Polym Ed, 2020 06;31(9):1144-1162.
PMID: 32202207 DOI: 10.1080/09205063.2020.1744289

Design and development of novel therapeutic strategies to regenerate lost tissue structure and function is a serious clinical hurdle for researchers. Traditionally, much of the research is dedicated in optimising properties of scaffolds. Current synthetic biomaterials remain rudimentary in comparison to their natural counterparts. The ability to incorporate biologically inspired elements into the design of synthetic materials has advanced with time. Recent reports suggest that functionally graded material mimicking the natural tissue morphology can have a more exaggerated response on the targeted tissue. The aim of this review is to deliver an overview of the functionally graded concept with respect to applications in clinical dentistry. A comprehensive understanding of spatiotemporal arrangement in fields of restorative, prosthodontics, periodontics, orthodontics and oral surgery is presented. Different processing techniques have been adapted to achieve such gradients ranging from additive manufacturing (three dimensional printing/rapid prototyping) to conventional techniques of freeze gelation, freeze drying, electrospinning and particulate leaching. The scope of employing additive manufacturing technique as a reliable and predictable tool for the design and accurate reproduction of biomimetic templates is vast by any measure. Further research in the materials used and refinement of the synthesis techniques will continue to expand the frontiers of functionally graded membrane based biomaterials application in the clinical domain.
Fulltext Fit Accuracy of Removable Partial Denture Frameworks Fabricated with CAD/CAM, Rapid Prototyping, and Conventional Techniques: A Systematic Review

Ahmed N, Abbasi MS, Haider S, Ahmed N, Habib SR, Altamash S, et al.

Biomed Res Int, 2021;2021:3194433.
PMID: 34532499 DOI: 10.1155/2021/3194433

Objective: Analyzing and comparing the fit and accuracy of removable partial denture (RPDs) frameworks fabricated with CAD/CAM and rapid prototyping methods with conventional techniques.
Materials and Methods: The present systematic review was carried out according to PRISMA guidelines. The search was carried out on PubMed/MEDLINE, Cochrane collaboration, Science direct, and Scopus scientific engines using selected MeSH keywords. The articles fulfilling the predefined selection criteria based on the fit and accuracy of removable partial denture (RPD) frameworks constructed from digital workflow (CAD/CAM; rapid prototyping) and conventional techniques were included.
Results: Nine full-text articles comprising 6 in vitro and 3 in vivo studies were included in this review. The digital RPDs were fabricated in all articles by CAD/CAM selective laser sintering and selective laser melting techniques. The articles that have used CAD/CAM and rapid prototyping technique demonstrated better fit and accuracy as compared to the RPDs fabricated through conventional techniques. The least gaps between the framework and cast (41.677 ± 15.546 μm) were found in RPDs constructed through digital CAD/CAM systems.
Conclusion: A better accuracy was achieved using CAD/CAM and rapid prototyping techniques. The RPD frameworks fabricated by CAD/CAM and rapid prototyping techniques had clinically acceptable fit, superior precision, and better accuracy than conventionally fabricated RPD frameworks.
Different pontic design for porcelain fused to metal fixed dental prosthesis: Contemporary guidelines and practice by general dental practitioners

Raza Kazmi SM, Iqbal Z, Muneer MU, Riaz S, Zafar MS

Eur J Dent, 2018 8 28;12(3):375-379.
PMID: 30147402 DOI: 10.4103/ejd.ejd_232_18

Objective: The current study aimed to assess the knowledge and practice of pontic design selection by the general dental practitioners (GDPs) in the light of contemporary guidelines.
Materials and Methods: This cross-sectional study was conducted among the GDPs of Karachi. A questionnaire was designed to collect data from 100 GDPs. The questionnaire included general/demographic information (practitioner's education, experience, and place of practice) and an average number of fixed prosthesis constructed by the GDP. The questionnaire was further categorized to evaluate the knowledge/practice of pontic design selection and latest recommendations.
Results: For the maxillary anterior segment, the ridge lap pontic was the most common (32%) followed by the modified ridge lap (28%). In the maxillary posterior segment, the ridge lap pontic was the most common (37%) followed by sanitary design (34%). For the mandibular anterior segment, the modified ridge lap (50%) was the most common followed by ridge lap pontic (17%). In case of the mandibular posterior segment, the sanitary design (34%) was the most common followed by ridge lap pontic (30%).
Conclusions: The pontic design selection for the fixed prosthesis is a neglected domain. The contemporary guidelines are not followed with full spirit by the GDPs leading to wide variations in the pontic design selection.
Fulltext Characterization of various acrylate based artificial teeth for denture fabrication

Muhammad N, Sarfraz Z, Zafar MS, Liaqat S, Rahim A, Ahmad P, et al.

J Mater Sci Mater Med, 2022 Jan 24;33(2):17.
PMID: 35072817 DOI: 10.1007/s10856-022-06645-8

Acrylic resins-based artificial teeth are frequently used for the fabrication of dentures has and contribute a very strong share in the global market. However, the scientific literature reporting the comparative analysis data of various artificial teeth is scarce. Focusing on that, the present study investigated various types of commercially available artificial teeth, composed of polymethyl methacrylate (PMMA). Artificial teeth are characterized for chemical analysis, morphological features, thermal analysis, and mechanical properties (surface hardness, compressive strength). Different types of artificial teeth showed distinct mechanical (compression strength, Vickers hardness) and thermal properties (thermal gravimetric analysis) which may be attributed to the difference in the content of PMMA and type and quantity of different fillers in their composition. Thermogravimetric analysis (TGA) results exhibited that vinyl end groups of PMMA degraded above 200 °C, whereas 340-400 °C maximum degradation temperature was measured by differential thermal analysis (DTA) for all samples. Crisma brand showed the highest compressive strength and young modulus (88.6 MPa and 1654 MPa) while the lowest value of Vickers hardness was demonstrated by Pigeon and Vital brands. Scanning electron microscope (SEM) photographs showed that Crisma, Pigeon, and Vital exhibited characteristics of a brittle fracture; however, Artis and Well bite brands contained elongated voids on their surfaces. According to the mechanical analysis and SEM data, Well bite teeth showed a significantly higher mechanical strength compared to other groups. However, no considerable difference was observed in Vickers hardness of all groups. Graphical abstract.
Fulltext Physical activities pre- and post-COVID-19 vaccination and its implementations: A narrative review

Al-Mhanna SB, Wan Ghazali WS, Maqsood A, Mohamed M, Ahmed N, Afolabi HA, et al.

SAGE Open Med, 2023;11:20503121231158981.
PMID: 36909796 DOI: 10.1177/20503121231158981

Coronavirus disease 2019 is a severe communicable pulmonary medical problem that has been a challenging disease for everyone in the globe, but vaccines development and administration against this severe acute respiratory syndrome-inducing disease (coronavirus disease 2019) are currently yielding fabulous results. The mean duration of the coronavirus disease 2019 pandemic for this study spanned from 2020 until 2022. These manifestations are accompanied by symptoms of respiratory tract illnesses such as non-productive cough, sore throat, and nasal discharge. Relevant reviews on coronavirus disease 2019 manifestations and outcomes, consisting mainly of the infections/outbreaks, experimental information, and pre- and post-serovaccination details that occurred, were described. After a typical vaccination course, the study aims to summarize and understand more about the effectiveness of exercise on the pre-and post-coronavirus disease 2019 vaccination and its implementations. Physical activity is an immunological function adjuvant to decrease communicable disease risk and enhance immunity post-viral infection vaccination. Moderate-intensity resistance exercisesession directly before getting the influenza vaccine decreases vaccine responses in older adults, such as redness, pain, or inflammation at the injection spot or other adverse consequences compared to the inactive circumstance. However, it was reported that exercise after a shot is generally safe as long as vaccinated people feel well enough. Though exercise before or after vaccination has no negative impact on the protection afforded by the vaccine, people can exercise immediately after receiving the vaccine, as any changes in blood flow will not affect the vaccine's response. One episode of light-to-moderate-intensifying exercise after vaccination may improve the antibody reactions to influenza or the coronavirus disease 2019 vaccine. Vaccination administered pre- and post-regular exercise is an effective approach for boosting antibody responses due to its immunostimulant effects. Future research should investigate how different vaccine antibodies respond to low, moderate, and high physical activity levels.