REVIEW ARTICLE |
https://doi.org/10.5005/jp-journals-10015-2239 |
Evolution and Progress of Biologically Compatible Materials in Dental Field: A Descriptive Review
1,2School of Mechanical Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
Corresponding Author: Senthilnathan Natarajan, School of Mechanical Engineering, Vellore Institute of Technology, Vellore, Tamilnadu, India, Phone: +91 6379498916, e-mail: senthil_nsn75@yahoo.co.in
Received on: 09 April 2023; Accepted on: 10 May 2023; Published on: 02 August 2023
ABSTRACT
Aim: The objective of this article is to review the evolution and advancement of biomaterials in the dental sector, especially the development of biomaterials for dental implants, while also focusing on their biocompatibility properties and assessment procedures.
Background: Biomaterials are rapidly developing new classes of materials, particularly in the fields of medicine and materials engineering. Dentistry exerts special demands on the materials used to repair damaged hard tissues, like teeth and bones, as well as damaged soft tissues. In terms of their physical, chemical, and biological activities, a variety of materials are being used with potential benefits and drawbacks.
Review results: The dental care sector is benefiting from the growth of biomaterials with specialized properties. Titanium (Ti) and its alloys, zirconia (Zr), and a few biopolymers are the most commonly utilized biomaterials. These materials are suitable for usage due to their anticorrosion, mechanical strength, biocompatibility, and nontoxicity properties. In allergic people, these materials can cause inflammation, bone loss, and pain, despite their widespread use.
Conclusion: These biomaterials have received considerable attention given their numerous potential uses in the medical field and their advantages in the long-term safety of implants. It is very important to choose a material that meets the requirements for biocompatibility and has a low risk and a high benefit-to-risk ratio.
Clinical significance: As the world recognizes the superior functional features of one material over another, the dentistry industry is transitioning to the idea of material advantage. In light of this, there has to be additional investigation into the materials’ individual performance in reducing allergic reactions in people with consistent success.
How to cite this article: Karunanithi C, Natarajan S. Evolution and Progress of Biologically Compatible Materials in Dental Field: A Descriptive Review. World J Dent 2023;14(5):471–477.
Source of support: Nil
Conflict of interest: None
Keywords: Biocompatibility, Biomaterials, Cytotoxicity, Dental materials, Image processing.
INTRODUCTION
One of the rapidly developing new classes of materials, particularly in the fields of medicine and materials engineering, is said to be biomaterials. Biomaterials are materials or combinations of materials that interact with biological tissues to restore or replace the function of damaged sections or tissues.1 This ability of the material to interact with the living tissues that help in performing the restoring capability is known as “bioactivity.”1 The primary consideration when selecting any biomaterial should be its biocompatibility with the intended use. The ability of the biomaterials to restore the beneficiary’s functionality while having no long-term effects is referred to as biocompatibility.1,2 To be more precise, specific biomedical applications will dictate how responsive the material substrate is. Understanding the characteristic uses and structure of biological materials is essential because the main purpose of using biomaterials is to replace missing organs or living tissues to restore the body’s normal functionality. One of the main causes of the material’s changes in chemical and mechanical properties is protein absorption within the body. Many questions surround how the body’s physical and chemical processes work, as well as how the biological properties of materials affect a particular activity in an evolving community.
PROGRESS OF MATERIALS IN DIFFERENT PERIODS
Prehistoric Period
The use of materials for therapeutic purposes was originally done around the year 200 AD; the materials utilized at the time were wrought iron, gold, and copper, and they are now used for a variety of health-related diseases.3 In 600 AD, Mayan people created nacre teeth from seashells and evidence indicates that they were successful without any biological understanding, which is quite remarkable when compared to the duration of implant success.3 Figure 1 depicts the evolution of materials employed for this purpose over time, as well as biomaterial advancement in the medical industry.
Fig. 1: Evolution of materials in the dental field
Middle-age Period
In the 1700s, porcelain was commonly utilized, and it was burned to resemble the contours of teeth.3 These materials are used in the making of dental crowns, bridges, and veneers, which protect the surface from damage. In the 1800s, dental amalgams such as gutta-percha resin and sealers were employed to fill cavities.3 Despite the lack of material science and biological understanding at the time, it resulted in good osseointegration with the bone. In this discipline, polymers were first applied in the early 1900s. The first polymer substance to be utilized in dental restorations is polymethyl methacrylate (PMMA).3 They are used to make prosthetic teeth, dentures, and temporary crowns.
Modern Period
Ceramics and titanium (Ti) were introduced in the mid-1900s, creating a significant impact in this industry.3 Because these materials have very good mechanical and biological qualities, as demonstrated by materials science, these materials are started to follow methods for undergoing medical evaluations with appropriate norms.3 Though all of these materials have been in use for a long time, the terms biomaterials and biocompatibility have recently gained popularity.
The use of biomaterials in the dental industry is steadily growing, owing to the wide variety of materials that are now available. The tissues that connect the teeth serve a variety of purposes, including protecting and enhancing nutrition. The incidence of dental caries among the general population is one of the most significant obstacles confronting efforts to improve oral health.4 Dental caries may be caused by the interaction of hard tissues with their external sites. As a result, these connective tissues are removed, which leads to tooth decay and fracture. To combat tooth damage, regenerative therapy with the aid of novel biomaterial development is helpful. The percentage of people who are in need of oral health rehabilitation is continually increasing, especially in developed nations. It is important to mention that 20% of Americans looked for remedies for dental health-related problems in 2021 alone. In addition to this, the American Society of Orthodontics acknowledged that approximately half of the world’s population has significant abnormalities to heal from orthodontic treatment in terms of improved health.5 The reasons for these issues could include the cost of a dentist in a specific area, the cost of materials that people choose, the grade of material at that particular cost, and so on.5
Due to a lack of research on material safety and long-term benefits, some academic journals and professional associations in this field are not endorsing it. However, as the proportion of people grows and the success rates rise, they are gradually coming around to the idea of the treatment’s entire range of safe advantages. This type of fluctuation in health benefits is brought on by the lack of solid scientific evidence supporting the treatment. The biomaterials that are currently being used in dental practice, as well as their development over time, and the biocompatibility characteristics that need to be considered when selecting the materials for dental implants are discussed in this review article. In addition, data collection and image processing are also covered to a lesser extent.
Classification of Biomaterials
Biomaterials are substances that can be used in place of damaged systems to improve their function internally or externally while also extending their quality and lifespan.6 Natural biomaterials and synthetic biomaterials are the two primary categories into which biomaterials fall. Biomaterials that are naturally occurring and unaltered by addition or modification are known as natural biomaterials. Proteins, cellulose, chitin, fibrin, chitosan, silk, gelatin, and others are a few examples of natural biomaterials. Synthetic biomaterials are those that are created artificially in labs or industries using human effort.7 These synthetic biomaterials are further categorized into three major groups—metallic biomaterials, ceramic biomaterials, and polymeric biomaterials. Metallic biomaterials consist of Ti alloys, stainless steels, cobalt-chromium alloys, and many others. Zirconia (Zr), alumina, graphite, bioglass, hydroxyapatite, etc. are examples of ceramic biomaterials. Some examples of polymeric biomaterials include polyvinyl chloride, PMMA, polypropylene, polystyrene, and many others.7
Furthermore, dental materials are classified into two types—restorative materials and laboratory materials. Restorative materials are utilized to rebuild the lost oral structure, whereas laboratory materials are used for manufacturing.7 Dental materials must meet precise specifications based on the demands of the patient and some individuals believe they should also be appealing. This can be accomplished with materials like restorative composites and dental amalgam. In the current medical market, biomaterials are valued more highly than other materials because of their advantages over those that were used in earlier decades. The dentistry sector is able to benefit from the material qualities as the world notices improved functional properties from one material over another.
Characteristics of Biocompatibility
Biocompatibility, as previously stated, is the capacity of the biomaterials to promote the recipient’s well-being by developing appropriate therapy without causing any systematic effects. Because it monitors the interaction between the material and the host tissues in the form of a device or system, certain characteristics must be determined in order to decide and confirm the biocompatibility of a material or device.8 Some requirements for a device’s or material’s biocompatibility depend on a few things, like the material’s physical and chemical makeup, the type of host tissue, and the length of exposure. The corporate manufacturers’ regulatory objective may be to produce goods, but they design their products to have the fewest possible risks while maximizing patient benefits.9 The Food and Defense Administration, European Union, and Indian Standard Organization (ISO) have developed a procedure to better understand the biocompatibility requirements. Most of the requirements that a biocompatible material should meet are covered by ISO standard 10993, “Biological Evaluation of Medical Devices.”10 Undoubtedly, there are only about 12 or so test methods available to determine a material’s biocompatibility. Additionally, not all of those tests need to be performed on every device that will be implanted. When compared to work involving tissues and organs, testing procedures and complications related to dentistry are less complicated. In order to confirm that a particular biocompatible material is functioning properly, several clinical trials should be conducted. Three phases make up a typical biocompatibility test—analytical chemistry, in vitro experiments, and animal models.10,11
One of the most important things to remember is that all biocompatibility test materials must be properly sterile. The most widely used test methodologies today are as follows—genotoxicity, hemocompatibility, sensitization assays, irritation tests, and cytotoxicity.11 Other required tests are also practical in practice, but when compared to the other individual tests, the above tests are used more frequently and are also more cost-effective. Tissue culture, also known as cytotoxicity, is the process of using isolated cells obtained through cell extraction for in vitro studies. It involves preliminary screening prior to processing for in vitro tests, and the assay is its primary tool for material screening. Because it directly extracts results, the MTT assay [3-(4,5-dimethylthiazol-2-yl)—2,5-diphenyl-2H-tetrazolium bromide] used in quantitative cytotoxicity has a greater advantage over other assays. Depending on the needs, Pacific BioLabs11 developed a reference tool called BioPT, which outlines the fundamental concepts required to follow testing procedures for a specific biomaterial implant. To ensure compliance with safety margins, the extract condition must be at least 50°C for 72 hours, as specified in the extraction media for testing the material. Vegetable oils, polyethylene glycol 400, and 1:20 alcohol in Saline are other frequently used extracting media.11 The field of orthodontics focuses on adjusting a patient’s bite as well as straightening their teeth. Orthodontics falls under the category of external communicating devices and the subcategory of dentin communicating devices because it deals with dentistry. The tests are necessary for evaluating the biocompatible qualities of the biomaterials used generally in dentistry for the implant process, as shown in Table 1. The notation Y indicates yes, indicating that the test must be performed, whereas the notation N indicates no, indicating that there is no need to evaluate the test.11
| Category | Material | Time period hours (h) days (d) | Cytotoxicity | Sensitization | Irritation | Implantation | Hemocompatibility | Genotoxicity |
|---|---|---|---|---|---|---|---|---|
| External impart device | Dentin materials | ≤24 hours | Y | Y | Y | N | N | N |
| Up to 30 days | Y | Y | Y | Y | Y | Y | ||
| >30 days | Y | Y | Y | Y | Y | Y |
Y: yes, N: no
Selection Process and Materials Associated with Dentistry
Over the years, the use of biomaterials has gained significant respect in the field of biomedical engineering. Researchers from all over the world have worked on numerous research projects that have used a variety of biomaterials to produce noteworthy outcomes. Table 2 provides an overview of some of the significant discoveries in this area.12,21 Materials such as nickel-Ti (Ni-TI) alloys, thermoplastic polymers, stainless steel, glass ionomer cement (GIC), and other materials were discussed along with the conclusions drawn from them. Ti and its alloys are among the most popular materials because they are durable, noncorrosive, and nontoxic. Some significant features to examine before undergoing in selecting the material for the treatment include anticorrosive property, nontoxic property, adhesive property, bioactive property, antiresistive property, antimicrobial property, wear rate, thermal stability, material strength, good osseointegration property, and so on. A point to refer to is that all these examinations are collectively noted down as mechanical and biocompatibility properties.
| S. No. | Author | Material used | Inference |
|---|---|---|---|
| 1 | Lin et al.12 | Stainless steel | When chewing actions were used, in vitro wear tests revealed that the duration of wear increased with the contact angle of incident water. These actions boosted toughness and reduced bacterial growth by preventing food buildup and dental caries |
| 2 | Charles13 | GIC | The biggest advantage of GIC was that it led to less decalcification and that they could be recharged again with fluoride toothpaste |
| 3 | Imai et al.14 | Fiber-reinforced polymers orthodontic wire using CaO–P2O5–SiO2–Al2O3 glass fibers | The results of the investigations led to the creation of wire at 250°C and 8–20 µm in diameter. It provided a decent range of reliable mechanical and aesthetic qualities that were lacking in typical conventional materials |
| 4 | Nicholson15 | GIC adhesive | In dentistry, the use of adhesive materials has grown in importance for preventing marginal leakage, assisting in the preservation of healthy tissues, and increasing retention rates |
| 5 | Rondelli16 | Stainless steel and Ni-Ti alloy | The experimental investigation of the potentiodynamic test on orthodontic wires study also discovered that, in comparison to Ni-Ti, the stainless steel wires had low pitting resistance. This was in order to evaluate the corrosion behavior against artificial saliva and to determine the pitting potential values |
| 6 | Bogdanski et al.17 | Ni-Ti | When the amount of Ni is 50% in Ni-Ti, the cytotoxic effect is not present with a temperature range of 5–40° C |
| 7 | Varela et al.18 | Thermoplastic polymer wires | The experiments resulted in materials with good mechanical properties and a low coefficient of friction when compared to metallic wires. It was also demonstrated that over the course of 2 hours, the tensile stress had decreased by 2% in relation to the initial stress |
| 8 | Noronha et al.19 | Silver nanoparticles | Numerous antiresistive properties have been shown to be significantly influenced by silver nanoparticles. The research on antimicrobial potency was still in its early stages, and it was only occasionally used in dentistry |
| 9 | Khonina et al.20 | Si-HA-glycerohydrogel | Improved enamel strength as a result of remineralization was seen in studies with different hydroxyapatite (HA) proportions. Therefore, the biomaterial would show promise as a component of future therapies |
| 10 | Cho et al.21 | Hydroxyapatite and brushite | The measured sizes of the bioceramic-coated films were found to be under 100 nm using diffraction data, and they displayed improved mechanical properties, a high deposition rate, and a strong adhesive |
| 11 | Wever et al.22 | Ni-Ti alloy | The anti-corrosive property of Ni-Ti alloy was considered to make it a safe material for biological implants, and the tests done on the model produced more favorable results because there were no toxic reactions |
| 12 | Fatani et al.23 | Stainless steel | Tests on the antimicrobial properties of major pathogens were done by coating stainless steel brackets with TiO2+Ag. It was discovered that these coated brackets showed resistance to the formation of biofilms and improved cell viability |
Biocompatibility Test on Ti Alloys
Titanium (Ti) has the highest success rate among other materials due to its strong strength and low weight, which makes it more pleasant for patients. In this regard, Ti has been used more frequently than any other material, as shown in Table 3, which contains information on the evaluation of previous biocompatibility tests. The different Ti alloys and their modes of testing, including temperature, duration, and concentration, with their results, were discussed. Wever et al.,22 conducted three biocompatibility experiments on Ni-Ti alloy (cytotoxicity test, sensitization test, and genotoxicity test) and determined that the findings were comparable to those of the commonly used AISI 316 Vacuum arc remelted stainless steel. In an antibacterial test of coated and uncoated stainless steel Fatani et al.,23 concluded that the titanium dioxide (TiO2+) Ag-coated material showed less bacteria on the surface and offered good resistance to a number of different pathogens. Using four different orthodontic wire materials, Pun and Berzins,24 conducted corrosion investigations and discovered that temperature accelerated the corrosion rate.
| Test materials | Test method | Concentration temperature duration | Result |
|---|---|---|---|
| Ni-Ti alloy | Cytotoxicity minimal essential medium assay | 100, 50, 25, 12.5% 37°C 24, 48, 72 hours |
No negative impacts were found, and it compares favorably to stainless steel, which is used as the reference control22 |
| Genotoxicity (salmonella reverse mutation) | Five concentration, 0.9% NaCl, 37°C 48, 72 hours | With added positive controls of sodium azide, the relevant colonies of each strain were observed. With the mutation index, more than two showed signs of mutagenicity22 | |
| Sensitization (guinea pig) | 30 mL, 0.9% NaCl at 50°C 24, 48, 72 hours |
No signs of dermal sensitivity were present22 | |
| Stainless steel coated with TiO2+Ag | Bacteria culture | Microbial evaluation at −70°C | This material provides good antimicrobial activity for various pathogens23 |
| Adhesion assay | 2 mL of PBS, 8 hours at 37°C | ||
| Biofilm assay | 1:100 dilution, 24 hours at 37°C | ||
| CuNiTi Ni-Ti Nitinol |
Corrosion testing | 27 and 40°C 2 hours 5, 24, 37, and 45°C 2 hours |
Showed small variation in phase change when exposed to different temperatures and results in an increase in corrosion rate24 |
Critical Factors for Implant Success
The information in Table 4 lists the key elements and their consequences that researchers utilized to frame their study and determine the effectiveness of implant implementation in patients.25,41 Surface treatments and material testing are among the most important aspects that might make or break implant treatments. In terms of mechanical strength and biological capabilities, the coating of the material also benefits those characteristics. For these kinds of coating procedures, ceramic materials are frequently used. Zr, bioglass, hydroxyapatite, and other materials are some notable examples of coating materials.
| Parameters | Qualities |
|---|---|
| Surface treatments | After surface treatment, both Ti and Zr demonstrated comparable osseointegration rates; however, Zr demonstrated superior bacterial adhesion while Ti demonstrated superior mechanical properties25 |
| When surface texturing was carried out using a laser, the material’s surface topography improved. In addition, Zr is more brittle than Ti, making it more challenging to surface texture26 | |
| Irradiation intensity, time, and frequency are some crucial variables for a better surface response27 | |
| Design | Implants with a conical shape offer better connections to abutment junctions. Additionally, implants with a hexagonal shape offer good edentulous retention for prosthetic retention28 |
| Biomaterial(chitosan) | It shares with other biomaterials the distinctive qualities of biocompatibility and non-toxicity. Additionally, it has effective antibacterial and antifungal properties29 |
| Biomaterial(manganese) | Collagen-hydroxyapatite promotes bone conductivity and bone formation by releasing manganese ions. Additionally, it enhances mechanical, antibacterial, and corrosion properties30 |
| Digital evolution | Digital techniques, like computer-aided design/computer-aided manufacturing abutments, have higher success and survival rates than traditional techniques31 |
| Biomaterials that can be printed using 3D technology are becoming more and more popular because they are more accurate than traditional methods32 | |
| The building blocks of modifications in human gingival regions are proteins. It enhances cell adhesion by tailoring adhesive proteins like fibronectin and vitronectin33 | |
| When combined with other technologies, digital image correlation is reliable for more accurate evaluation of the material characteristics34 | |
| Tribocorrosion | Wear: materials were put through 12,000 cycles of dry sliding wear in accordance with American Society for Testing and Materials (ASTM) standardsMaterials were tested for potentiodynamic polarization corrosion of ASTM F2129 while artificial saliva was present. When Zr was added, the outcomes improved35 |
| Round-robin testing and new implant protocols must be used because tribocorrosion is the main cause of dental implant failure36 | |
| Material test | Reusing dental abutments can save money, but it also runs the risk of spreading infection due to the source of the product. Therefore, it needs to be resterilized before being submerged in test tubes filled with brain and heart infusion broth37 |
| It is necessary to standardize the implant location-specific test in order to increase its clinical applicability based on host interaction38 | |
| Characterization and coating | Ti electrodes outperformed copper electrodes in terms of resistance to electrochemical deterioration39 |
| After being etched, the mechanical and surface properties of the Ti–Zr alloy coating were improved40 | |
| Zirconium dioxide coated using electron beam physical vapor deposition demonstrated improved adhesion and guards against oral bacteria that cause tooth decay41 |
Merits, Demerits, and Applications of Implant Materials in Dental Field
The physical, chemical, and biological qualities of a substance determine its value and drawbacks. The following are some of the most crucial materials, along with the advantages and disadvantages of using them.
Titanium and its Alloys
Titanium (Ti) is regarded as a promising material because of its low specific weight, good corrosion resistance, high strength-to-weight ratio, low elastic modulus, good tribiological characteristics, and better biocompatibility. In addition to the benefits listed above, it has a high osseointegration rate and is resistant to wear. Various composites are added to Ti material to improve its mechanical properties, with Ti-6Al-4V42 being the most often used Ti alloy. Ti and its alloys are commonly utilized in dental implants, restorative dentistry, endodontics, orthodontics, and maxillofacial surgery. They are utilized to restore or repair damages to the crown’s inner structure, anchoring screws, springs, bracing, and rotary files. Although it is extensively used, it has certain negative health effects on people, such as allergic reactions like inflammation and pain, and bone loss due to the difference in elastic modulus between bone material and Ti alloy material.43 It also does not look like real teeth from an esthetic perspective. Ti and its alloys are more expensive compared to other metal biomaterials. Further studies need to be done to overcome the constraints as a result of a lack of study in a few areas of Ti application.
Zirconia-based Materials
Ceramic biomaterials are replacing conventional materials in the dental sector because of their great wear resistance, fracture toughness, biocompatibility, and flexural strength.44 These substances are nontoxic and have strong osseointegration, similar to Ti. Materials made of Zr are less expensive than Ti. These materials are widely used in dental implants, brackets, crowns, bridges, pins, and other structures. The material’s significant drawbacks are its poor performance at low temperatures and the potential for early implant failure.44 Further studies should be done to determine how well bioceramics can treat people with dental problems.
Polymeric Biomaterials
Polymer biomaterials, in particular polyetheretherketone, have gained popularity as an alternative to other materials in the dental industry in recent years. In comparison to other polymer biomaterials, it is a high-temperature polymer.45 When combined with carbon, these composites demonstrated improved mechanical properties. It possesses the characteristics of bone and has high chemical resistance. Moreover, these materials are utilized as braces, abutments, frameworks, implants, and healing caps. This material’s drawbacks include implant loss, bone resorption, and surface degradation. These challenges need to be the focus of studies in order to produce useful results.
Data Collection and Image Processing
The level of sophistication of treatment methods has increased during the past few years. One must also be familiar with the foundations of developing a medical model in order to apply the component in the intended application efficiently. In this regard, the present digital economy heavily relies on data collecting and image processing. It involves the idea of gathering data from disordered patients and transmitting it for processing using digital instruments. Figure 2 illustrates the steps taken in creating the medical model. Moreover, three-dimensional (3D) printing is a viable option given the basic model of fixing a fractured tooth and the designated class of raw materials.46 The initial usage of the medical software necessitates the use of Digital Imaging and Communications in Medicine, or DICOM, pictures.47 These images were acquired from a computed tomography or magnetic resonance imaging scan following a careful assessment of the component, and the patient’s data was recorded for subsequent processing. Following the acquisition of additional information, the development of a model using appropriate material begins. A few other procedures, including material selection, fabrication, and testing, should also be completed before an implant is processed and used on the market, as shown in Figure 3.
Fig. 2: Date capturing and image processing
Fig. 3: Concurrent procedures for an implant to the practical application
CONCLUSION
In general, biomaterials, especially those used in medicine, are not frequently viewed as a blessing for all civilizations. Currently, the use of biomaterials that have passed all necessary biocompatible tests is growing. Therefore, the dentist must favor the material that meets the criteria for biocompatibility while posing the least risk and providing the greatest benefit. Some materials that exhibit excellent mechanical qualities cannot satisfy biological requirements. However, the struggle to meet the demands continues due to the lack of readily available materials. It will serve as an alternative by producing implants and medical devices that are newly derived from biomaterial science and custom-based manufacturing technology that meet up with several advancements. Researchers will inevitably concentrate on the creation of new materials to support the medical industry as they work to identify the availability of materials with significant biocompatibility resources. Therefore, researchers must possess an in-depth understanding of the fundamentals of particular materials and their biological domains.
ORCID
Chithambaram Karunanithi https://orcid.org/0000-0003-0195-0553
Senthilnathan Natarajan https://orcid.org/0000-0002-3423-1419
ACKNOWLEDGMENT
The authors are very grateful to the Vellore Institute of Technology, Vellore, Tamil Nadu, India.
REFERENCES
1. Ratner BD, Hoffman AS, Schoen FJ, et al. Biomaterials science: an introduction to materials in medicine. Elsevier 2004.
2. Rezaie HR, Bakhtiari L, Öchsner A. Biomaterials and their applications. Berlin, Germany: Springer International Publishing; 2015 Apr 30.
3. Stoddart A, Cleave V. The evolution of biomaterials. Nature Materials 2009;8(6):444–445. DOI: 10.1038/nmat2447
4. Chapin R. Dental benefits improve access to oral care. Dent Clin North Arm 2009;53(3):505–509. DOI: 10.1016/j.cden.2009.03.004
5. Press Room | American Association of Orthodontists. American Association of Orthodontists, https://aaoinfo.org/resources/press-room/.
6. Park JB, Bronzino JD. Biomaterials: principles and applications. CRC Press, 2002 Aug 29.
7. Parida P, Behera A, Mishra SC. Classification of Biomaterials used in Medicine. Int J Adv Appl Sci 2012;1(3). DOI: 10.11591/ijaas.v1i3.882
8. Williams DF. A model for biocompatibility and its evaluation. J Biomed Eng 1989;11(3):185–191. DOI: 10.1016/0141-5425(89)90138-6
9. Schmalz G, Bindslev D. Biocompatibility of dental materials. Berlin. Springer; 2009.
10. Hanks CT, Wataha JC, Sun Z. In vitro models of biocompatibility: a review. Dent Mater 1996;12(3):186–193. DOI: 10.1016/s0109-5641(96)80020-0
11. BioLabs P. Assessing biocompatibility. A Guide for Medical Device Manufacturers. 2009.
12. Lin CW, Chung CJ, Chou CM, et al. In vitro wear tests of the dual-layer grid blasting-plasma polymerized superhydrophobic coatings on stainless steel orthodontic substrates. Thin Solid Films 2019;687:137464. DOI: 10.1016/j.tsf.2019.137464
13. Charles C. Bonding orthodontic brackets with glass-ionomer cement. Biomaterials 1998;19(6):589–591. DOI: 10.1016/s0142-9612(97)00141-5
14. Imai T, Watari F, Yamagata S, et al. Mechanical properties and aesthetics of FRP orthodontic wire fabricated by hot drawing. Biomaterials 1998;19(23):2195–2200. DOI: 10.1016/s0142-9612(98)00127-6
15. Nicholson JW. Adhesive dental materials—a review. Int J Adh Adhes 1998;18(4):229–236. DOI: 10.1016/S0143-7496(98)00027-X
16. Rondelli G, Corrosion resistance tests on NiTi shape memory alloy. Biomaterials 1996;17(20):2003–2008. DOI: 10.1016/0142-9612(95)00352-5
17. Bogdanski D, Köller M, Müller D, et al. Easy assessment of the biocompatibility of Ni–Ti alloys by in vitro cell culture experiments on a functionally graded Ni–NiTi–Ti material. Biomaterials 2002;23(23):4549–4555. DOI: 10.1016/s0142-9612(02)00200-4
18. Varela JC, Velo M, Espinar E, et al. Mechanical properties of a new thermoplastic polymer orthodontic archwire. Mater Sci Eng C Mater Biol Appl 2014;42:1–6. DOI: 10.1016/j.msec.2014.05.008
19. Noronha VT, Paula AJ, Durán G, et al. Silver nanoparticles in dentistry. Dent Mate 2017;33(10):1110–1126. DOI: 10.1016/j.dental.2017.07.002
20. Khonina TG, Chupakhin ON, Shur VY, et al. Silicon-hydroxyapatite–glycerohydrogel as a promising biomaterial for dental applications. Colloids Surf B Biointerfaces 2020;189:110851. DOI: 10.1016/j.colsurfb.2020.110851
21. Cho MY, Lee DW, Kim IS, et al. Evaluation of structural and mechanical properties of aerosol-deposited bioceramic films for orthodontic brackets. Ceram Int 2019;45(6):6702–6711. DOI: 10.1016/j.ceramint.2018.12.159
22. Wever DJ, Veldhuizen AG, Sanders MM, et al. Cytotoxic, allergic and genotoxic activity of a nickel-titanium alloy. Biomaterials 1997;18(16):1115–1120. DOI: 10.1016/s0142-9612(97)00041-0
23. Fatani EJ, Almutairi HH, Alharbi AO, et al. In vitro assessment of stainless steel orthodontic brackets coated with titanium oxide mixed Ag for anti-adherent and antibacterial properties against Streptococcus mutans and Porphyromonas gingivalis. Micro Pathog 2017;112:190–194. DOI: 10.1016/j.micpath.2017.09.052
24. Pun DK, Berzins DW. Corrosion behavior of shape memory, superelastic, and nonsuperelastic nickel–titanium-based orthodontic wires at various temperatures. Dent Mater 2008;24(2):221–227. DOI:10.1016/j.dental.2007.05.003
25. Hanawa T. Zirconia versus titanium in dentistry: a review. Dental Mater J 2020;39(1):24–36. DOI: 10.4012/dmj.2019-172
26. Han J, Zhang F, Van Meerbeek B, et al. Laser surface texturing of zirconia-based ceramics for dental applications: a review. Mater Sci Eng C 2021;123:112034. DOI: 10.1016/j.msec.2021.112034
27. Cunha W, Carvalho O, Henriques B, et al. Surface modification of zirconia dental implants by laser texturing. Lasers Med Sci 2022;37(1):77–93. DOI: 10.1007/s10103-021-03475-y
28. Hurson S. Implant/abutment biomechanics and material selection for predictable results. Compend Cont Edu Dent 2018;39(6):440–444. PMID: 30020799.
29. Fakhri E, Eslami H, Maroufi P, et al. Chitosan biomaterials application in dentistry. Int J Biol Macromol 2020;162:956–974. DOI: 10.1016/j.ijbiomac.2020.06.211
30. Brune D. Metal release from dental biomaterials. Biomaterials 1986;7(3):163–175. DOI: 10.1016/0142-9612(86)90097-9
31. Bozkurt Y, Karayel E. 3D printing technology; methods, biomedical applications, future opportunities and trends. J Mater Res Technol 2021;14:1430–1450. DOI: 10.1016/j.jmrt.2021.07.050
32. Punia U, Kaushik A, Garg RK, et al. 3D printable biomaterials for dental restoration: a systematic review. Materials Today:Proceedings. 2022.
33. Mo W, Qi H, Zhang F, et al. Customized protein modification improves human gingival fibroblasts adhesion on SiO2. Applied Materials Today 2021;25:101232. DOI: 10.1016/j.apmt.2021.101232
34. Yoon S, Jung HJ, Knowles JC, et al. Digital image correlation in dental materials and related research: a review. Dent Mater 2021;37(5):758–771. DOI: 10.1016/j.dental.2021.02.024
35. Mehkri S, Abishek NR, Sumanth KS, et al. Study of the tribocorrosion occurring at the implant and implant alloy interface: dental implant materials. Mater TodayProceed 2021;44:157–165. DOI: 10.1016/j.matpr.2020.08.550
36. Revathi A, Borrás AD, Muñoz AI, et al. Degradation mechanisms and future challenges of titanium and its alloys for dental implant applications in oral environment. Mater Sci Eng C 2017;76:1354–1368. DOI: 10.1016/j.msec.2017.02.159
37. Cakan U, Delilbasi C, Er S, et al. Is it safe to reuse dental implant healing abutments sterilized and serviced by dealers of dental implant manufacturers? An in vitro sterility analysis. Imp Dent 2015;24(2):174–179. DOI: 10.1097/ID.0000000000000198
38. Camilleri J, Moliz TA, Bettencourt A, et al. Standardization of antimicrobial testing of dental devices. Dent Mater 2020;36(3):e59–e73. DOI: 10.1016/j.dental.2019.12.006
39. Chakmakchi M, Ntasi A, Mueller WD, et al. Effect of Cu and Ti electrodes on surface and electrochemical properties of electro discharge machined (EDMed) structures made of Co-Cr and Ti dental alloys. Dent Mater 2021;37(4):588–596. DOI: 10.1016/j.dental.2021.01.012
40. Wong CS. Surface and biological characterization of biomaterials. InStructural Biomaterials 2021:33–66. DOI: 10.1016/B978-0-12-818831-6.00002-1
41. Cordeiro JM, Faverani LP, Grandini CR, et al. Characterization of chemically treated Ti-Zr system alloys for dental implant application. Mater Sci Eng C 2018;92:849–861. DOI: 10.1016/j.msec.2018.07.046
42. Hoque ME, Showva NN, Ahmed M, et al. Titanium and titanium alloys in dentistry: current trends, recent developments, and future prospects. Heliyon 2022;8(11):e11300. DOI: 10.1016/j.heliyon.2022.e11300
43. Singh R, Singh S, Hashmi MS. Implant materials and their processing technologies.
44. Denry I, Kelly JR. State of the art of zirconia for dental applications. Dent Mater 2008;24(3):299–307. DOI: 10.1016/j.dental.2007.05.007
45. Akay C, Ersöz MB. PEEK in dentistry, properties and application areas. Int Dent Res 2020;10(2):60–65. DOI: 10.5577/intdentres.2020.vol10.no2.6
46. Pugliese R, Beltrami B, Regondi S, et al. Polymeric biomaterials for 3D printing in medicine: an overview. Annals 3D Print Med 2021;2:100011. DOI: 10.1016/j.stlm.2021.100011
47. Hong Q, Lin L, Li Q, et al. A direct slicing technique for the 3D printing of implicitly represented medical models. Comput Biol Med 2021;135:104534. DOI: 10.1016/j.compbiomed.2021.104534
________________________
© The Author(s). 2023 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.