Melbourne Dental School - Research Publications
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ItemAntimicrobial nanoparticle coatings for medical implants: Design challenges and prospects(AMER INST PHYSICS, 2020-11)Microbial colonization, infection, and biofilm formation are major complications in the use of implants and are the predominant risk factors in implant failure. Although aseptic surgery and the administration of antimicrobial drugs may reduce the risk of infection, the systemic use of antibiotics can lead to a lack of efficacy, an increase in the risk of tissue toxicity, and the development of drug-resistant infections. To reduce implant-related infections, antimicrobial materials are increasingly being investigated and applied to implant surfaces using various methods depending on the agents and their microbicidal mechanisms. Through the development of biomaterials and nanotechnology, antimicrobial nanoparticles are becoming promising candidates for implant coatings, as their multifactorial antimicrobial mechanisms combat microbial adherence, viability, and biofilm formation. Despite their antimicrobial promise, the application of nanoparticles onto implant surfaces while retaining their antimicrobial potency faces many challenges. Herein, we review the potential and challenges associated with the design and implementation of antimicrobial nanoparticle coatings for the medical implant industry, particularly focusing on manufacturing considerations, sterilization, long-term stability, protein fouling, regulation, and safety, with a view to providing researchers the necessary tools to aid the translation of materials from the bench to the clinic.
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ItemMultifunctional Antimicrobial Polypeptide-Selenium Nanoparticles Combat Drug-Resistant Bacteria(AMER CHEMICAL SOC, 2020-12-16)Antibiotic-resistant bacteria are a severe threat to human health. The World Health Organization's Global Antimicrobial Surveillance System has revealed widespread occurrence of antibiotic resistance among half a million patients across 22 countries, with Staphylococcus aureus, Escherichia coli, and Klebsiella pneumoniae being the most common resistant species. Antimicrobial nanoparticles are emerging as a promising alternative to antibiotics in the fight against antimicrobial resistance. In this work, selenium nanoparticles coated with the antimicrobial polypeptide, ε-poly-l-lysine, (Se NP-ε-PL) were synthesized and their antibacterial activity and cytotoxicity were investigated. Se NP-ε-PL exhibited significantly greater antibacterial activity against all eight bacterial species tested, including Gram-positive, Gram-negative, and drug-resistant strains, than their individual components, Se NP and ε-PL. The nanoparticles showed no toxicity toward human dermal fibroblasts at the minimum inhibitory concentrations, demonstrating a therapeutic window. Furthermore, unlike the conventional antibiotic kanamycin, Se NP-ε-PL did not readily induce resistance in E. coli or S. aureus. Specifically, S. aureus began to develop resistance to kanamycin from ∼44 generations, whereas it took ∼132 generations for resistance to develop to Se NP-ε-PL. Startlingly, E. coli was not able to develop resistance to the nanoparticles over ∼300 generations. These results indicate that the multifunctional approach of combining Se NP with ε-PL to form Se NP-ε-PL is a highly efficacious new strategy with wide-spectrum antibacterial activity, low cytotoxicity, and significant delays in development of resistance.
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ItemComplementation in trans of Porphyromonas gingivalis Lipopolysaccharide Biosynthetic Mutants Demonstrates Lipopolysaccharide Exchange(American Society for Microbiology, 2021-04-21)Porphyromonas gingivalis, a bacterial pathogen contributing to human periodontitis, exports and anchors cargo proteins to its surface, enabling the production of black pigmentation using a type IX secretion system (T9SS) and conjugation to anionic lipopolysaccharide (A-LPS). To determine whether T9SS components need to be assembled in situ for correct secretion and A-LPS modification of cargo proteins, combinations of nonpigmented mutants lacking A-LPS or a T9SS component were mixed to investigate in trans complementation. Reacquisition of pigmentation occurred only between an A-LPS mutant and a T9SS mutant, which coincided with A-LPS modification of cargo proteins detected by Western blotting and coimmunoprecipitation/quantitative mass spectrometry. Complementation also occurred using an A-LPS mutant mixed with outer membrane vesicles (OMVs) or purified A-LPS. Fluorescence experiments demonstrated that OMVs can fuse with and transfer lipid to P. gingivalis, leading to the conclusion that complementation of T9SS function occurred through A-LPS transfer between cells. None of the two-strain crosses involving only the five T9SS OM component mutants produced black pigmentation, implying that the OM proteins cannot be transferred in a manner that restores function and surface pigmentation, and hence, a more ordered temporal in situ assembly of T9SS components may be required. Our results show that LPS can be transferred between cells or between cells and OMVs to complement deficiencies in LPS biosynthesis and hemin-related pigmentation to reveal a potentially new mechanism by which the oral microbial community is modulated to produce clinical consequences in the human host. IMPORTANCE: Porphyromonas gingivalis is a keystone pathogen contributing to periodontitis in humans, leading to tooth loss. The oral microbiota is essential in this pathogenic process and changes from predominantly Gram-positive (health) to predominantly Gram-negative (disease) species. P. gingivalis uses its type IX secretion system (T9SS) to secrete and conjugate virulence proteins to anionic lipopolysaccharide (A-LPS). This study investigated whether components of this secretion system could be complemented and found that it was possible for A-LPS biosynthetic mutants to be complemented in trans both by strains that had the A-LPS on the cell surface and by exogenous sources of A-LPS. This is the first known example of LPS exchange in a human bacterial pathogen which causes disease through complex microbiota-host interactions.
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ItemPrevalence and morphology of C-shaped and non-C-shaped root canal systems in mandibular second molars(WILEY, 2022-03)BACKGROUND: There are no cone-beam computed tomography (CBCT)-based data on the anatomy of mandibular second molars in an Australian population. This study investigated the prevalence and descending morphology of mandibular second molars with and without C-shaped canals using retrospective analysis of CBCT scans. METHODS: Scans from 715 patients were screened for the presence of C-shaped canals and assessed for cross-sectional configuration at five axial levels. Non-C-shaped molars were assessed for other morphological characteristics. Data were modelled against patient, tooth and CBCT scan characteristics. RESULTS: A total of 1278 teeth from 657 patients were evaluated. The overall prevalence of C-shaped canals was 13%. Cross-sectional configuration of C-shaped canals was variable, with an average of 2.8 unique cross-sections per tooth. Non-C-shaped teeth were predominantly Vertucci Type II (60%) and Type IV (29%) configurations in mesial roots, and Type I (91%) in distal roots. Additional roots occurred in 4.3% of teeth and there was a significant association between radix paramolaris and distal root bifurcation (P < 0.001). CONCLUSIONS: Cross-sectional analysis confirmed the complexity and variability of C-shaped canals. Clinicians should be cognizant of the prevalence and variability of C-shaped root canal morphology and how this may affect endodontic treatment.
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ItemEffect of CPP-ACP modified-GIC on prevention of demineralization in comparison to other fluoride-containing restorative materials(WILEY, 2022-09)BACKGROUND: This study evaluated the ability of a CPP-ACP-modified Glass-ionomer cement (GIC) to inhibit demineralization around the margins of cervical cavities in natural teeth in comparison with a Giomer and conventional GIC with and without coating. METHODS: Thirty-two sound human molars were used. Box-shaped cavities were prepared along the CEJ. Teeth were randomly divided into four groups and restored with Equia Forte Fil, Coated Equia Forte Fil, Fuji VII EP or Beautifil II. Teeth were subjected to pH cycling. Micromorphological and elemental analyses were done using SEM and EDX. Polarized light microscope analysis and microhardness tests were also performed. RESULTS: Microhardness tests on enamel showed a significant difference between the coated Equia group, Equia and Beautifil II groups (P < 0.05). Dentine results showed significant differences between the coated Equia group and all other groups (P < 0.05). Elemental analysis showed significant differences in calcium weight percentage among the first and second observation levels in all groups (P < 0.05). A significant difference was found between the coated Equia group and the other three groups (P < 0.05). CONCLUSIONS: All tested materials showed some ability to resist demineralization at the restoration margins. The coated GIC restoration showed better outcomes compared with the other tested materials.
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ItemAn In Vitro Evaluation of the Effect of 3D Printing Orientation on the Accuracy of Implant Surgical Templates Fabricated By Desktop Printer(WILEY, 2022-12)PURPOSE: To evaluate the effect of different 3D printing orientations on internal and seating accuracy of implant surgical templates fabricated by a digital light processing (DLP) printer. MATERIALS AND METHODS: A single maxillary model with a missing central incisor was used to design a surgical template for single implant placement. According to the printing orientation, three surgical template groups were included in the study: horizontal (H), angled (A) and vertical (V) (n = 10). For the H group, the templates were produced parallel to the printing platform, while for the V group, the templates were perpendicular to the platform. The A group templates had a 45° angle orientation to the platform. Each template was scanned at the fitting surface and after seating on the master model. The internal accuracy involved measuring the trueness and precision of the internal surface, while for the seating accuracy, the vertical discrepancy after seating the template was measured. To determine the difference among the groups, ANOVA test was applied followed by Tukey post hoc tests (α = 0.05). RESULTS: The H group had the lowest internal surface inaccuracy (trueness = 100.7 μm; precision = 69.1 μm) followed by A (trueness = 114.0 μm; precision = 77.3 μm) and V (trueness = 120.3 μm; precision = 82.4 μm) groups, respectively (p < 0.001). Similarly, the H group had the most superior seating accuracy (543.8 μm) followed by A group (1006.0 μm) and V group (1278.0 μm), respectively (p < 0.001). CONCLUSIONS: The orientation of 3D printing of implant surgical templates fabricated by the DLP desktop printer influenced the accuracy of the templates. The horizontally printed templates consistently exhibited superior accuracy. To reduce deviation of implant placement, it is recommended to print the surgical templates with their largest dimension parallel to the printing platform.
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ItemDenosumab and invasive cervical root resorption: a case report(WILEY, 2022-06)