Journal Of Functional Biomaterials[JOURNAL]
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200 papers
Do Different Durations of Hyperbaric Oxygen Therapy Affect the Microleakage of Bulk-Fill Composites?
Kedici Alp C, Sumra Kaçmaz S, Yazım A … +2 more , Aydin Z, Özkan R
J Funct Biomater · 2026 May · PMID 42188376 · Full text
This in vitro study evaluated the effect of exposure duration (5, 20, and 40 days) to constant increased ambient pressure (2.4 atmospheres absolute; ATA) on microleakage at the dentin-composite interface of teeth restore...
This in vitro study evaluated the effect of exposure duration (5, 20, and 40 days) to constant increased ambient pressure (2.4 atmospheres absolute; ATA) on microleakage at the dentin-composite interface of teeth restored with two bulk-fill composites. Specimens stored in distilled water at atmospheric pressure (1 atm) served as controls. A total of 192 extracted human molars with standardized Class V cavities were randomly assigned to two groups: sonic-activated bulk-fill composite (SonicFill) or conventional bulk-fill composite (Filtek One Bulk Fill). Each group was subdivided into controls maintained under atmospheric pressure (1 atm) and specimens under hyperbaric pressure (2.4 ATA), and exposed for 5, 20, or 40 days (total of 12 groups, = 16 per group). Microleakage was assessed using the dye penetration method and scored under a stereomicroscope according to ISO criteria. Statistical analyses were performed using Fisher's Exact chi-squared and Fisher-Freeman-Halton Exact tests (α = 0.05). No significant differences were found between materials or pressure conditions at 5 and 20 days ( > 0.05). After 40 days, both composites showed significantly higher microleakage at increased pressure than atmospheric controls ( < 0.05). Microleakage increased over time in the hyperbaric groups, while no time-dependent changes occurred at atmospheric pressure. After 40 days, prolonged exposure to elevated pressure increased microleakage, whereas shorter exposure produced no significant changes. Both materials demonstrated similar susceptibility to pressure-related deterioration.
Mechanobiological Response of Peri-Implant Bone to Variations in Inter-Implant Distance: A Finite Element Analysis of Conometric Implants at Crestal and Subcrestal Positions.
Ceddia M, Romasco T, Di Pietro N … +2 more , Lamberti L, Trentadue B
J Funct Biomater · 2026 Apr · PMID 42188375 · Full text
Inter-implant distance (IID) is crucial for peri-implant bone preservation and long-term implant success. Traditionally, a minimum IID of 3 mm is recommended to limit marginal bone loss, although the biomechanical effect...
Inter-implant distance (IID) is crucial for peri-implant bone preservation and long-term implant success. Traditionally, a minimum IID of 3 mm is recommended to limit marginal bone loss, although the biomechanical effect of smaller distances remains debated and may depend on multiple biological, prosthetic, and surgical factors. This study uses finite element analysis (FEA) to evaluate the effect of IID on stress distribution in peri-implant bones of D3 and D4 quality, considering crestal versus subcrestal implant placement, and interpreting results within Frost's mechanostat theory. Implants with an internal conometric connection were modeled within simulated D3 and D4 mandibular bone blocks. IID values of 3 mm, 1.5 mm, and 1 mm were analyzed under masticatory load. Von Mises stresses in cortical and trabecular bone were compared against biomechanical thresholds (2 MPa disuse and 20 MPa remodeling limit). Results: Cortical stress increased with decreasing IID, more pronounced in crestal placement. In D3 bone, maximum cortical stress rose from 7.2 MPa (3 mm IID) to 16.5 MPa (1 mm IID) under crestal placement, while remaining within the mechanostat-based thresholds adopted in the present stress-interpretation framework. In D4 bone, cortical stress approached 20 MPa at 1 mm IID under crestal placement, indicating a less favorable mechanical condition within the interpretive framework adopted. Subcrestal placement reduced cortical stresses in both bone qualities. Trabecular stress remained stable in D3 (~1.7-8 MPa) and increased moderately in D4 (~up to 13 MPa). Conclusions: Within the limitations of this preclinical finite element study, decreasing inter-implant distance was associated with increased cortical stress, while subcrestal placement was associated with lower cortical stress than crestal placement. These findings should be interpreted only as comparative computational results, and no direct clinical conclusion can be drawn regarding the acceptability of a 1 mm inter-implant distance.
Tumor-Targeted Delivery Therapy Based on PLGA Nanoparticles.
Wu F, Gao Y, Chi Y … +9 more , Wang D, Zhang S, Cheung O, Zhao K, Lu H, Chen Q, Chen Y, Wang L, Zhu Y
J Funct Biomater · 2026 Apr · PMID 42188374 · Full text
Poly(lactic acid-lactic acid) (PLGA) has demonstrated significant application potential in tumor-targeted drug delivery systems due to its excellent biocompatibility, degradability, and multifunctionality for loading var...
Poly(lactic acid-lactic acid) (PLGA) has demonstrated significant application potential in tumor-targeted drug delivery systems due to its excellent biocompatibility, degradability, and multifunctionality for loading various therapeutic agents. PLGA nanoparticles (NPs) can achieve targeted delivery to tumor cells through specific surface modifications and stimulus-responsive release mechanisms, significantly enhancing drug accumulation efficiency at tumor sites while reducing toxic side effects on normal tissues. This review systematically summarizes the fundamental physicochemical properties of PLGA materials and recent advances in tumor-targeting strategies for PLGA NPs. It comprehensively elucidates research breakthroughs in PLGA-based delivery systems regarding stimulus-response mechanisms, passive targeting, active targeting, and tumor combination immunotherapy, while revealing the intrinsic logic of synergistic strategies for enhancing targeting efficiency. Finally, from the perspective of clinical translation and individualized oncology, this review conducts an in-depth assessment of the current challenges and looks forward to future research directions, aiming to provide forward-looking guidance for the development of precision nanomedicine.
Correction: Petropoulou et al. Conversion and Tack-Curing of Light-Cured Veneer Luting Agents. 2025, , 307.
Petropoulou A, Dimitriadi M, Zinelis S … +2 more , Papathanasiou I, Eliades G
J Funct Biomater · 2026 Apr · PMID 42042313 · Full text
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ZrO Ceramic without and with Fullerene C Films: In Vitro Direct-Contact Model Using and Bacteria.
Dorner-Reisel A, Li J, Trzaskowska M … +8 more , Vivcharenko V, Chu J, Freiberger E, Ritter U, Przekora A, Zima A, Wang T, Moje J
J Funct Biomater · 2026 Apr · PMID 42042312 · Full text
Zirconia is known as a strong and bioinert load-bearing material for dental implants. It typically exhibits no antibacterial activity. Inflammation is a crucial problem for dental implant surgery: about 3-5% of all denta...
Zirconia is known as a strong and bioinert load-bearing material for dental implants. It typically exhibits no antibacterial activity. Inflammation is a crucial problem for dental implant surgery: about 3-5% of all dental implants experience inflammation. This study demonstrates that either fullerene C films or a tribomechanical loading of zirconia without the fullerene C coating can cause an improvement in antibacterial activity against Gram-positive . This moderate antibacterial activity is especially important, because a strong antibacterial effect could disturb the sensitive and beneficial oral bacterial biota. In the present study, different fullerene C films were examined. In addition to fullerene C film in an "as deposited" condition, treatment with nitrogen plasma as well as tribomechanical produced surface patterns with and without plasma post-treatment were tested. An 85.8% (log reduction 0.85) reduction in Gram-positive bacterial formation was observed on the zirconia with fullerene C film. Plasma treatment of the C film increases the antibacterial impact to 72.2% (log reduction 0.56) in comparison to zirconia without fullerene C film. Also, tribomechanical loaded fullerene C films suppress the growth of Gram-positive The tribomechanical loading seems to compensate for the effect of the plasma treatment. ZrO samples with fullerene C film and tribomechanical loading achieve an increase in antibacterial impact of 83.36% (log reduction 0.78). Furthermore, surprisingly yttria-stabilized zirconia bioceramic without fullerene C film also shows an improved antibacterial efficacy after a tribomechanical patterning procedure. The addition of surface patterning on the ZrO by scratching microgroove arrangements with a diamond tip, increased the antibacterial effect against Gram-positive by 70.46% (log reduction 0.53).
4D Printing in Biomedical Implants and Functional Healthcare Devices.
Shafiq M, Zeb L
J Funct Biomater · 2026 Apr · PMID 42042311 · Full text
Four-dimensional (4D) printing integrates additive manufacturing with stimuli-responsive materials to fabricate biomedical implants and functional healthcare devices that undergo programmed, time-dependent changes in sha...
Four-dimensional (4D) printing integrates additive manufacturing with stimuli-responsive materials to fabricate biomedical implants and functional healthcare devices that undergo programmed, time-dependent changes in shape or function. Unlike static 3D-printed constructs, 4D-printed systems can respond to clinically relevant stimuli such as temperature, hydration, pH, light (including near-infrared), magnetic fields, or electrical inputs. These triggers drive defined actuation mechanisms, most commonly thermomechanical shape-memory recovery, swelling-induced morphing, and magnetothermal activation. This review synthesizes the principal material platforms used for biomedical 4D printing, including shape-memory polymers and alloys, hydrogels, liquid-crystal elastomers, and responsive composites, and links material choice to device behavior and translational feasibility. Applications are discussed across self-expanding stents, cardiac occluders, tissue-engineered constructs, implantable drug delivery systems, and adaptive wearables. Key translational challenges include sterilization compatibility, manufacturing reproducibility and quality control, safe stimulus delivery, predictable biodegradation and long-term biocompatibility, and regulatory pathway definition.
Recombinant Human SLPI Surface Functionalization Enhances Early Osseointegration and Biomechanical Stability of Titanium Implants in Rat Model.
Chouyratchakarn W, Boonsri B, Tangkamonsri S … +3 more , Thepsupa W, Supanchart C, Kumphune S
J Funct Biomater · 2026 Apr · PMID 42042310 · Full text
Titanium and its alloys are used in dental and orthopedic implants. However, long-term stability remains a clinical challenge. To overcome this limitation, surface modification has been investigated to improve surface pr...
Titanium and its alloys are used in dental and orthopedic implants. However, long-term stability remains a clinical challenge. To overcome this limitation, surface modification has been investigated to improve surface properties. Our previous study demonstrated that the immobilization of secretory leukocyte protease inhibitor (SLPI) on the titanium surface promotes osteoblast adhesion, proliferation, and differentiation in vitro. The current study demonstrated the first in vivo evaluation of SLPI as a bioactive coating for medical implants. Grade 5 titanium screws were coated with 10 µg/mL of recombinant human SLPI (rhSLPI) for 24 h via simple physical adsorption, and the results were preliminarily validated via FE-SEM and ELISA. These SLPI-coated titanium screws (TiSs) were then placed in the tibia of Sprague-Dawley rats for 4 and 8 weeks. The hematological and biochemical parameters (BUN, Creatinine, AST, and Troponin I) demonstrated no acute systemic alterations within the 8-week period across all groups. Moreover, micro-computed tomography (micro-CT) and histological analysis revealed significantly higher bone volume fraction (%BV/TV) at 4 weeks compared to uncoated controls (20.64% ± 2.452% vs. 11.73% ± 0.524%). Finally, the biomechanical stability of implants, assessed using the removal torque test, showed that TiSs showed higher strength compared to Ti at both 4 and 8 weeks. In conclusion, this study represents a novel approach to transitioning rhSLPI-coated titanium evaluation from in vitro models to an in vivo rat model. rhSLPI surface functionalization enhances early-stage osseointegration and improves implant mechanical stability without acute hematological and biochemical alterations. These proof-of-concept findings suggest the potential of SLPI as a bioactive coating strategy.
Microstructure-Dependent Rotational Wear of Dental Glass-Ceramics Under Low Humidity.
Sánchez-González E, Rodríguez-Rojas F, Borrero-López O
J Funct Biomater · 2026 Apr · PMID 42042309 · Full text
: The wear resistance of modern commercial glass-ceramic materials used in dental prostheses was investigated under cyclic contact conditions that included a rotational component. This loading mode has been largely overl...
: The wear resistance of modern commercial glass-ceramic materials used in dental prostheses was investigated under cyclic contact conditions that included a rotational component. This loading mode has been largely overlooked in conventional in vitro wear testing, yet may be clinically relevant in patients with parafunctional conditions such as bruxism. : Rotational loading was applied using an all-electric testing machine equipped with a biaxial actuator. Loading cycles combined a normal load (50 N) and a rotation (30°), at a frequency of 1 Hz. Microstructure and damage were characterized using advanced microscopy. : Rotational loading induced substantial damage across this class of materials, including the formation of glassy tribolayers with limited protective capability under the low-humidity conditions examined. Significant microstructure-dependent variations in wear volume were observed, with specific wear rates indicating severe wear (SWR above 10 mm/N·m threshold) in three of the five materials tested. Lithium disilicate glass-ceramics, characterized by a high fraction of elongated reinforcement crystals, exhibited the greatest resistance to damage, whereas leucite-based glass-ceramics showed the lowest. The dominant wear mechanisms were plastic-deformation-induced grooving and fracture-driven chipping. The findings are interpreted within established wear models for brittle materials (Archard and fracture-based) and supported by numerical simulations of stress fields across multiple length scales. : The results provide mechanistic insight into rotational wear damage in glass-ceramic systems, a material class particularly susceptible to such loading, and inform strategies for material selection and microstructural design aimed at improving prosthetic durability.
Cotton-Type Nanofiber Guided Pathway Engineering Enables Rapid Tissue Integration and Accelerated Bone Regeneration in Mineral Powder-Based Bone Grafts.
Park S, Nonjola SC, Kim JI … +1 more , Lee S
J Funct Biomater · 2026 Apr · PMID 42042308 · Full text
Mineral powder-based bone grafts exhibit excellent osteoconductivity; however, their clinical efficacy is often compromised by insufficient early-stage tissue ingrowth, leading to particle aggregation and pocket formatio...
Mineral powder-based bone grafts exhibit excellent osteoconductivity; however, their clinical efficacy is often compromised by insufficient early-stage tissue ingrowth, leading to particle aggregation and pocket formation within the defect site during the initial healing phase. Here, we report a cotton-type nanofiber-guided mineral graft designed to overcome this early integration failure by creating fibrous pathways for tissue ingress. Cotton-type polycaprolactone (PCL) nanofibers were fabricated via electrospinning using a pin-based collector engineered to induce strong inter-fiber repulsion, resulting in a highly expanded, three-dimensional cottony architecture. Tetracalcium phosphate (TTCP) and α-tricalcium phosphate (α-TCP) mineral particles were subsequently deposited onto the surface of the cottony nanofibers, forming a fibrous-mineral hybrid graft (c-NF@T/α-TCP) in which the nanofibers act as a transient, functionally defined tissue-guiding framework during the early healing phase. The cottony nanofiber network effectively prevented mineral particle aggregation and generated continuous pathways within the graft, facilitating early tissue infiltration and vascular ingress during the first week after implantation. In vivo evaluation in a bone defect model demonstrated that c-NF@T/α-TCP significantly reduced tissue pocket formation at early time points and promoted subsequent bone regeneration compared to mineral powder-only grafts. This study highlights the critical importance of early-stage structural guidance in mineral-based bone grafts and introduces cotton-type nanofiber-guided pathway engineering as a simple yet effective strategy to unlock the regenerative potential of conventional inorganic bone substitutes.
How Bioactive Glass S53P4 Kills Bacteria.
Rajkumar D, Stiller A, Wijnheijmer J … +6 more , Schimmel IM, Hamoen LW, Hupa L, Wel NNV, Balraadjsing PPS, Zaat SAJ
J Funct Biomater · 2026 Apr · PMID 42042307 · Full text
Bioactive glass (BAG) S53P4 is a clinically approved bone substitute with antibacterial, osteoconductive and osteostimulatory properties. Its antibacterial effect is associated with ion release, local pH elevation and os...
Bioactive glass (BAG) S53P4 is a clinically approved bone substitute with antibacterial, osteoconductive and osteostimulatory properties. Its antibacterial effect is associated with ion release, local pH elevation and osmolality, but the precise biochemical and biophysical mode-of-action is unclear. This study investigates the antibacterial mechanism of BAG S53P4 eluates. BAG eluates, collected at 2, 4, 8, and 24 h, eradicated . Elemental analysis revealed an early increase in concentrations of Si and Na, a later rise in Ca, depletion of P over time and rapid loss of Mg. Membrane disturbances occurred within 5 min, evident by permeability for SYTOX, aligning with time-kill kinetics for and . In , 2h-BAG-eluate induced rapid delocalization of marker proteins for cell division and DNA repair, signaling membrane potential collapse and nucleoid condensation. Transcriptomics revealed early transcription remodeling reflecting ionic and energetic imbalance, including disruption of central metabolism, redox homeostasis, and translational stability. Scanning electron microscopy revealed severe cell surface damage and particulate deposits on . Transmission electron microscopy showed cell envelop disruptions and cytoplasmic leakage. Energy dispersive X-ray analysis identified Si on bacterial cell surface at 4 h and intracellular accumulation in punctured, empty cells at 24 h. Overall, BAG ionic dissolution products kill bacteria through a stepwise mechanism involving membrane damage, protein delocalization and metabolic impairment, accompanied by Si deposition on bacterial surfaces and loss of Mg. This finally leads to cell wall degradation, cytoplasmic content leakage and further Si deposition on the cells and inside cell ghosts.
Nanotopography-Mediated Mechanotransduction Enhances hBMSCs Adhesion on TiO Nanotubes.
Xiong C, Feng H, Lu L … +7 more , Jing Z, Wang Y, Yang Y, Meng D, Zhang Y, Li W, Cai H
J Funct Biomater · 2026 Apr · PMID 42042306 · Full text
Titanium and its alloys are widely used for orthopedic implants, but their intrinsic bioinertness may hinder osseointegration. In this study, titanium dioxide nanotube (TNT) arrays were fabricated on Ti-6Al-4V scaffolds...
Titanium and its alloys are widely used for orthopedic implants, but their intrinsic bioinertness may hinder osseointegration. In this study, titanium dioxide nanotube (TNT) arrays were fabricated on Ti-6Al-4V scaffolds via anodization, and their effects on the adhesion behavior of human bone marrow mesenchymal stem cells (hBMSCs) were investigated. Surface characterization showed that anodization successfully generated ordered TNT layers, increased surface roughness, enhanced protein adsorption, and induced an apparent superhydrophilic wetting response. Compared to the untreated scaffold and TNT50, the small-diameter TNT10 surface significantly promoted hBMSC adhesion and proliferation. Microscope imaging further revealed enhanced cell spreading, F-actin organization, and vinculin expression on TNT surfaces, with the most prominent focal adhesion-related staining observed in TNT10. Quantitative proteomic analysis showed that TNT10 was associated with coordinated remodeling of adhesion- and cytoskeleton-related molecular programs, including focal adhesion, cell-substrate junction, and regulation of the actin cytoskeleton. In contrast, TNT50, despite supporting obvious cytoskeletal remodeling, was more compatible with a dynamic, higher-turnover adhesion state. Overall, these findings suggest that small-diameter TNTs provide a more favorable interfacial microenvironment for stable early hBMSC adhesion on porous titanium scaffolds.
ATP-Responsive Bimetallic Metal-Organic Frameworks Amplify Oxidative Stress in the Tumor Microenvironment for Synergistic Chemo-Immunotherapy.
Li Y, Zhang W, Xu Z … +6 more , Ma S, Xiong Y, Yu L, Gao H, Shu Y, Fei T
J Funct Biomater · 2026 Apr · PMID 42042305 · Full text
Metal ion-based chemo-immunotherapy is often limited by rigid intracellular metal homeostasis, insufficient reactive oxygen species (ROS) accumulation, and an immunosuppressive tumor microenvironment (TME). To overcome t...
Metal ion-based chemo-immunotherapy is often limited by rigid intracellular metal homeostasis, insufficient reactive oxygen species (ROS) accumulation, and an immunosuppressive tumor microenvironment (TME). To overcome these limitations, we engineered an ATP-responsive, core-shell bimetallic nanoreactor (Cu/ZIF@PDA, termed CZP) featuring a precisely controlled ~25 nm biomimetic polydopamine (PDA) coating. Triggered by elevated tumoral ATP levels, CZP undergoes coordination-induced disassembly and promotes oxidative stress amplification. Specifically, the PDA shell acts as a superoxide dismutase (SOD) mimetic to continuously supply HO, fueling Cu-mediated Fenton-like reactions to unleash highly toxic hydroxyl radicals (•OH) while aggressively depleting the intracellular glutathione (GSH) pool. This irreversible oxidative damage, coupled with Zn-induced mitochondrial dysfunction, triggers profound mitochondrial DNA (mtDNA) leakage. Crucially, this cytosolic DNA robustly activates the cGAS-STING signaling axis, driving a massive surge in immunogenic cell death (ICD) and significantly promoting dendritic cell (DC) maturation. Furthermore, CZP markedly inhibited primary tumor growth in vivo and showed protection in a tumor re-challenge model, accompanied by enhanced dendritic cell maturation. These findings support the potential of this ATP-responsive bimetallic nanoplatform to promote antitumor immune activation.
Bone Compatibility of Experimental Ti-Ag and Ti-Cu Alloy Dental Implants in a Beagle Dog Model.
Ohtsuka Y, Tenkumo T, Takahashi M … +3 more , Nakanishi Y, Takebe H, Nezu T
J Funct Biomater · 2026 Apr · PMID 42042304 · Full text
Titanium-silver (Ti-Ag) and titanium-copper (Ti-Cu) alloys have been developed to improve the mechanical properties and machinability of titanium (Ti) for dental applications while maintaining corrosion resistance compar...
Titanium-silver (Ti-Ag) and titanium-copper (Ti-Cu) alloys have been developed to improve the mechanical properties and machinability of titanium (Ti) for dental applications while maintaining corrosion resistance comparable to that of pure Ti. Herein, cylindrical dental implants composed of experimental Ti-20Ag, Ti-30Ag, Ti-5Cu, and Ti-10Cu (mass%) alloys were fabricated and implanted into the jawbones of beagle dogs to evaluate bone compatibility. Pure Ti and Ti-6Al-4V alloy implants were used as controls. Because the implant surfaces were mechanically polished, the experimental alloys, which exhibited higher hardness than Ti, showed lower surface roughness than Ti. Radiographic observations revealed no remarkable bone resorption around any implants during the experimental period. Histological evaluation demonstrated new bone formation and partial bone contact around implants at 1 and 3 months post-implantation. Although the bone-implant contact ratio was relatively low owing to the cylindrical implant design and limited initial stability, no significant differences were observed between the experimental alloys and Ti. These results indicate that Ti-Ag and Ti-Cu alloys improve mechanical properties while maintaining bone compatibility comparable to that of Ti, suggesting their potential as candidate materials for dental implant applications, particularly for narrow dental implants.
Personalized 3D-Printed Hybrid PDMS and PEEK Implants for Revisional Orbitomaxillary Reconstruction: A Translational Case-Based Technical Note.
Marić G, Solter D, Doko Mandić B … +5 more , Škunca Herman J, Vatavuk Z, Godec D, Vagić D, Pegan A
J Funct Biomater · 2026 Apr · PMID 42042303 · Full text
The reconstruction of complex orbitomaxillary defects requires biomaterials that can simultaneously provide structural stability, biocompatibility, and accurate restoration of facial volume and contour. While rigid polym...
The reconstruction of complex orbitomaxillary defects requires biomaterials that can simultaneously provide structural stability, biocompatibility, and accurate restoration of facial volume and contour. While rigid polymers such as polyetheretherketone (PEEK) offer reliable mechanical support, they do not adequately replicate the viscoelastic behavior of soft tissues. This report presents a translational revision case employing a personalized hybrid biomaterial approach that combines a 3D-printed PEEK implant for structural orbital floor support with a patient-specific polydimethylsiloxane (PDMS) implant for malar volumetric augmentation. Reconstruction was planned using CT segmentation and contralateral mirroring. Patient-specific implants were subsequently designed using CAD/CAM techniques, combining a rigid PEEK implant for structural orbital support with a flexible PDMS implant for malar volumetric augmentation with complementary mechanical properties. Revision surgery included the removal of inadequately positioned titanium hardware, the release of incarcerated extraocular muscles, and the restoration of orbital anatomy and facial symmetry. Postoperative imaging demonstrated stable implant positioning and sustained orbitomaxillary stability. Despite successful anatomical reconstruction, residual functional sequelae, including strabismus related to the severity of the initial orbital trauma, persisted and were addressed separately in a staged manner, resulting in satisfactory ocular alignment and resolution of diplopia in primary gaze. This case underscores the complementary functional roles of rigid and elastic polymers and highlights the translational potential of PDMS as a permanent, patient-specific implant material for volumetric and contour restoration in craniofacial reconstruction.
Acellular Dermal Matrix (WITHderm) Spacer Grafts for the Prevention of Lower Eyelid Ectropion After Subciliary Approaches in Facial Fracture Surgery: A Preliminary Study.
Kim W, Jang EA, Kim KN
J Funct Biomater · 2026 Apr · PMID 42042302 · Full text
The subciliary approach offers excellent exposure for orbital and zygomaticomaxillary complex fracture repair but is associated with a relatively high risk of postoperative lower eyelid ectropion. This study evaluated th...
The subciliary approach offers excellent exposure for orbital and zygomaticomaxillary complex fracture repair but is associated with a relatively high risk of postoperative lower eyelid ectropion. This study evaluated the preventive efficacy of an acellular dermal matrix (ADM; WITHderm) spacer graft placed during subciliary incision repair. This prospective observational cohort study included 20 patients who underwent open reduction and internal fixation for orbital wall or zygomaticomaxillary complex fractures using a subciliary approach between June and December 2024. A human-derived ADM (WITHderm) spacer graft was interposed between the orbital septum and the orbicularis oculi muscle during incision closure. Postoperative outcomes were assessed at three time points: ectropion grading at 1 month and scar outcomes at 3 and 6 months using the Patient and Observer Scar Assessment Scale (POSAS). No patients developed postoperative lower eyelid ectropion at 1-month follow-up (0% incidence). Both patient-reported and observer-reported scar outcomes improved significantly over time. The mean total PSAS score decreased from 21.0 ± 2.85 at 3 months to 11.3 ± 2.13 at 6 months ( < 0.001), while the mean total OSAS score decreased from 21.35 ± 2.25 to 11.4 ± 1.67 ( < 0.001). Overall patient satisfaction and objective scar ratings also showed significant improvement. ADM (WITHderm) spacer grafting during subciliary incision repair appears to be a safe and effective strategy for preventing early postoperative lower eyelid ectropion and achieving favorable scar outcomes. Further studies are warranted to confirm these findings.
Comparative Cytocompatibility and Oxidative Stress Analysis of Green-Synthesized Nano-Silver Fluoride and Silver Diamine Fluoride in Human Gingival Fibroblasts.
Palankalieva AP, Stoykova ID, Georgiev MI … +1 more , Belcheva AB
J Funct Biomater · 2026 Apr · PMID 42042301 · Full text
Silver diamine fluoride (SDF) is widely used in pediatric dentistry for caries arrest; however, concerns exist regarding its cytotoxicity. Green-synthesized nano-silver fluoride (NSF) is a potential alternative to SDF, o...
Silver diamine fluoride (SDF) is widely used in pediatric dentistry for caries arrest; however, concerns exist regarding its cytotoxicity. Green-synthesized nano-silver fluoride (NSF) is a potential alternative to SDF, offering antimicrobial efficacy with improved biocompatibility. This study aimed to evaluate the in vitro safety profile of green-synthesized NSF with 5% (/) fluoride using extract and to compare it with 38% SDF + potassium iodide (KI) formulation in human gingival fibroblasts (HGFs). Eluates of NSF and SDF+KI were tested at serial concentrations of 5%, 1%, 0.1%, 0.01% and 0.005%. Cell viability was assessed after 24, 48, and 72 h using the MTT assay. Additionally, the formation of reactive oxygen species (ROS) in HGFs was detected through fluorescence microscopy. Exposure to 5% SDF+KI resulted in almost complete loss of cell viability at all time points, whereas NSF demonstrated significantly higher viability under the same conditions. Lower concentrations of both materials maintained acceptable biocompatibility. ROS analysis revealed increased oxidative stress in response to 5% SDF+KI, while NSF induced significantly lower ROS levels. NSF exhibited superior biocompatibility compared to SDF+KI, supporting its potential as a safer silver-based material for caries management. Further in vitro and in vivo studies are needed to confirm its clinical safety profile.
Accuracy of Static Computer-Aided Implant Surgery: A Clinical Comparison of Tooth-, Bone-, and Mucosa-Supported Surgical Guides.
Smojver I, Bjelica R, Vuletić M … +3 more , Stojić L, Njari Galić V, Gabrić D
J Funct Biomater · 2026 Apr · PMID 42042300 · Full text
The accuracy of static computer-aided implant surgery (s-CAIS) is fundamental for predictable clinical outcomes. The objective of this study was to evaluate the influence of different guide-support modalities on the line...
The accuracy of static computer-aided implant surgery (s-CAIS) is fundamental for predictable clinical outcomes. The objective of this study was to evaluate the influence of different guide-support modalities on the linear and angular accuracy of implant placement. In this retrospective clinical investigation conducted at a single specialty hospital, a total of 180 implants were analyzed, divided into three equal groups (n = 60) based on the guide support type: tooth-supported, bone-supported, and mucosa-supported. Accuracy was assessed by superimposing preoperative virtual plans with postoperative cone-beam computed tomography (CBCT) scans, measuring linear deviations at the neck and apex of the implant, as well as angular discrepancies. The type of guide support was found to be a significant factor associated with surgical accuracy ( < 0.001). Tooth-supported guides demonstrated the highest level of accuracy, with a mean angular deviation of 1.81° ± 0.45° and linear deviations at the neck and apex of 0.59 ± 0.18 mm and 0.73 ± 0.19 mm, respectively. These were followed by bone-supported guides (2.14° ± 0.48°; 1.04 ± 0.26 mm; 1.61 ± 0.31 mm), while mucosa-supported guides exhibited the greatest deviations (2.95° ± 0.60°; 1.47 ± 0.29 mm; 1.87 ± 0.37 mm). Significant intergroup differences and large effect sizes were observed, particularly regarding angular and horizontal discrepancies. These findings demonstrate a distinct gradient of accuracy based on guide support, establishing tooth-supported guides as the most accurate, followed by bone-supported and, lastly, mucosa-supported guides. While all modalities are clinically applicable, the use of mucosa-supported guides necessitates increased safety margins to account for the increased risk of linear and angular discrepancies inherent to mucosal tissue displacement.
Synthesis and Characterization of Modified Chitosan Materials with Assessment of Their Antibacterial and Antiviral Activities.
Bouzir D, Elamri A, Zdiri K … +4 more , Hamdaoui M, Delaite C, Lallam A, Harzallah OA
J Funct Biomater · 2026 Apr · PMID 42042299 · Full text
Modified chitosan (Cs) derivatives were synthesized and evaluated as potential antibacterial and antiviral coatings of medical protective equipment (facial masks, gloves, …). Quaternized chitosan (HTCC) and chitosan-silv...
Modified chitosan (Cs) derivatives were synthesized and evaluated as potential antibacterial and antiviral coatings of medical protective equipment (facial masks, gloves, …). Quaternized chitosan (HTCC) and chitosan-silver nanocomposites (Ag/Cs) were successfully prepared, with structural characterization confirming efficient quaternization and uniform incorporation of silver nanoparticles. Antibacterial testing revealed that HTCC exhibited concentration-dependent activity, while Ag/Cs showed strong broad-spectrum antibacterial effects and enhanced thermal stability. Antiviral assays against SARS-CoV-2 demonstrated significant viral inhibition for HTCC6 and Ag/Cs at non-cytotoxic concentrations (6 mg/mL), highlighting the role of cationic charge and nanoparticle inclusion in antiviral efficacy. These findings indicate that the developed chitosan derivatives are promising candidates for sustainable functional coatings on medical devices, offering potential applications in infection prevention.
Setting Characteristics, Solubility, Bioactivity and Interaction with Dentin of Four Calcium Silicate-Based Endodontic Sealers.
Vrochari AD, Agrafioti A, Dimitriadi M … +1 more , Eliades G
J Funct Biomater · 2026 Apr · PMID 42042298 · Full text
The aim of this study was to evaluate setting time, hardness, solubility, bioactivity and interaction with dentin of four calcium silicate-based sealers (CSBS). Three single-phase CSBS (AH Plus Bioceramic/AHB, CeraSeal/C...
The aim of this study was to evaluate setting time, hardness, solubility, bioactivity and interaction with dentin of four calcium silicate-based sealers (CSBS). Three single-phase CSBS (AH Plus Bioceramic/AHB, CeraSeal/CSL, TotalFill BC/TFL), one powder/liquid CSBS (BioRoot RCS/BRT) and an epoxy control (AH Plus Jet/AHP) were investigated. Setting time was evaluated on glass (G1) and dentin (G2) surfaces, by adding 1%wt purified water to single-phase products. For hardness measurements, the Shore-D hardness test was used. Solubility was assessed according to the ISO 6876:2012 standard. For bioactivity screening, 1-week set specimens were immersed in SBF or water (30 days/37 °C) and examined by ATR-FTIR spectroscopy. Interaction with dentin was tested by ATR-FTIR before and after contact with the sealers. For setting time in G1, all CSBS failed to comply with the ISO standard, while in G2, most materials were set in the range of 6-8 h, except for CSL. The ranking of significant differences in hardness was AHP, BRT > CSL, AHB, TFL. Regarding solubility, AHB, BRT and AHP were found to comply with the ISO standard, whereas CSL and TFL failed. For bioactivity, characteristic peaks of calcium phosphates were found in all CSBS, with TFL being the most bioactive. A chemical interaction between CSBS and dentin was registered, with a strong reduction in collagen peaks and an increase in carbonates. The CSBS tested exhibited great variance in their behaviour regarding the properties assessed, although a strong deproteinating effect was registered on dentin for all.
Using Citric-Acid-Based Anodization to Form Magnesium-Doped Carbonated Apatite-Containing Oxides on Solid and 3D-Printed Titanium Substrates.
Parekh A, Ettuthaiyil Sambasivan A, Paul M … +7 more , Soltani A, Ali A, Tucker J, Pegues JW, Shamsaei N, Janorkar AV, Roach MD
J Funct Biomater · 2026 Apr · PMID 42042297 · Full text
With increasing life expectancy and an aging global population, the demand for orthopedic and dental implants is increasing. Recently developed, citric-acid-based anodization processes facilitate the production of more b...
With increasing life expectancy and an aging global population, the demand for orthopedic and dental implants is increasing. Recently developed, citric-acid-based anodization processes facilitate the production of more bioactive oxide layers by incorporating important bone minerals such as Ca, P, and Mg and forming bone-like crystalline compounds such as carbonated apatite on titanium implant materials. The primary goal of the present study was to evaluate the applicability of these anodization processes to solid and 3D-printed titanium alloy substrates. The anodized oxides produced on each solid or 3D-printed lattice substrate revealed multi-scaled surface roughness profiles as evidenced by scanning electron microscopy, optical microscopy, and surface roughness analyses. Additionally, each oxide group was shown to incorporate substantial amounts of Ca, P, and Mg bone-mineral dopants and form AB-type carbonated apatite, as shown using a combination of energy-dispersive spectroscopy, X-ray photoelectron spectroscopy, X-ray diffraction, and attenuated total reflectance-Fourier transform infrared spectroscopy analyses. Finally, each oxide group showed sustained Ca, P, and Mg ion release during an inductively coupled plasma spectroscopy dissolution assessment, and demonstrated early apatite-forming ability during simulated body fluid bioactivity testing. The findings of this study show much promise for the applicability of these novel oxide coatings to a wide variety of future titanium implant applications.
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