Nature is the mystery and chasing andunfolding that mystery is human nature.

Biomimetic materials

used in

Conservative Dentistry &

EndodonticsPresented by:

Dept. of Conservative Dentistry & EndodonticsGuru Nanak Institute of Dental Sciences & Research

Kolkata

Dr. Tirthankar Bhaumik, Dr. Antava Maiti, Dr. Debojyoti Majumdar, Dr. Monojit Roy

• Starting from prehistoric era man behavedsimilarly to animals in hunting and makingshelter for survival.

• In the legend of Icarus & his father

Daedalus, inspired by birds, made wingsfrom feathers and wax for them to escapefrom prison.

• In the real world, Leonardo da Vinci in the15th century dreamed of fabulous flyingmachines based on birds, although it was notuntil the 20th century that the Wrightbrothers successfully created a prototypethat led to the modern aircraft of today.

• So these revolution from flying birds totodays aircraft reflects the human’s nature ofmimicking the Nature’s secrets.

• Thus Nature acts as a motivation factor whichlead to development of new era of science—

Yes, it is

BIOMIMETICS

CONCEPT OF BIOMIMETICS

AND

BIOMIMETIC MATERIAL

WHAT IS BIOMIMICRY ?

Biomimicry is the science and art of emulating Nature's best biological ideas to solve human

problems.

In biomimicry, we look at nature as model, measure, and mentor.

Janine Benyus1997,Biomimicry

After 3.8 billion years of evolution, nature has learned

What works. What is appropriate. What lasts.

Biomimicry introduces an era based not on whatwe can extract from organisms and theirecosystems, but on what we can learn from them.

Examples….

Mimicking can be done by using either

Natural substitutes

or

Synthetic substitutes

Why synthetic materials are preferred?

• More availability

• Relatively easier synthesis

• Reduced risk of pathogen transmission

• Biocompatibility

• Biodegradability

Synthetic mimicking• Structural

• Functional

• Esthetic

• Structural-functional

• Biological process mimicking

WHAT IS BIOMIMETICS?

Biomimetic refers to human-made processes, materials, devices, or systems that imitate nature.

Materials

Processing & tools

Fabrication/Manufacturing

Devices & machines

Functions & Mechanisms

Principles

Almost all engineering could be thought of as a form of biomimicry

Scope of Biomimetics

• Biomedical science

• Dentistry

• Electronics

• Materials scientists

• Chemists

• Geologists

What is Biomimetic material?

A material fabricated by Biomimetic

technique based on natural process

found in biological systems is called a

biomimetic material

Don’t Confuse

with…

Bioactive material

A bioactive material is one that elicits a specificbiological response at the interface of thematerial which results in the formation of abond between the tissues and the material

Hench LL, Splinter RJ, Allen WC, Greenlee TK Jr.; Bonding mechanisms at the interface of ceramic prosthetic materials. J Biomed Mater Res., 1972; 2:117-141

Bioactive material

Osteoproductive(45S5 Bio glass)

Osteoconductive(Synthetic HA)

Key points

of

biomimetic

materials

1) Should be synthetic in origin

2) Should mimic biology

3) Should bond with natural structure

4) Should not elicit any biological responses

Advanced Ceramics for Strategic Applications, Prof. H. S. Maiti, Department of Mechanical Engineering, Indian Institute of Technology, Kharagpur , Lecture – 47, Bio ceramics

HISTORY

• The foundation of this broad new field hasancient roots.

• First or second century AD- Evidence ofcrude dental implants seen in romanpopulation and the first use of dentalamalgam was recorded in pre-Columbiancultures of central and south America.

• 659 AD- use of heart pacemaker the artificialheart valve and hip and knee joint arewritten in Chinese literature.

• 1960 - The subject of copying, imitating, andlearning from biology was coined Bionics byJack Steele

• 1969- Otto Schmitt, an American academicand inventor, coined the term biomimetics

• 1974- The term biomimetics only entered theWebsters Dictionary.

• 1982- The term biomimicry appeared.

• 1997- The term biomimicry was popularizedby scientist and author Janine Benyus in herbook ‘Biomimicry: Innovation Inspired byNature.’

Biomimetic materials used in Biomedical Science

• PMMA (acrylic), Silicone- Intra ocular lens, Breast implant

• Titanium & its alloys, Polyether ether ketone (PEEK)- Artificial hip joints,

Dental implants

• Polyurethane, Teflon & Dacron- Vascular grafts

etc……

Biomimetic dentistry

• The use of dental materials and technologies that mimic tooth structure and function.

• Maintaining as much natural tooth structure as possible.

• Materials should absorb and distribute stress like tooth structure and should bond with natural structure.

• Enamel like materials.

• Dentin like materials.

Biomimetic materials

used in

Conservative Dentistry

and Endodontics

Why?

Natural hard tooth structure once lost forany reason is not ever reproduced by thebody system, hence dependence onsimulating materials becomes essentialfor restoring it to form and function.

• Some of the materials simulate toothmaterials but additionally exhibit some bio-active properties.

• These materials are clubbed together in thegroup of bioactive material

• e.g.-

MTA,

Biodentine,

Synthetic hydroxyapatite etc..

1) Glass ionomer cement

2) Dental composite material

3) Dental ceramics

Definition

• Glass-ionomer is the generic name of a

group of materials that use silicate glass

powder and aqueous solution of polyacrylic

acid” -Kenneth J Anusavice.

Composition

Conventional Glass-ionomer cement

Basic Component Calcium aluminosilicate

glass containing fluoride

Acid Component

Polyelectrolyte which is a

homopolymer or copolymer of

unsaturated carboxylic acids

known scientifically as

alkenoic acids.

GLASS-IONOMER CEMENT is a Biomimetic

Material

Because ,

1. It is synthetic

2. It does not form any natural tooth structure.

3. It’s similar mechanical properties to dentin.

4. Adheres chemically to the tooth structure

5. Less shrinkage ,so less microleakage

6. Dimensional stability at high humidity

Elastic Modulus (Gpa)

Thermal Expansion Coefficient(ppm)

Ultimate Tensile Strength (Mpa)

Ultimate compressive strength (Mpa)

Hardness (KHN)

Enamel ~82 ~10 ~384 350-430

Dentin ~40-105 ~297 ~68

Conventional GIC

~4.5 196-251 87-177

~11

~10-11

~14

~4-10

~8

• Properties of GIC not adequately matching it’s biomimetic behaviour

1. Low Tensile strength

2. High opacity (Contrast ratio- 0.9 )

3. Less Wear Resistance

Modifications of Glass-Ionomer

• 1) Water settable GIC

• 2) Metal modified GIC

• 3) Resin modified GIC

Metal modified GIC –

• Glass ionomer have been modified by addition of filler particles ,to improve fracture toughness & resistance to wear with different results.

• Disadvantages-

Poor aesthetics

Alteration of Biomimetic property

• Inspite of modification the mechanical properties did not reflect much improvement. Compressive strength ,flexural strength and solubility remained same .

• Wear resistance- wear resistance of silver cermet cement is somewhat improved over traditional glass ionomer cement.

• Esthetics- By the incorporation of silver particle it takes away the estheticproperty of glass ionomer .

Resin modified GIC –

It may be auto-cured, Light-cured, dual-cured depending on activator initiator system.

• Alteration of Biomimetic properties –• Optical properties- Improved from

conventional GIC, as translucency improved.

• Strength- The diametral tensile strength is much higher but compressive strength and hardness is lesser.

• Adhesion- Bond strength of resin modified glass ionomer with dentin is higher than that of conventional G.I.C

• Microleakage- Increased due to polymerization shrinkage of resin

N-vinylpyrrolidone (NVP) or N-vinylcaprolactam(NVC) containing GIC –

• NVP or NVC co-monomers when incorporated in GIC they act as a spacer in between itaconic acid and acrylic acid, thereby increasing the degree of freedom of side chain carboxylic group for reaction.

• AA-IA-NPV (Fuzi IX) mechanical properties--

Compressive strength-277 MpaFlexural strength- 46 MpaDiametral Tensile strength-21.6 Mpa

GIC as Biomimetic Material

• Glass-Ionomer cement is extensively used to replace Dentin, hence it is called as

• Dentin Substitute

• Man made Dentin

• Artificial Dentin

Restorative including deep cavities

LutingGIC as Biomimetic

Material in Conservative

Dentistry

Liner & BasesMinimum Intervention

Restoration of Non Carious Cervical Lesion with G.I.C

Class V caries restored with G.I.C

Restoration of Class I cavity with G.I.C

GIC as base

GIC as a luting agent

• GIC as Biomimetic Material in Endodontics –

• Intracanal Rehabilitation, reinforcement-• To ensure a better prognosis in cases like flared canal

where intraradicular dentin thickness is very less, “Reinforcement Technique” should be followed.

• The intraradicular reinforcement method includes placing a thick intermediate layer of adhesive material, sandwiched between the root dentine and a small-diameter metal post or dowel, to improve the fracture resistance of such roots , which acts as a dentin substitute.

• GIC is one of the preferred dentin substitute here, as a biomimetic material.

Core Build up –

• The metal reinforced glass ionomer cements are used for this purpose

• Glass ionomercements reinforce the teeth

Glass-ionomer based sealer

• Glass ionomer based sealer has been advocated for use in obturation because of their dentin bondngproperty

• It enables adhesion between the material and canal wall

• Disadvantage-It has minimum anti bacterial property

• Removal is difficult in case of retreatment

Root canal perforation repair—

• GIC can be used to repair perforation during root canal procedure as dentin substitute.

• Calcium

phosphate i.e

hydroxyapati

te

substituted

with

carbonate

ions.

• Ions of

Strontium,Mg

,lead,Fl.

Inorganics,96% by vol.

ENAMEL

Organics & water,4% by vol.

• Proteins like

enamelins..

• Ameloblast

cells

DENTIN

Organics20% by wt.,33% by vol.

Calcium 26.9%

Phosphorous

13.2%

Carbonate

4.6%

Sodium 0.6%

Magnesium

0.8%

• Collagen 90%

• Proteins

• Lipids

Water10% by wt.,22% by vol.

Materials formed from two constituents that are insoluble in one another, forming a material with properties that are superior or intermediate to those of the constituents but at the same time maintaining their own characteristics..

I Resin Matrix :BIS-GMA or Urethane

Dimethacrylate (UDMA) +

Dimethacrylate monomers (TEGDMA)

II Inorganic Fillers :

Quartz/Glass Particles (0.1 to 100µm)

Colloidal Silica (0.02 to 0.04 µm)

CONTENT 30-70% vol.

50-85% wt.

III Coupling Agents : organosilanes

IV Pigments : oxides of titanium

ACTIVATOR:Tertiary amines

PHOTO-

INITIATOR:Camphorquinone

CHEMICAL-

INITIATOR:Benzoyl Peroxide

Esthetics

The Influence of Dental Anatomy

Dental anatomy and contour influence the color of the teeth and esthetic restorations.

Dentin gives teeth a more opaque (dense) appearance than enamel.

Variation of shade

• Acc. to age:In younger patients, enamel and dentin are thicker, and

more opaque and less translucent, in the

incisal area. In newly erupted permanent incisors, the

mamelons are present and result in a

dense, slightly darker, yellowish area at the incisal edges.

• Whether enamel or dentin is exposed

• Acc.to the vitality of the tooth:

Physics, Light and Color

• The hue is what we would typically think of as “color”.

• The chroma is the degree of saturation or purity of that hue.

• The value is the degree of lightness or darkness of the color or material and ranges from black (value 0) to white (value 10).

Acc. to the Munsell system

The type of light under which color/shade is

judged

influences the perception of color/shade.

A shade must mimic the translucency and opacity

of the

tooth in order to be able to blend in.

• Ask patient to remove lipstick.• Place a light blue/grey/white bib over the patient’s clothing.• Select shades at the start of the appointment and before prep-ping the

tooth.• Select shades after removal of any significant extrinsic stain on the

adjacent dentition.• Place the shade guide tab at arm’s length from your eyes.• Place the shade guide tab alongside the patient’s surrounding dentition.• Look for only a few seconds at a time to avoid eye fatigue that would

influence shade selection.• Use the shade guide recommended by the composite manufacturer.• Consider the light source – natural daylight is best. • Use more than one source of light.• Ensure that the shade taker has been tested for color blindness and has

no such abnormality.

Other Shade Influencing Factors

MEGAFILL : >100 µm

MACROFILL : 10 - 100 µm

MIDIFILL : 1-10 µm

MINIFILL : 0.1 - 1 µm

MICROFILL : 0.01 - 0.1 µm

NANOFILL : 0.005 – 0.01 µm

Shade of composite depends on

Size of filler particleFiller content influences

esthetics; micro-filled and

nanofilled composites contain

microscopic filler particles that

scatter light, whereas hybrid

resins are less esthetic.

Shape of filler particleLight-scattering is also

influenced by the shape of the

filler particles – multifaceted

particles scatter and reflect light

in different directions, and

nanofilled composites transmit

light more than other

composites.

When performing shade selection, first the hue, then the chroma and then the value are chosen. If using a Vitapan shade guide, this

order will result first in choosing from A-D for the hue, then selecting from within that group

for the chroma. Lastly, the value is selected based on degree of lightness/darkness and

may result in a different shade being viewed as an alternative.

When using a composite resin, the manufacturer’s

recommended shade guide must be used to ensure the best

match possible of the restoration with the teeth.

Digital Shade

guide

Vita 3D Shade Guide

flexural

strength

modulus of

elasticity

UNFILLED TRADITIO

NAL

MICRO-

FILLED

SMALL

PARTICLE

HYBRID

COMPRE-

SSIVE

STR.(MPa)

70 250-300 250-300 350-400 300-350

TENSILE

STR.(MPa)

24 50-65 30-50 75-90 70-90

ELASTIC

MODULUS

(GPa)

2.4 8-15 3-6 15-20 7-12

CO-EFF. OF

THERMAL

EXP.

10-6

/0C

928 25-35 50-60 9-26 30-40

KHN 15 55 5-30 50-60 50-60

ENAMEL DENTIN

384 297

10 52

84 18

16.96×10 10.59×10

68343

BONDING..

FIRST GENERA

TION

WHICH ONE SHOULD WE CHOOSE

Generation classification of bondingagents does not exist anymore. It wasofficially withdrawn by its introducerDr. Marcus Vargas during 5th IndianaConference held at University Centreon June 2000.

Marketing gimmicks are being playedby various manufacturers givinggeneration classification to theirsystems on their own.

From that time the classification

of bonding agents have been

classified as –

(a) Total etch.

(b) Self etch.

Kuraray was the first company to

manufacture the first dentin bonding

agent of the world in 1978 called Clearfil

Bond System – F, which gave birth to

adhesive dentistry based on the

research of Prof. Fusayama and clinical

trials by Dr.Raymond Berttoloti.

Formation of a hybrid layer involving dentin collagen & resin.

Dentin immediately after application of Self

Etching Systems

Demineralization of dentin 20 s after application

of Self Etching Systems forms retentive resin

tags

Lower right lateral incisor with etched Class IV preparation

Placement of bonding agent

Light-curing of bonding agent

Class IV restoration during light-curing

Class IV restoration after light-curing

Completed Class IV restoration

COMPOSITE RESIN is a Biomimetic Material

Good esthetics

Long term color stability

High hardness & compressive

strength

Chemical inertness

Excellent biocompatibility

CERESTORE

DICOR

LITHIUM DISILICATE

ALUMINOUS CORE

PORCELAIN

LEUCITE RE-INFORCED

IPS EMPRESS

CERAMICS

Modulus of elasticity(Al2O3)-350GPa

Fracture toughness(Al2O3)- 3.5 to 4 MPa.m1/2

Flexural Strength-

1) Platinum foil Method- 139 to 145 Mpa

2) Dry pressing and Sintering(15500C)-600MPa

Fracture toughness: 1.6-

2.1MPa.m1/2

Flexural strength 81 ± 6.8

Mpa

Marginal adaptation :

Avarage

Flexural strength-upto 112MPa

Fracture toughness- 0.9 to 1.3 Mpa.m1/2

Esthetics : high esthetic value

CERESTOREFlexural strength-150MPa

Fracture toughness- 1.79

MPa.m1/2

Flexural Strength- 350 MPa

Fracture toughness- 3.3

Mpa.m1/2

It is fairly translucent but

somewhat more opaque.

ALUMINOUS CORE PORCELAIN DI-COR

CERESTORE

Excellent fit & marginal integrity.

Radio-density similar to that of

enamel.

Advantages

STAINS

Stain is more concentrated than the color modifier

They can be supplied as pure metal oxides but are

sometimes made from lower fusion point glasses.

Used as surface colorants or to provide enamel check

lines, decalcification spots

The wear properties of indirect dental composites and all-ceramic materials were compared with each other by in vitro tests. Human teeth were used as antagonists and their wear loss was calculated and the overall properties of a composite are found to be influenced by the volume fraction and types of fillers. The results of this study indicate that indirect dental composite is relatively more wear-friendly than all-ceramic restoration. As for the wear loss of the enamel antagonist, indirect composites are favorable and less offensive. Therefore, the second generation of indirect composites is promising in long-life dental restorations. Int. J Oral Sci. 2013

Dec; 5(4): 183-190.

Knoop hardness, wear rate, mean friction coefficient and wear loss of antagonist

Studies Results, mean wear (s.d.)

Occlusal wear of ceramic crowns Occlusal wear of opposing natural

teeth

Suputta-mongkol 2008

Wear volume/mm3 Premolar 0.19 (0.06) Premolar 0.21 (0.06)

Molar 0.34 (0.08) Molar 0.50 (0.22)

Wear height/µm Premolar 29 (12) Premolar 46 (13)

Molar 36 (34) Molar 65 (29)

Etman 2008

Procera

Wear in µm after 6 months 143.60 (9.47) 130.96 (15.08)

Wear in µm after 12 months 201.18 (0.22) 184.24 (15.02)

Wear in µm after 18 months 243.70 (7.31) 216.84 (14.14)

Wear in µm after 24 months 321.60 (12.79) 261.58 (12.88)

Experimental ceramic

Wear in µm after 6 months 108.50 (4.87) 102.02 (8.49)

Wear in µm after 12 months 148.16 (6.38) 149.7 (6.59)

Wear in µm after 18 months 194.18 (11.92) 193.92 (12.07)

Wear in µm after 24 months 214.76 (4.9) 214.86 (6.09)

MC

Wear in µm after 6 months 87.06 (2.96) 75.52 (7.15)

Wear in µm after 12 months 116.3 (4.70) 106.9 (10.19)

Wear in µm after 18 months 142.30 (3.91) 133.82 (6.94)

Wear in µm after 24 months 176 (3.93) 156.42 (14.34)

Silva 2011 (at year 3 in mm3)

MC 1.48 (0.20) 1.10 (0.10)

IPS e.max Press without

veneering

1.06 (0.12) 0.80 (0.09)

IPS Empress 2/IPS Eris 1.31 (0.17) 1.02 (0.20)

Wear results of the teeth and their opposing crowns obtained in the reviewed studies

T h e H u n t i s s t i l l o n . . ! ! !

Recent Advancement in

Biomimetic Material

FIBER REINFORCED GICIt involves incorporation of a continuous network / scaffold of alumina and SiO2 ceramic fibers

•Flexural strength increased(15.6 Mpa)•Compressive strength increased (200Mpa)•Fracture Toughness—0.22 Mpam0.5

This technology is called the Polymeric Rigid Inorganic Matrix Material or PRIMM

Alumina and SiO2 ceramic fibers

Nano-Hydroxyaptite/yttria stabilized ZIRCONIA (HA/YSZ) containing GIC

Here HA/YSZ is added to GIC. Nano-Hydroxyaptite/yttria stabilized ZIRCONIA (HA/YSZ) containing GIC defines a new class of restorative glass ionomer that promises the strength and durability ideal for permanent posterior restoration maintaining aesthetics.

• (HA/YSZ) stabilized ZIRCONIA containing GIC–

Elastic Modulus (Gpa)

Thermal Expansion Coefficient(x106)

Ultimate Tensile Strength (Mpa)

Ultimate compressive strength (Mpa)

Hardness (KHN)

Enamel ~82 ~17 ~10 ~384 350-430

Dentin ~14 ~11 ~40-105 ~297 ~68

(HA/YSZ) stabilized ZIRCONIA containing GIC

~15 215-346 104-106245~15 ~11-14

(HA/YSZ) stabilized ZIRCONIA containing GIC

• Strength and durability match to enamel and amalgam

• Packable and condensable like amalgam

• No hazard of mercury, the risk of corrosion, expansion and thermal conductivity

• High flexural modulus and compressive strength

• Chemically bonds to enamel/dentin

• Tooth-like co-efficient of thermal expansion

• Excellent resistance to abrasion and erosion

Clinical applications of Nano-Hydroxyapatite/yttria stabilized ZIRCONIA

(HA/YSZ) containing GIC1. Class I & II cavities2. Structural base in sandwich restorations3. Core build-up under indirect restorations4. Root surfaces where overdentures rest5. Pediatric and Geriatric restorations6. Long-term temporary replacement for fractured

cusps7. Fractured amalgam restoration8. Suitable for ART techniques

Preparation of Class I Cavity Restored with (HA/YSZ) stabilized ZIRCONIA

containing GIC

“white amalgam”•.

PROLINE CONTAINING GLASS IONOMER CEMENT

• Amino acid (glycin, ß-alanin, glutamic acid) are incorporated in GIC to increase the degree of freedom of side chain amino acids to increase salt bridge formation.

• Compressive strength increased (193-236 Mpa)

• Flexural strength increased (55-71 Mpa)

• Surface Hardness increased (52.3-64.5 VHN)

• Indication-

• Class v cavity restoration

Nano Glass Ionomers (Nano-Ionomers)

• Nanotechnologies have been applied to the resin modified glass ionomers in the form of nanoparticles (nanomers) and nanoclusters in fluoro-alumino-silicate (FAS) glass.

• Increased polishability• Increased aesthetics

• Decreased compressive strength (48 KHN)

• INDICATIONS 0F NANO-IONOMERS -

• Class III, class V cavity restoration

• Primary teeth restoration

Advanced Ceramics

Cercon

It is Zirconia based smart ceramics.

1. Metal-free restoration, increased aesthetics2. Fracture toughness (5-10 Mpa.m1/2) increased3. flexural strength (800-1300 Mpa) increased4. Resistance to crack formation and propagation

increased.

Copping

Cerconas

BiomimeticMaterial

Closed Bite

Full Crown

Elevated Occlusal

Force

High wear and tear

Bruxism

High Musculature

Less Inter-occlusal Clearance

Short Crown Hight

Full Crown Preparation By

Cercon

Still today there is no perfect Biomimetic material

A perfect biomimetic restorative material that contains all the synthetically manufactured ingredients of enamel, dentin separately including Hydroxyapatite crystal with all their natural properties, that can be applied directly on the lost tooth structure to restore enamel, dentin respectively.

Future scope of Biomimetic Material

• Future scopes of Biomimetic Materials in Conservative Dentistry and Endodontics still now is potentially dynamic.

• The Dental profession continues to look for one perfect material, the “Holy Grail” of dentistry, to replace two very different structural components of the tooth ( enamel and Dentin), simultaneously.

Equia®System

It is an upcoming system. Inorganic silica nanofillers (40 nm size) are dispersed in liquid and reinforce the resulting polymer matrix.

1. Better resistance to dissolution, disintegration and wear

2. Highly polishable surface3. Maintenance of polished surface

for a longer period of time 4. Enhancement of optical

properties and translucency

Equia®System

Many studies claimed that Equia®System is as good as of natural teeth, means towards the goal of a perfect biomimetic material.

Nano hydroxyapatite (HA) and Nanofluoroapatite (FA) incorporated GIC –

• Nano-HA and Nano-FA particle size-100-150 nm

1. Increased bond Strength

2. Filling of demineralizing micro-pores in the tooth structure

3. Compressive strength(210 Mpa when 5% wt HA is added), diametral tensile strength and biaxial flexural strength increased.(when Ethanol is added)

• Research is going on a number of materials such as alumina, alumina/titania, zirconia and yttria stabilized zirconia incorporation in GIC

• There are very high expectations from this on-going research on nanomaterials.

Nano-endodontic Sealer

• It is worldwide hot topic for researchers.

Composition-

– calcium silicate

– calcium phosphate

– calcium hydroxide

– zirconia

– thickening agent (hydroxypropyl methylcellulose)

– Bentonite

• Biomimetic properties of Nano-endodontic Sealer --

On hydration reaction in root canal during it’s setting calcium silicate and hydroxyapatite is formed, which adopt to irregular dentin surfaces and can rehabilitate the lost intra-canal dentin.

Conclusion

• Replacement of diseased or lost tooth structure with biomimetic materials is currently the technique of today which will fulfil our dreams. Yes, ‘Future is coming, it will be amazing’

• But future advances in this field will require materials and computer scientist , physicist , bioengineers, clinicians, biologist and related industries working together towards a shared vision rather than pursuing their separate objectives..

Hench LL, Splinter RJ, Allen WC, Greenlee TK Jr.; Bonding mechanisms at the interface of

ceramic prosthetic materials. J Biomed Mater Res., 1972; 2:117-141

Advanced Ceramics for Strategic Applications, Prof. H. S. Maiti, Department of Mechanical

Engineering, Indian Institute of Technology, Kharagpur , Lecture – 47, Bio ceramics

Srinivasan & Chitra: Emerging Trends in Oral Health Profession, Archives of Dental and

Medical Research Vol 1 Issue 3

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