Introduction: The aim of this study is to investigate the force distribution of the anterior teeth with the different alignment statements during the molar distalization with clear aligners. Methods A three-dimensional (3D) finite element model of maxillary molar distalization with clear aligners (CA) and four types of anterior tooth arrangement was developed. These include Group A with properly aligned incisors, Group B with anterior teeth rotation alignment, Group C with labiolingual malpositioning of anterior teeth, and group D with anterior teeth absence. Each group simulated the sequential distal movement of the maxillary second molars by 0.2mm. The study recorded the trends of 3D displacement and force distribution in the maxillary incisors during the process of molar distalization Results the total displacement of the central incisors, lateral incisors, and canines in Group B was found to be the least. The total displacement of anterior tooth was similar in Groups A and D. Interestingly, the anterior teeth of all groups demonstrated an extrusion trend, and compared to Groups A and D, the Group B and Group C showed significantly less extrusion. Additionally, the lingual surface of the crowns in the anterior teeth area of Group B experienced higher compressive stress than in the other groups. Conclusions the arrangement of the anterior teeth affects the design of anchorage during the process of molar distalization. The crowded anterior teeth can significantly enhance the "anterior anchorage" during the molar distal movement, which potentially reduce the need for supplementary anchorage devices.

The regeneration of bone tissue depends on the harmonious interaction between blood vessels and nerve fibers, both essential for various physiological and pathological functions in the skeletal system. The key to mimicking the structure and function of natural bone lies in integrating angiogenesis and neurogenesis processes to prepare vascular-nerve-tissue-engineered bone (TEB). Unlike traditional strategies for constructing vascular nerve TEB (such as adding growth factors or cells to scaffolds or preparing composite scaffolds), this study employs a bottom-up approach, using modular microtissue units to construct novel vascular nerve TEB. Initially, vascular-nerve-bone microtissues composed of bone marrow mesenchymal stem cells, endothelial progenitor cells (EPCs), and Schwann cells (SCs) were generated through three-dimensional coculture in microporous array plates. These vascular-neural-bone microtissues were then encapsulated as modular building blocks within gelatin methacrylate (GelMA) hydrogels to construct large-scale vascular-neural TEB. The microtissue-based vascular-neural-TEB construction protocol demonstrated feasibility at the molecular, cellular, and tissue/organ levels. Research findings indicate that the GelMA/MSC/EPC/SC vascular-neural-TEB possesses concurrent capabilities for angiogenesis, neurogenesis, and osteogenesis during bone repair. These findings provide novel insights for the construction of multifunctional bone grafts and lay the foundation for the clinical treatment of bone defects.

Clear aligners have become a preferred orthodontic solution due to their aesthetics, comfort, and convenience. However, current aligners still suffer from poor fit caused by thermoforming-induced dimensional inaccuracies and force mismatch due to stress relaxation in thermoplastic materials. Here we address these limitations by developing a biocompatible, highly transparent polyurethane-based material (PUP) tailored for high-precision DLP printing. The PUP ink enables rapid, spatially resolved curing within 30 s and supports high-fidelity printing with feature sizes down to similar to 10 mu m. Moreover, 4D-printed PUP aligners combine accurate fit with programmable, long-term force delivery and can be reshaped for multiple treatment stages. Notably, the representative formulation meets clear-aligner-relevant yield thresholds (yield strength > 25 MPa and yield strain > 4%), supporting stable elastic force output within a clinically meaningful deformation window. This work demonstrates a smart aligner strategy that integrates precision manufacturing with active force control through shape memory, offering a practical route toward next-generation personalized orthodontic devices. [GRAPHICS]

Pre-vascularized cartilage enhances bone regeneration (intrachondral osteogenesis) and accelerates bone defect healing. While current strategies focus on co-culturing chondrocytes with endothelial cells, mature endothelial cells inhibit the necessary osteogenic transformation. To overcome this, we implemented a co-differentiation strategy using human induced pluripotent stem cells (hiPSCs)-derived mesodermal progenitor cells (iMPCs) instead. We generated pre-vascularized cartilage aggregates by 3D co-culture of these iMPCs with hiPSC-derived chondrocytes (Chos) and evaluated their osteogenic potential. This approach offers new insights and potential strategies for repairing bone defects. HiPSCs were differentiated into iMPCs (characterized by FLK1(VEGF-R) expression, CD31/vWF immunofluorescence, tube formation, flow cytometry) and Chos (confirmed by SOX9/COL2/ACAN qRT-PCR, Alcian blue staining, VEGF165 ELISA). Pre-vascularized aggregates were generated by 3D co-culture of iMPCs and Chos in ultra-low attachment plates (monocultures as controls). After 14 days, aggregates were assessed in vitro for vascularization (CD31 immunofluorescence), gene/protein expression (qRT-PCR/immunofluorescence for IHH, ALP, COL1A1), and mineralization (Alizarin Red). In vivo osteogenesis was evaluated by implanting aggregates into rat calvarial defects, analyzing healing at 4/8 weeks via Micro-CT, histology (H E, Masson’s trichrome), and neovascularization (CD31 immunohistochemistry). IMPCs exhibited high endothelial potential, with a 52.84

Titanium implants face long-term reliability challenges due to corrosion and mechanical degradation in physiological environments. To address this, we engineered polysiloxane coatings on titanium substrates via plasma-enhanced chemical vapor deposition (PECVD) by modulating the hexamethyldisiloxane (HMDSO)/O2 flow ratio (20: 2 to 20: 20 sccm) and systematically elucidated their structure-property relationships. Results demonstrate that as the O2 flow rate increases from 2 sccm to 12 sccm, the coatings transition from an organic-modified structure to an inorganic-dominated network, forming a dense amorphous architecture. This structural evolution significantly enhances protective performance, reducing the corrosion current density (Icorr) from 9.27 & times; 10-8 to 5.73 & times; 10-8 A/cm2 (a 86.1% decrease compared to the bare Ti substrate), while simultaneously optimizing mechanical properties: nanoindentation hardness increases from 1.01 to 2.06 GPa, elastic modulus improves from 6.90 to 16.14 GPa. However, excessive O2 (20 sccm) induces particle-aggregated microstructures, elevated oxygen vacancy concentration, and interfacial microcracks, leading to Icorr rebound (1.08 & times; 10-7 A/ cm2). The optimal O2 flow rate is 12 sccm, balancing corrosion resistance and mechanical durability. This work provides critical insights into designing multifunctional coatings for biomedical titanium implants.

Prevascularized cell sheets are widely used in tissue engineering; however, enhancing their angiogenic potential within hypoxic microenvironments remains a significant challenge. In this study, we employed genetic manipulation to upregulate Sestrin2 (SESN2) expression in human umbilical vein endothelial cells (HUVECs) and investigated its effect on their angiogenic potential under hypoxic conditions. Transwell migration and Matrigel tube formation assays confirmed that SESN2 significantly promoted proliferation, migration, and tube formation of HUVECs under hypoxia, thereby enhancing angiogenesis. Furthermore, HUVECs overexpressing SESN2 were seeded onto cell sheets, and immunofluorescence staining for CD31 revealed increased lumen formation compared with the control group. SESN2 was also found to promote the secretion of vascular endothelial growth factor A and platelet-derived growth factor BB in vitro. Subsequent subcutaneous implantation studies demonstrated that prevascularized cell sheets with SESN2 overexpression enhanced angiogenesis and promoted the formation of functional blood vessels. In conclusion, SESN2 improves the vascularization capacity of tissue-engineered grafts in hypoxic environments, thereby facilitating successful transplantation of engineered tissues.

The prevalence of Class III malocclusion varies among different countries and regions. The populations from Southeast Asian countries (Chinese and Malaysian) showed the highest prevalence rate of 15.8%, which can seriously affect oral function, facial appearance, and mental health. As anterior crossbite tends to worsen with growth, early orthodontic treatment can harness growth potential to normalize maxillofacial development or reduce skeletal malformation severity, thereby reducing the difficulty and shortening the treatment cycle of later-stage treatment. This is beneficial for the physical and mental growth of children. Therefore, early orthodontic treatment for Class III malocclusion is particularly important. Determining the optimal timing for early orthodontic treatment requires a comprehensive assessment of clinical manifestations, dental age, and skeletal age, and can lead to better results with less effort. Currently, standardized treatment guidelines for early orthodontic treatment of Class III malocclusion are lacking. This review provides a comprehensive summary of the etiology, clinical manifestations, classification, and early orthodontic techniques for Class III malocclusion, along with systematic discussions on selecting early treatment plans. The purpose of this expert consensus is to standardize clinical practices and improve the treatment outcomes of Class III malocclusion through early orthodontic treatment.

Objectives:To evaluate the influence of personalized aligner replacement, with or without physical methods of acceleration using low-frequency vibration combined with a low-level laser, on the tooth movement rate and accuracy of clear aligners. Materials and Methods:Forty participants were randomly allocated to three groups. Fourteen participants used the standard replacement protocol in Group A, Group B included 14 participants using a personalized replacement protocol, and 12 participants in Group C followed the personalized replacement protocol and used a physical device that combined low-frequency vibration and low-level laser. Aligner replacement cycles of the first 12 steps were recorded, and GOM inspect suite software 2022 (GOM; Braunschweig, Germany) was used to evaluate maxillary molar movement accuracy using digital models collected before treatment and at the end of the 12th step. Results:No significant difference was found in the accuracy of maxillary molar movement between Groups A and B, but the tooth movement rate in Group B was significantly greater. The accuracy of maxillary molar movement was similar in Groups B and C, and the tooth movement rate in Group C was significantly increased. Conclusions:The personalized replacement protocol decreased the number of aligner replacement cycles without impacting the accuracy of tooth movement. With personalized replacement, a physical method of acceleration combining low-level laser and low-frequency vibration significantly accelerated orthodontic tooth movement and had little influence on the accuracy of tooth movement.

Enamel demineralization, the formation of white spot lesions, is a common issue in clinical orthodontic treatment. The appearance of white spot lesions not only affects the texture and health of dental hard tissues but also impacts the health and aesthetics of teeth after orthodontic treatment. The prevention, diagnosis, and treatment of white spot lesions that occur throughout the orthodontic treatment process involve multiple dental specialties. This expert consensus will focus on providing guiding opinions on the management and prevention of white spot lesions during orthodontic treatment, advocating for proactive prevention, early detection, timely treatment, scientific follow-up, and multidisciplinary management of white spot lesions throughout the orthodontic process, thereby maintaining the dental health of patients during orthodontic treatment.

Aim or purpose: This study aims to to explore the relationship between the target position of lower anterior teeth and the mandibular ramus in patients with skeletal Class II Materials and methods: The cephalometric of 122 skeletal Class II patients before (T0) and after treatment (T1) were converted into black-and-white silhouette of soft tissue ; 15 raters evaluated the silhouette using a 5-point Likert scale; Pearson correlation analysis was used to preliminarily identify measurement items related to lower incisor position of The patients with lateral profile improved (T1>T0); the good-looking group (T1 ≥ 4 points and ΔT ≥ 2 points) was selected to establish a multiple linear regression equation for predicting the lower incisors' target position. Results: 116 cases with improved lateral profile (52 males, 64 females, mean 26.6 ± 8.3 ages) showed the lower incisors’ target position (T1, ΔT) was significantly correlated with mandibular ramus parameters and vertical skeletal pattern at T0 (p < 0.01);Multiple linear regression analysis indicators in the hyperdivergent good-looking group : IMPA (ΔT) = 91.50 – 3.20 × Go-Ar-FH (T0) + 3.15 × Go-R3-FH (T0) + 1.00 × Wits (T0) (adjusted R² = 0.64) had strong predictive ability and value Conclusions: For skeletal Class II hyperdivergent patients, initial mandibular ramus (Go-Ar-FH) and sigmoid notch (Go-R3-FH) inclinations can predict lower incisor retraction for a high-aesthetic profile. The regression equation is IMPA (ΔT) = 91.50 – 3.20 × Go-Ar-FH (T0) + 3.15 × Go-R3-FH (T0) + 1.00 × Wits (T0) (adjusted R² = 0.64)

The purpose of this cross-sectional study is to compare the agreement of three diagnostic methods for maxillary transverse deficiency (MTD) across different skeletal malocclusion. Three hundred and sixty patients were categorized into skeletal classes I, II, and III based on the ANB angle and assessed using University of Pennsylvania analysis (UPA), Yonsei transverse analysis (YTA), and Andrews Element III analysis (AEA). The intraclass correlation coefficient (ICC) was used to evaluate quantitative agreement, while Cohen's kappa was used to measure qualitative agreement. In class I, the AEA showed moderate quantitative agreement with the UPA and AEA (ICC = 0.712), but the UPA and YTA had poor agreement (ICC = 0.404). Qualitatively, UPA and AEA were highly consistent (kappa = 0.896), while YTA and UPA (kappa = 0.371), YTA and AEA (kappa = 0.330) were poor uniformity. For class II, AEA and UPA showed moderate quantitative (ICC = 0.708) and high qualitative agreement (kappa = 0.917), while YTA's qualitative agreement with UPA (kappa = 0.550)/AEA (kappa = 0.544) was moderate. In class III, the AEA again had moderate quantitative agreement with the UPA (ICC = 0.657) and YTA (ICC = 0.580), but the agreement between the UPA and YTA is poor (ICC = 0.408). UPA and YTA were similar in qualitative agreement (kappa > 0.8), and both showed substantial agreement with AEA (kappa = 0.657). 1. The incidence of MTD is highest in the skeletal class III group and the lowest in the skeletal class II group. 2. The results of YTA, AEA and UPA for diagnosing MTD are only consistent in patients with skeletal class III. In clinical practice, all three methods can be used to diagnose MTD in patients with skeletal class III malocclusion. 3. For patients with skeletal class I and class II malocclusion, it is recommended to use AEA and UPA for MTD diagnosis.

The reconstruction of critical-sized bone defects remains a challenging clinical problem. At present, the implantation of autogenous and allogeneic grafts is the main clinical treatment strategy but faces some drawbacks, such as inadequate source, donor site-related complications, and immune rejection, driving researchers to develop artificial bone substitutes based on distinct materials and fabrication technologies. Among the bone substitutes, bioceramic-based substitutes exhibit a remarkable biocompatibility, which can also be designed to degrade concomitantly with the formation of new bone. In addition, three-dimensional (3D) printing technologies are frequently used for fabricating personalized 3D bioceramic scaffolds, which can achieve accurate imitation of native bone structures. Especially, bioprinting can produce organoids by integrating cells into scaffolds, which achieves the simultaneous imitation of organ structure and biological function. This review summarizes recent progresses of bioceramic-based materials, including hydroxyapatite, tricalcium phosphate, bioactive glass, calcium silicate, alumina, and zirconia. In addition, the application of 3D printing technologies and bioprinting is also elaborated in this text, offering important reference for future research of 3D-printed bioceramics.

This retrospective clinical study, using cone-beam computed tomography (CBCT), examined the presence of fenestration and dehiscence in anterior teeth following non-extraction clear aligner therapy, along with the associated risk factors. The study included 224 adult patients who underwent non-extraction clear aligner treatment. CBCT scans taken before (T1) and after treatment (T2) were analyzed to detect the presence of fenestration and dehiscence. Patient-related and treatment design-related variables were collected, with the latter from the planned tooth movements specified in the aligner software. The exact McNemar test was used to compare the occurrence of alveolar bone defects between T1 and T2. Univariate and multivariate logistic regression analyses were performed to evaluate the associations between posttreatment alveolar bone defects and various factors. From T1 to T2, the occurrence of fenestration and dehiscence increased on most maxillary and mandibular anterior root surfaces. At T2, the presence of alveolar bone defects at different tooth positions was influenced by multiple factors, including crowding, curve of Spee depth, alveolar bone thickness, gingival thickness, sagittal skeletal pattern, magnitude and type of intrusion, amount of retraction, molar distalization, and number of attachments. Specifically, labial fenestration of the maxillary lateral incisors and canines, as well as the mandibular central incisors and canines, and lingual dehiscence of the mandibular central incisors were significantly associated with the amount of intrusion (P < 0.05). Labial dehiscence of the mandibular central and lateral incisors was significantly associated with the number of attachments (P < 0.05). No significant associations were found between alveolar bone defects and factors such as age, gender, vertical skeletal pattern, changes in arch width, use of miniscrews, the amount of interproximal enamel reduction, attachment type, or treatment duration. In patients undergoing non-extraction clear aligner therapy, factors such as crowding, curve of Spee depth, alveolar bone thickness, gingival thickness, sagittal skeletal pattern, amount and type of intrusion, amount of retraction, molar distalization, and number of attachments were significantly associated with the presence of fenestration and dehiscence at T2. Orthodontists should assess these factors, conduct thorough pretreatment evaluations of individual oral conditions, and develop tailored treatment plans accordingly.

OBJECTIVE:Craniofacial and oral malformations (COMs) represent an important class of human developmental disorders with profound implications on the anatomical structure, appearance, and various physiological functions. In this study, we aimed to define the spectrum of COMs and analysis its features or possible influencing factors to improve the surveillance and control of the disease. MATERIALS AND METHODS:We organized a multicenter survey of COMs from 19 hospitals in 14 provinces. The clinical data of COM cases were collected from the electronic medical records system, cleaned and aggregated for analysis. RESULTS:A total of 90,895 COM cases with 76 types of diseases were identified from 34,649,545 hospital population. The four most common COMs were supernumery teeth (62.64%), cleft lip and palate (28.53%), microdontia (2.86%), and tooth agenesis (1.70%). The remaining 72 diseases were detected in 3881 cases and were considered to be rare COMs. Moreover, 84.72% of rare COMs also manifested as other malformations or dysfunctions of the bone, skin and other tissues. CONCLUSIONS:COMs exhibit age and gender distribution patterns, have multiple types, and significant dental malformations. The diagnostic criteria and registration practices for COMs influence their reported prevalence and temporal trends, necessitating future improvements.

Epigallocatechin-3-gallate (EGCG) is the most effective active ingredient in tea polyphenols and belongs to the category of catechins. EGCG has excellent antioxidant activity, anti-inflammatory, osteogenesis-promoting, and antibacterial properties, and has been widely studied in orthopedic diseases such as osteoporosis. To reach the lesion site, achieve sustained release, promote osteogenesis, regulate macrophage polarization, and improve the physical properties of materials, EGCG needs to be cross-linked or incorporated in bone regeneration materials. This article reviews the application of bone regeneration materials combined with EGCG, including natural polymer bone regeneration materials, synthetic polymer bone regeneration materials, bioceramic bone regeneration materials, metal bone regeneration materials, hydrogel bone regeneration materials and metal-EGCG networks. In addition, the fabrication methods for the regenerated scaffolds are also elaborated in the text. To sum up, it reveals the excellent development potential of materials containing EGCG and the shortcomings of current research, which will provide important reference for the future exploration of bone regeneration materials containing EGCG.

Enhancing the antibacterial properties of polymethyl methacrylate (PMMA) dental resins is crucial in preventing secondary infections following dental procedures. Despite the necessity for such improvement, a universally applicable method for augmenting the antibacterial properties of PMMA without compromising its mechanical properties and cytotoxicity remains elusive. Consequently, this study aims to address the aforementioned challenges by developing and implementing a composite material known as zinc oxide/graphene oxide (ZnO/GO) nanocomposites, to modify the PMMA. ZnO/GO nanocomposites were successfully synthesized by a one-step procedure and fully characterized by TEM, EDS, FTIR and XRD. Then the physical and mechanical properties of PMMA modified by ZnO/GO nanocomposites were evaluated through water absorption and solubility test, contact angle test, three-point bending tests, and compression test. Furthermore, the biological properties of the modified PMMA were evaluated by direct microscopic colony count method, crystal violet staining and CCK-8. The results revealed that ZnO/GO nanocomposites were successfully constructed. When the concentration of nanocomposites in PMMA was 0.2 wt.

With the development of tissue engineering and regenerative medicine, prevascularized bone marrow mesenchymal stem cell (BMSC) sheets have been regarded as a promising method for tissue regeneration. Furthermore, the inflammatory response is one of the main regulators of vascularization and the restoration of engineered tissue function; among them, macrophages and cytokines produced by them are considered to be the decisive factors of the downstream outcomes. This study investigated the effect of macrophages on the formation of microvascular-like structures of human umbilical vein endothelial cells (HUVECs) in BMSC sheets. First, a human monocytic leukemia cell line (THP-1 cells) was differentiated into derived macrophages (M0) with phorbol 12-myristate 13-acetate and further activated into proinflammatory macrophages (M1 macrophages) with interferon-γ and lipopolysaccharide or anti-inflammatory macrophages (M2 macrophages) with interleukin-4. Then, HUVECs and prevascularized sheets were treated with conditioned media (CM) from different macrophages, and the impact of macrophage phenotypes on vascularized network formation in prevascularized cell sheets was examined by hematoxylin and eosin staining, CD31 immunofluorescence staining and enzyme-linked immunosorbent assay. Our study showed that macrophages may guide the arrangement of endothelial cells through a paracrine pathway. Cell sheets that were cultured in the CM from M2 macrophages were thinner than those cultured in other media. At various time points, the levels of tumor necrosis factor alpha and vascular endothelial growth factor in prevascularized sheets cultured with CM(M1) was higher than that in sheets cultured with other media; however, the levels of platelet-derived growth factor in prevascularized sheets cultured with CM(M2) was higher than that in sheets cultured with other media. These findings suggest that the paracrine effect of macrophages can influence the formation of microvascular networks in prevascularized sheets by regulating the arrangement of cells, the thickness of the cell sheet and the secretion of cytokines related to angiogenesis. Macrophages with different phenotypes have unique effects on prevascularized sheets.

In conventional bone tissue engineering, cells are seeded onto scaffolds to create three-dimensional (3D) tissues, but the cells on the scaffolds are unable to effectively perform their physiological functions due to their low density and viability. Cell sheet (CS) engineering is expected to be free from this limitation. CS engineering uses the principles of self-assembly and self-organization of endothelial and mesenchymal stem cells to prepare CSs as building blocks for engineering bone grafts. This process recapitulates the native tissue development, thus attracting significant attention in the field of bone regeneration. However, the method is still in the prebasic experimental stage in bone defect repair. To make the method clinically applicable and valuable in personalized and precision medicine, current research is focused on the preparation of multifunctionalized building blocks using CS technologies, such as 3D layered CSs containing microvascular structures. Considering the great potential of CS engineering in repairing bone defects, in this review, the types of cell technologies are first outlined. We then summarize the various types of CSs as building blocks for engineering bone grafts. Furthermore, the specific applications of CSs in bone repair are discussed. Finally, we present specific suggestions for accelerating the application of CS engineering in the clinical treatment of bone defects.

Periodontitis is a frequent chronic inflammatory disease brought on by bacterial infection in the biofilm that forms on the teeth. It can cause the gingival recession and tooth loss, gravely jeopardizing the oral health of people. Current therapies still suffer from issues like bleeding, pain, injured gums, limited treatment effective-ness, a lengthy treatment cycle, and bacterial resistance when using a combination of surgical intervention and antibiotic therapy. Herein, a simple one-step cross-linking process was used to create glucose oxidase (GOD) loaded upon iron alginate (FeAlg/GOD), which has a strong anti-biofilm activity, good biocompatibility, and was successfully used to treat periodontitis caused by biofilms. The results demonstrated that in the presence of a high glucose concentration in the gingival crevicular fluid, FeAlg/GOD could catalyze the conversion of glucose into gluconic acid and hydrogen peroxide. The produced hydrogen peroxide could convert Fe3+ to Fe2+ when it got to the deep periodontal pockets. Following that, the Fenton reaction was activated, producing large amounts of hydroxyl radical (center dot OH). In conclusion, oral plaque biofilms were removed by the FeAlg/GOD. Additionally, successful in vivo treatment was accomplished in rat's experimental periodontitis models, as evidenced by a markedly reduced inflammatory response, decreased bone loss, and made healthier gum tissue. Overall, our biocompatible and antibacterial FeAlg/GOD study presents a novel strategy for effectively speeding periodontal tissue repair and eliminating oral pathogens to tackle the grave threat of biofilm-associated illnesses.

This study aims to look for the best concentration of nanohydroxyapatite (NHA) and polyhexamethylene biguanide (PHMB) incorporated into glass ionomer cement (GIC) in accordance with ISO:9917-1 and evaluate its mechanical, antibacterial, biocompatible and microleakages properties. NHA was incorporated into Fuji Ⅱ GIC powder at 0-8.00 wt% concentration and specimens were prepared; the best concentration was sifted out according to ISO9917-1. Based on best NHA proportion, 0-0.80% PHMB was dispersed into powder and samples were respectively prepared. Mechanical properties include net setting time (ST), compressive strength (CS), microhardness (VNH), solubility and scanning electron microscopy (SEM) observation. Those met ISO standard were qualified to continue microleakage observation, antibacterial activity, and biocompatibility test. The results suggested that GIC/6%NHA/0.2% PHMB and GIC/6%NHA/0.4%PHMB showed great performances in mechanical, antibacterial, and microleakage improvements, and the cytotoxicity of modified GIC showed no statistical difference with pure GIC.