Alveolar Bone Research Articles

Radiographic evaluation of hard tissue changes in open flap technique versus flapless technique for implant placement

Open flap technique allows the clinician to directly visualize the alveolar bone and assess bone morphology of the ridge.However, this technique is relatively invasive and causes patient discomfort and marginal bone loss due to decreased supraperiosteal blood supply whereas the Flapless technique is one of the latest minimally invasive surgical methods of implant placement without the need to raise a mucoperiosteal flap to overcome the bone resorption process. The present study was designed to evaluate the hard tissue changes in open flap technique versus flapless ṭechnique for implant placement at the different time interval. Minimum thirty edentulous sites from Out Patient Department, Department of Periodontology (IDST) were randomly allocated to the following two groups by the flip of coin: Group I - Implant with open flap technique (fifteen sites) and Group II - Implant with flapless technique (fifteen sites). Patients were evaluated radiographically for crestal bone loss (mesial and distal) at Baseline (Immediately after implant placement), At the time of prosthetic loading and 3 months after prosthetic loading in both the groups. The result of the present study revealed that Sites where implants were placed with flapless technique showed lesser mean crestal bone loss scores as compared to sites where implants were placed with open flap technique, although the difference was insignificant. It can be concluded that flapless procedure may be considered as a better treatment option as compared to implant placed with open flap technique in terms of minimal pain, inflammation and less crestal bone loss associated with flapless technique than open flap technique.

Comparing the modified socket-shield technique with the conventional immediate implantation technique in the anterior dentition: A 5-year retrospective clinical study.

The aim of this retrospective clinical study was to compare the 5-year radiological and clinical outcomes of patients undergoing immediate implantation with or without the modified socket-shield technique. Patients who underwent anterior tooth replacement via the modified socket-shield technique (MSST) or the conventional immediate implantation technique (CIIT) between 2016 and 2017 were included. The labial bone thickness was assessed at different measurement levels (0, 2, 4 and 6 mm apical to the implant shoulder (IS)) postoperatively (T1), 6 months postoperatively (T2) and 5 years postoperatively (T3). The pink aesthetic score (PES) was evaluated before surgery (T0) and at T2 and T3. Implant success, complications and patient satisfaction were evaluated at every visit. Thirty-six patients (18 in the MSST group) underwent follow-up for 5 years, with no cases of implant failure. Two cases of exposure were detected in the MSST group, but there were no significant effects on hard or soft tissue. Patients in the MSST group showed less and more stable bone resorption than did those in the CIIT group at any measurement level and any time. A higher PES was achieved in the MSST group. Patient satisfaction was similar in both groups. The MSST is a reliable immediate implantation method because of its ability to preserve the alveolar bone and provide superior recovery of aesthetics.

Umbelliferone reduces inflammation and ligature-induced osteoclastic alveolar bone resorption in mice.

This study aimed to investigate the effects of Umbelliferone (UMB) on the inflammation underlying alveolar bone resorption in mouse periodontitis. Male Swiss mice subjected to a ligature of molars were grouped as non-treated (NT), received UMB (15, 45, or 135 mg/kg) or saline daily for 7 days, respectively, and were compared with naïve mice as control. Gingival tissues were evaluated by myeloperoxidase (MPO) activity and interleukin-1β level by ELISA. The bone resorption was directly assessed on the region between the cement-enamel junction and the alveolar bone crest. Microscopically, histomorphometry of the furcation region, immunofluorescence for nuclear factor-kappa B (NF-ĸB), and immunohistochemistry for tartrate-resistant acid phosphatase (TRAP), and cathepsin K (CTSK) were performed. Systemically, body mass variation and leukogram were analyzed. Periodontitis significantly increased MPO activity, interleukin-1β level, and NF-ĸB+ immunofluorescence, and induced severe alveolar bone and furcation resorptions, besides increased TRAP+ and CTSK+ cells compared with naïve. UMB significantly prevented the inflammation by reducing MPO activity, interleukin-1β level, and NF-ĸB+ intensity, besides reduction of resorption of alveolar bone and furcation area, and TRAP+ and CTSK+ cells compared with the NT group. Periodontitis or UMB treatment did not affect the animals systemically. UMB improved periodontitis by reducing inflammation and bone markers.

The Role of Dental Arch Dimensions and Impacted Third Molars on Mandibular Anterior Segment Crowding.

This study aimed to investigate the potential impact of arch dimensions and unerupted third molars on mandibular anterior segment crowding. This study included a total of 240 subjects with an average age of 18 years seeking orthodontic treatment. Panoramic radiographs, alginate impressions, and study models were taken for measurements. This study utilized the Ganss ratio to calculate the ratio of retromolar space to the width of the crown of the third molar, along with other measurements such as intercanine and intermolar widths, arch perimeter, and arch length to assess dental arch dimensions. We found that the Ganss ratio and angle B values on both the right and left sides were significantly different between the noncrowding and crowding groups, suggesting a potential role for third molars in mandibular anterior segment crowding. Additionally, there was an increase in angle A on both sides in the crowding group, indicating a more acute angle between the anterior teeth. This study also observed a reduction in the retromolar space on the third molars in the crowding group, further supporting the potential role of third molars in mandibular anterior segment crowding. The findings of our study provide substantial evidence to suggest that third molars may contribute to mandibular anterior segment crowding. These findings highlight the importance of carefully evaluating dental arch dimensions and the presence of third molars when assessing and treating mandibular anterior segment crowding.

The Anti-Inflammatory Effect of Nigella sativa Toothpaste on Porphyromonas gingivalis Bacteria Through Decreased TNF-α, MMP-9, PGE-2 Expression in Wistar Rats.

The main principle in preventing periodontal disease is to improve oral hygiene. The bacteria that cause the onset of periodontal disease, one of which is the Porphyromonas gingivalis bacterium, causes inflammation. Persistent inflammation causes tissue damage and alveolar bone resorption by secreting proinflammatory cytokines, matrix metalloproteinase-9 (MMP-9), prostaglandin E2 (PGE-2), and anti-inflammatory cytokines. In this case, preventive treatment is needed, such as using toothpaste that contains anti-inflammatories so that the progression of the disease does not get worse. The traditional ingredient currently being developed is Nigella sativa, which has anti-inflammatory properties. Therefore, this study analyzes the potential of toothpaste containing Nigella sativa on the expression of tumor necrosis factor-α (TNF-α), MMP-9, and PGE-2 in the Wistar rat model induced by Porphyromonas gingivalis bacteria. This study aims to prove the potential of Nigella sativa toothpaste to decrease the expression of PGE-2, TNF-α, and MMP-9 in the gingiva of rats induced by Porphyromonas gingivalis bacteria. Forty-five healthy male Wistar rats were used, consisting of the negative control group, which was only injected with Porphyromonas gingivalis bacteria ATCC3322. The positive control group was given enzyme toothpaste, and the treatment group was assigned 1 mg of Nigella sativa paste using a microbrush for 30 seconds on the gingiva incisors mandibular with a circular motion, given two times a day for a week. Immunohistochemical to see the expression of TNF-α, PGE-2, and MMP-9. Parametric comparative analysis using a one-way analysis of variance test was performed to analyze differences between groups. Nigella sativa toothpaste significantly reduced proinflammatory cytokines, as seen through the expression of TNF-α, PGE-2, and MMP-9 on days 3, 5, and 7 (p <0.05). In the limit of studied animal model, this trial indicates that giving toothpaste with black seed extract (Nigella sativa) could inhibit inflammatory mediators, as seen from the decreased expression of MMP-9, TNF-α, and PGE-2 seen from the 3rd, 5th, and 7th days.

Can narrow-diameter implants enhance patient-reported outcomes for mandibular implant-retained overdentures?

A systematic review and meta-analysis. To evaluate and compare stability and functionality between narrow and standard implant-retained mandibular overdentures in edentulous patients from multiple perspectives. Assessments included clinical parameters [survival rate (SR) and marginal bone loss (MBL)], along with patient-reported outcome measures (PROMs) including patient satisfaction and oral health-related quality of life (OHRQoL). The study protocol followed PRISMA criteria for reporting reviews and meta-analyses. Using appropriate keywords, electronic search was conducted in each of the following databases: Medline, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus, up to July 22, 2022. There were no restrictions based on language, publication type, or publication date. Additionally, ongoing studies were explored in ClinicalTrials.gov and WHO ICTRP, while cross-references in each selected study were manually examined. The eligible studies were randomized controlled trials (RCTs) or controlled clinical trials (CCTs) comparing narrow implants (diameter ≤ 3.5 mm) to standard implants (diameter > 3.5-4.5 mm) retaining mandibular overdentures in edentulous patients. Excluded were studies with unclear implant diameter information, fewer than 5 patients per group, observational studies, reviews, and laboratory studies. Two authors independently conducted study selection, data collection, and analysis, resolving any discrepancies through discussion with a third author. Methodological quality was assessed using RoB-2 and ROBINS-I tools. Implant SR and MBL measurements at final follow-up were recorded, while patient satisfaction and OHRQoL were evaluated using visual analogue scale (VAS-100) and oral health impact profile (OHIP) questionnaire, respectively. After duplicate removal, 782 publications and 83 registered clinical trials were identified, of which 26 were eligible for full-text assessment. Ultimately, the quantitative evaluation included 12 publications from 8 independent studies: 4 parallel design RCTs and 4 CCTs. Risk of bias assessment revealed variations among the studies, with only one study being rated as having low risk. The follow-up periods ranged from 1 to 3 years. Meta-analysis showed no significant difference in SR and MBL between narrow and standard implant groups (p = 0.29 and p = 0.93, respectively), with considerable heterogeneity (I2 = 100% and I2 = 78%, respectively). Regarding PROMs, the narrow implant group showed significantly higher levels of patient satisfaction (mean difference (MD): 8.18; 95% CI: 5.83 to 10.53; p < 0.00001; I2 = 36%) and exhibited a significant improvement in OHRQoL (MD: -4.36; 95% CI: -6.83 to -1.89; p < 0.001; I2 = 55%) compared to the standard implant group. For implant-retained mandibular overdentures, the use of narrow implants is associated with comparable SR and MBL, along with higher patient satisfaction and better OHRQoL improvement as compared to standard implants, offering a viable alternative option for patients with diminished alveolar bone width.

Polarized M2 macrophages induced by glycosylated nano-hydroxyapatites activate bone regeneration in periodontitis therapy.

To investigate the association between periodontal macrophage polarization states and the alveolar bone levels, and to assess whether glycosylated nano-hydroxyapatites (GHANPs) could improve bone regeneration in periodontitis by inducing macrophage M2 polarization. The change of macrophage polarization state in inflammatory periodontal tissues (with bone loss) was examined using clinical gingival samples. The relationship between macrophage phenotype and bone level in periodontal bone loss and repair was evaluated using a mouse periodontitis model. The effect of GHANPs on macrophage polarization was assessed by the in vitro model of lipopolysaccharide (LPS)-stimulated inflammation. The polarization-related markers were detected by immunofluorescence staining, real-time polymerase chain reaction and enzyme-linked immunosorbent assay analysis. The therapeutic effect of GHANPs on alveolar bone loss was explored in experimental periodontitis by histological staining and micro-CT analysis. A lower macrophage M2/M1 ratio was observed in periodontitis-affected human gingival tissues. The results of animal experiments demonstrated a positive correlation between a lower Arg-1/iNOS ratio and accelerated alveolar bone loss; also, the proportion of Arg-1-positive macrophages increased during bone repair and regeneration. The administration of GHANPs partially restored M2 macrophage polarization after LPS stimulation. GHANPs increased alveolar bone repair and regeneration in experimental periodontitis induced by ligation, potentially related to their macrophage M2 transition regulation. The findings of this study indicate that the induction of macrophage M2 polarization can be considered a viable approach for enhancing inflammatory bone repair. Additionally, GHANPs show potential in the clinical treatment of periodontitis.

Effect of fence tray matching care on excess adhesive and bracket placement accuracy for orthodontic bonding: an in vitro study

ObjectiveThis study aimed to evaluate the effect of fence tray matching care (FTMC) in bracket bonding by measuring excess adhesive, as well as linear and angular deviations, and by comparing it with the half-wrapped tray (HWT).Materials and methodsAn intraoral scanner was used to acquire data on the maxillary dental arch of a patient with periodontitis.Furthermore, 20 maxillary dental arch models were 3D printed. Using 3Shape, PlastyCAD software, and 3D printing technology, 10 FTMC (method I) and HWT (method II) were obtained. By preoperative preparation, intraoperative coordination, and postoperative measurement, the brackets were transferred from the trays to the 3D-printed maxillary dental arch models. Additionally, the bracket’s excess adhesive as well as linear and angular deviations were measured, and the differences between the two methods were analyzed.ResultsExcess adhesive was observed in both methods, with FTMC showing less adhesive (P< 0.001), with a statistical difference. Furthermore, HWT’s vertical, tip and torque, which was significantly greater than FTMC (P< 0.05), with no statistical difference among other respects. The study data of incisors, canines, and premolars, showed that the premolars had more adhesive residue and were more likely to have linear and angular deviations.ConclusionsThe FTMC had higher bracket bonding effect in comparison to HWT, and the adhesive residue, linear and angular deviations are smaller. The fence tray offers an intuitive view of the precise bonding of the bracket, and can remove excess adhesive to prevent white spot lesions via care, providing a different bonding method for clinical applications.

Application of autogenous dentinal block to increase alveolar bone volume: a clinical case

Introduction. Materials based on extracted teeth in various studies have been radiographically and histologically proven to be effective in osteoplastic operations. These materials can be used in the form of crushed dentin matrix, a fragment of the tooth’s root and an autogenous dentin block. The purpose of this clinical case was to evaluate the effectiveness of using an autogenous dentin block to increase the alveolar process of the jaws in the preimplantation period.Description of a clinical case. Patient F., 30 years old, applied to the clinic of the Clinical Center of Maxillofacial, Plastic Surgery and Dentistry Russian University of Medicine with a complaint of a missing tooth in the frontal region of the lower jaw. At the time of treatment, the patient was already undergoing orthodontic treatment in another medical institution in Moscow. The patient underwent a clinical and radiological examination together with a prosthodontst. A diagnosis of «partial secondary adentia», «atrophy of the alveolar ridge in the frontal part of the lower jaw» and «dystopia of teeth 1.8, 2.8, 3.8, 4.8» was established. A comprehensive treatment plan has been drawn up. At the first stage, the patient underwent extraction of teeth 1.8, 2.8, 3.8, 4.8 for orthodontic indications with simultaneous bone grafting of the alveolar ridge in the area of the missing tooth 3.1. At the second stage, the patient underwent a trephine biopsy in the area of augmentation and installation of a dental implant in the area of missing tooth 3.1. The third stage was rational prosthodontic treatment on a dental implant in the department of prosthodontics.Results. The present study showed that autogenous dentinal block can serve as an alternative material for alveolar ridge augmentation.

A 3D In-vitro model of the human dentine interface shows long-range osteoinduction from the dentine surface

Emerging regenerative cell therapies for alveolar bone loss have begun to explore the use of cell laden hydrogels for minimally invasive surgery to treat small and spatially complex maxilla-oral defects. However, the oral cavity presents a unique and challenging environment for in vivo bone tissue engineering, exhibiting both hard and soft periodontal tissue as well as acting as key biocenosis for many distinct microbial communities that interact with both the external environment and internal body systems, which will impact on cell fate and subsequent treatment efficacy. Herein, we design and bioprint a facile 3D in vitro model of a human dentine interface to probe the effect of the dentine surface on human mesenchymal stem cells (hMSCs) encapsulated in a microporous hydrogel bioink. We demonstrate that the dentine substrate induces osteogenic differentiation of encapsulated hMSCs, and that both dentine and β-tricalcium phosphate substrates stimulate extracellular matrix production and maturation at the gel-media interface, which is distal to the gel-substrate interface. Our findings demonstrate the potential for long-range effects on stem cells by mineralized surfaces during bone tissue engineering and provide a framework for the rapid development of 3D dentine-bone interface models.

Long-term survival rates of tapered self-tapping bone-level implants after immediate placement: a positional effective rationale

BackgroundImmediate implant placement has gained popularity due to its several advantages. However, immediate placement has its challenges, including concerns about primary stability and bone formation around the implant. The aim of the present study is to evaluate the clinical outcomes of tapered, sand-blasted, and acid-etched internal submerged dental implants in various regions of the jaw bones and to provide a positional rationale for immediate implant placement.MethodsBetween 2009 and 2018, a single surgeon at Seoul National University Dental Hospital in Seoul, Korea, immediately inserted 49 dental implants with tapered bone-level design after extraction, in a total of 34 patients. The clinical outcomes were collected and evaluated, focusing on location of implant placement and marginal bone loss (MBL), with consideration of other parameters such as implant diameter and length.ResultsOf 49 immediately installed Luna® (Shinhung Co., Seoul, Korea) dental implants, 23 were placed in the mandible, and 26 were set in the maxilla. The mean age of patients at the time of installation was 65.91 years, ranging from 40 to 86 years. The average follow-up period was 7.43 years, with a range of 5 to 14 years. After a 5-year retrospective evaluation of tapered, sand-blasted, and acid-etched internal submerged dental implants for immediate implant placement, the cumulative survival rate was 93.88%, with 100% survival rate in the mandible and premolar region of both the maxilla and mandible.ConclusionsAfter a 5-year evaluation, tapered, sand-blasted, and acid-etched internal submerged dental implants demonstrated good efficacy for immediate placement in various locations within the dental arches, exhibiting effective clinical performance.

Orthodontic treatment outcome predictive performance differences between artificial intelligence and conventional methods

ABSTRACT Objectives To evaluate an artificial intelligence (AI) model in predicting soft tissue and alveolar bone changes following orthodontic treatment and compare the predictive performance of the AI model with conventional prediction models. Materials and Methods A total of 1774 lateral cephalograms of 887 adult patients who had undergone orthodontic treatment were collected. Patients who had orthognathic surgery were excluded. On each cephalogram, 78 landmarks were detected using PIPNet-based AI. Prediction models consisted of 132 predictor variables and 88 outcome variables. Predictor variables were demographics (age, sex), clinical (treatment time, premolar extraction), and Cartesian coordinates of the 64 anatomic landmarks. Outcome variables were Cartesian coordinates of the 22 soft tissue and 22 hard tissue landmarks after orthodontic treatment. The AI prediction model was based on the TabNet deep neural network. Two conventional statistical methods, multivariate multiple linear regression (MMLR) and partial least squares regression (PLSR), were each implemented for comparison. Prediction accuracy among the methods was compared. Results Overall, MMLR demonstrated the most accurate results, while AI was least accurate. AI showed superior predictions in only 5 of the 44 anatomic landmarks, all of which were soft tissue landmarks inferior to menton to the terminal point of the neck. Conclusions When predicting changes following orthodontic treatment, AI was not as effective as conventional statistical methods. However, AI had an outstanding advantage in predicting soft tissue landmarks with substantial variability. Overall, results may indicate the need for a hybrid prediction model that combines conventional and AI methods.

An Injectable Black Phosphorus Hydrogel for Rapid Tooth Extraction Socket Healing.

The excess production of reactive oxygen species (ROS) will delay tooth extraction socket (TES) healing. In this study, we developed an injectable thermosensitive hydrogel (NBP@BP@CS) used to treat TES healing. The hydrogel formulation incorporated black phosphorus (BP) nanoflakes, recognized for their accelerated alveolar bone regeneration and ROS-scavenging properties, and dl-3-n-butylphthalide (NBP), a vasodilator aimed at enhancing angiogenesis. In vivo investigations strongly demonstrated that NBP@BP@CS improved TES healing due to antioxidation and promotion of alveolar bone regeneration by BP nanoflakes. The sustained release of NBP from the hydrogel promoted neovascularization and vascular remodeling. Our results demonstrated that the designed thermosensitive hydrogel provided great opportunity not only for ROS elimination but also for the promotion of osteogenesis and angiogenesis, reflecting the "three birds with one stone" concept, and has tremendous potential for rapid TES healing.

Mitigating jaw osteonecrosis: bioactive glass and pericardial membrane combination in a rat model

ObjectivesBisphosphonates (BFs) show clinical effectiveness in managing osteoporosis and bone metastases but pose risks of bisphosphonate-related jaw osteonecrosis (BRONJ). With no established gold standard for BRONJ treatment, our focus is on symptom severity reduction. We aimed to assess the preventive effects of bioactive glass and/or pericardial membrane in a preclinical BRONJ model, evaluating their potential to prevent osteonecrosis and bone loss post-tooth extractions in zoledronic acid (ZA)-treated animals.MethodsRats, receiving ZA or saline biweekly for four weeks, underwent 1st and 2nd lower left molar extractions. Pericardial membrane alone or with F18 bioglass was applied post-extractions. Microarchitecture analysis and bone loss assessment utilized computerized microtomography (CT) and positron emission tomography (PET) with 18F-FDG and 18F-NaF tracers. Histological analysis evaluated bone injury.ResultsExclusive alveolar bone loss occurred post-extraction in the continuous ZA group, inducing osteonecrosis, osteolysis, osteomyelitis, and abscess formation. Concurrent pericardial membrane with F18 bioglass application prevented these outcomes. Baseline PET/CT scans showed no discernible uptake differences, but post-extraction 18F-FDG tracer imaging revealed heightened glucose metabolism at the extraction site in the ZA-treated group with membrane, contrasting the control group.ConclusionThese findings suggest pericardial membrane with F18 bioglass effectively prevents BRONJ in the preclinical model.

Associations between periodontitis and serum anti-malondialdehyde-acetaldehyde antibody concentrations in rheumatoid arthritis: A case-control study.

Malondialdehyde-acetaldehyde (MAA) adducts lead to generation of anti-MAA autoantibodies and have been independently identified in inflamed periodontal and rheumatoid arthritis (RA) tissues. This study evaluates serum samples from RA cases and osteoarthritis (OA) controls to quantify associations between periodontal clinical measures, alveolar bone loss (ABL), and anti-Porphyromonas gingivalis, anti-Prevotella intermedia, and anti-Fusobacterium nucleatum antibody concentrations with anti-MAA antibody concentrations. Participants (n=284 RA cases, n=330 OA controls) underwent periodontal clinical assessments and ABL measurements. Serum immunoglobulin (Ig) A, IgG, and IgM anti-MAA and serum IgG antibacterial antibody concentrations were quantified by enzyme-linked immunosorbent assay (ELISA). Analyses utilized simple linear regression and multivariable adjusted models. No significant associations of periodontal clinical measures with serum anti-MAA were found. Moderate (p=0.038 and p=0.036, respectively) and high ABL (p=0.012 and p=0.014, respectively) in RA cases (but not in OA) were positively associated with IgG and IgM anti-MAA. Anti-P. gingivalis and anti-P. intermedia antibody concentrations were positively associated with IgA (p=0.001 for both), IgG (p=0.007 and p=0.034, respectively), and IgM anti-MAA antibody concentrations (p<0.001 and p=0.020, respectively), while anti-F. nucleatum was positively associated with IgG anti-MAA (p=0.042), findings that were similar across groups. A positive association was demonstrated between ABL and serum IgG and IgM anti-MAA antibody concentrations that was unique to RA and not observed in OA. Serum anti-P. gingivalis, anti-P. intermedia, and anti-F. nucleatum antibody concentrations displayed significant associations with anti-MAA antibody in both groups. These findings suggest MAA may play a role in the interrelationship between the periodontium and RA.

Characterization and functional prediction of the dental plaque microbiome in patients with alveolar clefts

IntroductionAlveolar cleft (AC) is a common congenital defect in people with cleft lip and palate (CLP). Alveolar bone grafting (ABG) is typically performed during adolescence, resulting in the fissure remaining in the mouth for a longer length of time. Patients with AC have a greater rate of oral diseases such as dental caries than the normal population, and the precise characteristics of the bacterial alterations caused by AC are unknown.MethodsWe recruited a total of 87 subjects and collected dental plaque samples from AC adolescents (AAP), post-operative ABG adolescents (PAP), healthy control adolescents (CAP), AC young adults (AYP), post-operative ABG young adults (PYP), and healthy control young adults (CYP). The sequencing of 16S rRNA genes was performed.ResultsThe microbial composition of plaque from alveolar cleft patients differed significantly from age-matched healthy controls. Linear discriminant analysis effect size (LEfSe) analysis revealed that AAP was enriched for Neisseria, Haemophilus, Fusobacterium, Rhodococcus, Aggregatibacter, Gemella, and Porphyromonas, whereas AYP was enriched for Capnocytophaga, Rhodococcus, and Actinomyces-f0332. There were phenotypic differences in facultatively anaerobic, Gram-negative, Gram-positive, and oxidative stress tolerance between the AYP group with longer alveolar cleft and the healthy control group according to Bugbase phenotypic predictions. Alveolar bone grafting did not alter the functional phenotype of alveolar cleft patients but reduced the number of differential genera between alveolar cleft patients and healthy controls at both ages.ConclusionsOur study systematically characterized the supragingival plaque microbiota of alveolar cleft patients, post-alveolar bone grafting patients, and matched healthy controls in two ages to gain a better understanding of plaque ecology and microbiology associated with alveolar clefts.

Assessment of the Alignment Acceleration of the Lower Incisors Using a Single Aligner Appliance Modified with Nickel-Titanium Coils: A Randomized Controlled Clinical Trial in Adults.

OBJECTIVE: The aim of this study was to investigate the effects of a single aligner appliance modified with nickel-titanium coils in accelerating the alignment of crowded lower incisors. MATERIALS AND METHODS: 36 patients with mild crowding of their lower incisors were randomly divided into two groups: one group received a modified aligner appliance with nickel-titanium coils (Experimental group), while the other group received traditional orthodontic brackets (Control group). The degree of irregularity in the alignment of the incisors was measured every 2 weeks using Little's irregularity index, and this was done at different time points throughout the study: before treatment (T0), after 2 weeks (T1), after 4 weeks (T2), after 6 weeks (T3), after 8 weeks (T4). RESULTS: A total of 87 patients with anterior mild crowding in the lower dental arch were initially assessed for eligibility. Out of these, 64 patients met the inclusion criteria. Eventually, 36 participants were assigned to receive the treatment. Accordingly, the data from 36 patients were analyzed statistically. There was no significant difference when comparing the two groups at T0, T1, T3, and T4. However, the difference was significant at T2 (p = 0.037). The differences were statistically significant at all time periods within each group (P &lt; 0.001). CONCLUSION: The use of a modified aligner appliance with nickel-titanium coils effectively treats lower incisors crowding, but it does not accelerate the alignment process compared to the traditional fixed orthodontic appliance.

Injectable Thermosensitive Gel CH-BPNs-NBP for Effective Periodontitis Treatment through ROS-Scavenging and Jaw Vascular Unit Protection.

Periodontitis, a prevalent inflammatory condition in the oral cavity, is closely associated with oxidative stress-induced tissue damage mediated by excessive reactive oxygen species (ROS) production. The jaw vascular unit (JVU), encompassing both vascular and lymphatic vessels, plays a crucial role in maintaining tissue fluid homeostasis and contributes to the pathological process in inflammatory diseases of the jaw. This study presents a novel approach for treating periodontitis through the development of an injectable thermosensitive gel (CH-BPNs-NBP). The gel formulation incorporates black phosphorus nanosheets (BPNs), which are notable for their ROS-scavenging properties, and dl-3-n-butylphthalide (NBP), a vasodilator that promotes lymphatic vessel function within the JVU. These results demonstrate that the designed thermosensitive gel serve as a controlled release system, delivering BPNs and NBP to the site of inflammation. CH-BPNs-NBP not only protects macrophages and human lymphatic endothelial cells from ROS attack but also promotes M2 polarization and lymphatic function. In in vivo studies, this work observes a significant reduction in inflammation and tissue damage, accompanied by a notable promotion of alveolar bone regeneration. This research introduces a promising therapeutic strategy for periodontitis, leveraging the unique properties of BPNs and NBP within an injectable thermosensitive gel.

A preliminary in vivo and in vitro study of endothelial cell pyroptosis in the periodontal inflammatory environment

Objective: To observe whether endothelial cells undergo pyroptosis in the inflammatory periodontal environment by using a model in vivo and in vitro, providing an experimental basis for indepth understanding of the underlying pathogenesis of periodontitis. Methods: According to the classification of periodontal diseases of 2018, gingival tissues were collected from periodontally healthy subjects and patients with stage Ⅲ-Ⅳ, grade C periodontitis, who presented Department of Oral and Maxillofacial Surgery and Department of Periodontology, School of Stomatology, The Fourth Military Medical University from April to May 2022. Immunohistochemical staining was performed to detect the expression level and distribution of gasdermin D (GSDMD), a hallmark protein of cell pyroptosis, in gingival tissues. Periodontitis models were established in each group by ligating the maxillary second molar teeth of three mice for 2 weeks (ligation group). The alveolar bone resorption was determined by micro-CT (mice without ligation treatment were used as the control group), and the colocalization of GSDMD and CD31 were quantitatively analyzed by immunofluorescence staining in gingival tissues of healthy and inflammatory mice. Human umbilical vein endothelial cells (HUVECs) were cultured in vitro and treated with lipopolysaccharide (LPS) of Porphyromonas gingivalis (Pg) combined with adenosine triphosphate (ATP) at various concentrations of 0.5, 1.0, 2.5, 5.0, and 10.0 mg/L, respectively, and the 0 mg/L group was set as the control group at the same time. Scanning electron microscopy was used to observe the morphology of HUVECs. Western blotting was used to detect the expression of gasdermin D-N terminal domains (GSDMD-N) protein and immunofluorescence cell staining was used to detect the expression and distribution of GSDMD. Cell counting kit-8 (CCK-8) was used to detect the proliferative ability of HUVECs, and propidium iodide (PI) staining was used to detect the integrity of cell membrane of HUVECs. Results: Immunohistochemistry showed that GSDMD in gingival tissues of periodontitis was mainly distributed around blood vessels and its expression level was higher than that in healthy tissues. Micro-CT showed that alveolar bone resorption around the maxillary second molar significantly increased in ligation group mice compared with control subjects (t=8.88, P<0.001). Immunofluorescence staining showed significant colocalization of GSDMD with CD31 in the gingival vascular endothelial cells in mice of ligation group. The results of scanning electron microscopy showed that there were pores of different sizes, the typical morphology of pyroptosis, on HUVECs cell membranes in the inflammatory environment simulated by ATP combined with different concentrations of LPS, and 2.5 mg/L group showed the most dilated and fused pores on cell membranes, with the cells tended to lyse and die. Western blotting showed that the expression of GSDMD-N, the hallmark protein of cell pyroptosis, was significantly higher in 2.5 and 5.0 mg/L groups than that in the control group (F=3.86, P<0.01). Immunofluorescence cell staining showed that the average fluorescence intensity of GSDMD in 2.5 mg/L group elevated the most significantly in comparison with that in the control group (F=35.25, P<0.001). The CCK-8 proliferation assay showed that compared to the control group (1.00±0.02), 0.5 mg/L (0.52±0.07), 1.0 mg/L (0.57±0.10), 2.5 mg/L (0.58±0.04), 5.0 mg/L (0.55±0.04), 10.0 mg/L (0.61±0.03) groups inhibited cell proliferation (F=39.95, P<0.001). PI staining showed that the proportion of positive stained cells was highest [(56.07±3.22)%] in 2.5 mg/L group (F=88.24, P<0.001). Conclusions: Endothelial cells undergo significant pyroptosis in both in vivo and in vitro periodontal inflammatory environments, suggesting that endothelial cell pyroptosis may be an important pathogenic factor contributing to the pathogenesis of periodontitis.

Biofunctionalization of dental abutments by a zinc/chitosan/gelatin coating to optimize fibroblast behavior and antibacterial properties.

Tightly sealed peri-implant gingival tissue provides a barrier against oral bacterial invasion, protecting the alveolar bone and maintaining long-term implant survival. To investigate if zinc can enhance the integration between peri-implant gingival tissue and abutment surface, we herein present novel zinc/chitosan/gelatin (Zn/CS/Gel) coatings prepared using the electrophoretic deposition (EPD) technique. The effect of these coatings on human gingival fibroblasts (hGFs) was investigated by culturing these cells on top of the EPD coatings. Surface characterization demonstrated that Zn2+ were released in a sustained and pH-responsive manner. The preclinical cell culture evaluation of these coatings indicated that the zinc-containing coatings enhanced cell migration, adhesion and collagen secretion of hGFs. Moreover, the zinc-containing coatings exhibited antibacterial efficacy by inhibiting the growth of Porphyromonas gingivalis and reducing attachment of Staphylococcus aureus. Notably, zinc-free CS/Gel coatings prevented attachment of P. gingivalis as well. The coatings were also shown to be cytocompatible with epithelial cells and osteoblasts, which are other relevant cell types which surround dental implants after clinical placement. Based on our findings, it can be concluded that Zn-containing coatings hold promise to enhance the adhesion of gingival tissue to the implant surface, which may potentially contribute to the formation of a robust peri-implant soft sealing counteracting bacterial invasion.