Initial Plaque Research Articles

Comparative evaluation of the clinical success of 3D-printed space maintainers and band-loop space maintainers.

Exploring the integration of 3D-printing technology in space maintainer (SM) manufacturing could offer innovative solutions and insights for enhancing SMs. To compare the clinical success, retention, and periodontal effect of traditional band-loop (TBL) SMs with 3D-printed SMs. Seventy children (mean age: 6.99 ± 1.18) were divided into two groups. Laser sintering (LS) group (n = 34): Patients were scanned with an intraoral scanner. SMs were produced with LS 3D-printing method from a titanium-based metal powder. T group (n = 36): Impressions were taken with alginate. SMs were produced by adjusting the bands and soldering the wires on the model. The retention and effects on oral hygiene of the SMs were evaluated at the sixth month. Preference for impression technique was assessed by a five-question survey. Thirty-eight percent of T SMs and 66% of LS SMs failed (p = .007). The mean survival time was significantly higher in the T group (p = .035). No difference was found between the initial and control full-mouth Gingival Index (GI) and Plaque Index (PI) values of the two groups. Both groups had increased GI/PI values in abutment teeth. Patients in the LS group interpreted their impression experience more positively. It is important to provide oral hygiene education before applying fixed SMs and utilize more digital workflow in paediatric dentistry.

COMPARATIVE EFFICACY OF CHLORHEXIDINE AND SODIUM BICARBONATE DENTIFRICES IN PLAQUE AND GINGIVAL INFLAMMATION REDUCTION: A RANDOMIZED CONTROLLED TRIAL

Objectives: To determine the effi cacy of Chlorhexidine dentifrice compared to Sodium Bicarbonate dentifrice in plaque and gingival Infl ammation reduction. Materials and Methods: From May 2022 to August 2022, a randomized controlled experiment was carried out in the Periodontology Department of Sardar Begum Dental College and Hospital Peshawar. Using WHO formulae for sample size, 98 patients were selected. The age range of the patient was chosen between 13-40 years. The mean age presentation was 19.7 ± 4.9 years. The females were N=56 (57.1%) predominant than males N=42 (42.9%). The patients were placed into two groups of 49 each. Group A received dentifrice containing chlorhexidine, whereas Group B received dentifrice containing sodium bicarbonate. The data was entered into a structured proforma. SPSS 22.0 was used to analyze data. The Chi-Square test was used to compare the means of the two groups. Values of ≤ .05 were considered signifi cant. Results: The mean plaque scores for both groups are shown in Table 7. Group A (Chlorhexidine group) participants had an initial mean plaque score of 2.7, while the plaque score after the intervention was 1.2. The initial mean plaque score was 2.7 in the participants of group B (Sodium Bicarbonate group), while the mean plaque score after intervention was 1.75. This shows that both dentifrices reduced plaque but chlorhexidine was more eff ective than sodium bicarbonate in plaque reduction. Similarly, both (Chlorhexidine and Sodium Bicarbonate) reduced the gingival index score, but chlorhexidine was more eff ective than sodium bicarbonate in reducing gingival inflammation. Conclusion: Both the dentifrices show a significant reduction in both the plaque scores and gingival scores after usage. Chlorhexidine group showed a notable reduction in plaque and gingival scores as compared to sodium bicarbonate.

Prediction of Early Atherosclerotic Plaques Using a Sequence-Activated Fluorescence Probe for the Simultaneous Detection of γ-Glutamyl Transpeptidase and Hypobromous Acid.

Atherosclerosis is a lipoprotein-driven disease, and there is no effective therapy to reverse atherosclerosis or existing plaques. Therefore, it is urgently necessary to create a noninvasive and reliable approach for early atherosclerosis detection to prevent initial plaque formation. Atherosclerosis is intimately associated with inflammation, which is accompanied by an excess of reactive oxygen species (ROS), leading to cells requiring more glutathione (GSH) to resist severe oxidative stress. Therefore, the GSH-hydrolyzed protein γ-glutamyl transpeptidase (GGT) and the ROS-hypobromous acid (HBrO) are potential biomarkers for predicting atherogenesis. Hence, to avoid false-positive diagnoses caused by a single biomarker, we constructed an ingenious sequence-activated double-locked TP fluorescent probe, C-HBrO-GGT, in which two sequential triggers of GGT and HBrO are meticulously designed to ensure that the probe fluoresces in response to HBrO only after GGT hydrolyzes the probe. By utilization of C-HBrO-GGT, the voltage-gated chloride channel (CLC-1)-HBrO-catalase (CAT)-GGT signaling pathway was confirmed in cellular level. Notably, the forthcoming atherosclerotic plaques were successfully predicted before the plaques could be observed via the naked eye or classical immunofluorescent staining. Collectively, this research proposed a powerful tool to indicate the precise position of mature plaques and provide early warning of atherosclerotic plaques.

Prediction of Early Atherosclerotic Plaques Using a Sequence‐Activated Fluorescence Probe for the Simultaneous Detection of γ‐Glutamyl Transpeptidase and Hypobromous Acid

AbstractAtherosclerosis is a lipoprotein‐driven disease, and there is no effective therapy to reverse atherosclerosis or existing plaques. Therefore, it is urgently necessary to create a noninvasive and reliable approach for early atherosclerosis detection to prevent initial plaque formation. Atherosclerosis is intimately associated with inflammation, which is accompanied by an excess of reactive oxygen species (ROS), leading to cells requiring more glutathione (GSH) to resist severe oxidative stress. Therefore, the GSH‐hydrolyzed protein γ‐glutamyl transpeptidase (GGT) and the ROS‐hypobromous acid (HBrO) are potential biomarkers for predicting atherogenesis. Hence, to avoid false‐positive diagnoses caused by a single biomarker, we constructed an ingenious sequence‐activated double‐locked TP fluorescent probe, C‐HBrO‐GGT, in which two sequential triggers of GGT and HBrO are meticulously designed to ensure that the probe fluoresces in response to HBrO only after GGT hydrolyzes the probe. By utilization of C‐HBrO‐GGT, the voltage‐gated chloride channel (CLC‐1)‐HBrO‐catalase (CAT)‐GGT signaling pathway was confirmed in cellular level. Notably, the forthcoming atherosclerotic plaques were successfully predicted before the plaques could be observed via the naked eye or classical immunofluorescent staining. Collectively, this research proposed a powerful tool to indicate the precise position of mature plaques and provide early warning of atherosclerotic plaques.

Safety and efficacy of a novel calcified plaque modification technique - Shockwave Intravascular Lithotripsy - in patients with coronary artery disease: Mid-term outcomes.

Coronary interventions in calcified lesions are associated with a higher rate of adverse clinical events. Initial aggressive plaque modification along with post-implantation optimization is pivotal for achieving a favorable outcome of percutaneous coronary intervention (PCI). Recently, the Shockwave C2 Intravascular Lithotripsy (S-IVL) System, a novel acoustic wave-based device designed to modify calcified plaque, has been introduced into clinical practice. We evaluated the mid-term safety and efficiency of S-IVL in a cohort of 131 consecutive patients with severely calcified coronary lesions. We retrospectively analyzed a total of 131 consecutive S-IVL PCI procedures. The study had two main inclusion criteria - the presence of a calcified resistant lesion (defined by inadequate non-compliant balloon catheter inflation) or a significantly underexpanded stent (more than 20% of reference diameter). The study had two primary endpoints - successful clinical outcome and safety concerns. Clinical success was defined as effective stent deployment or optimization of a previously underexpanded stent (with less than <20% in-stent residual stenosis). Safety outcomes were defined as periprocedural complications, such as device failure and major adverse cardiac and cerebrovascular events (MACCE). Clinical follow-up was performed at the end of hospitalization and 6 months after the index procedure. In-hospital MACCE was 4.6% with 1.5% target lesion revascularization (TLR) and one case of subacute fatal stent thrombosis. At 6-month follow-up, the MACCE rate was 7.9% with a concomitant TLR rate of 3.8%. Our mid-term data confirm acceptable safety and efficacy of intravascular lithotripsy as a valuable strategy for lesion preparation and stent optimization in a cohort of 131 consecutive patients with severely calcified coronary lesions.

The association of stroke risk factors with the future thickness of carotid atherosclerotic plaques

ABSTRACT Objectives An advancing atherosclerotic plaque is a risk factor for stroke. We conducted this study to assess the relationship between risk factors of stroke with changing in the thickness of carotid plaques thickness evident on sonography. Methods We carried out a secondary analysis of data from a study on carotid bifurcation plaques. Data were collected in the sonography laboratories of two university hospitals. In total, 564 (240; 42.6% men) patients with atherosclerotic plaques in the carotid bifurcation and internal carotid artery with stenosis ≥ 30% evident on duplex sonography were included. We developed machine learning models using an extreme gradient boosting algorithm with Shapley additive explanation method to find important risk factors and their interactions. The outcome was a change in the carotid plaque thickness after 36 months, and the predictors were initial plaque thickness and the risk factors of stroke. Results Two regression models were developed for left and right carotid arteries. The R-squared values were 0.964 for the left, and 0.993 for the right model. Overall, the three top features were BMI, age, and initial plaque thickness for both left and right plaques. However, the risk factors of stroke showed stronger interaction in predicting plaque thickening of the left carotid more than the right carotid artery. Discussion The effect of each predictor on plaque thickness is complicated by interactions with other risk factors, particularly for the left carotid artery. The side of carotid artery involvement should be considered for stroke prevention.

Tetramodal Chemical Imaging Delineates the Lipid-Amyloid Peptide Interplay at Single Plaques in Transgenic Alzheimer's Disease Models.

Beta-amyloid (Aβ) plaque pathology is one of the most prominent histopathological feature of Alzheimer's disease (AD). The exact pathogenic mechanisms linking Aβ to AD pathogenesis remain however not fully understood. Recent advances in amyloid-targeting pharmacotherapies highlight the critical relevance of Aβ aggregation for understanding the molecular basis of AD pathogenesis. We developed a novel, integrated, tetramodal chemical imaging paradigm for acquisition of trimodal mass spectrometry imaging (MSI) and interlaced fluorescent microscopy from a single tissue section. We used this approach to comprehensively investigate lipid-Aβ correlates at single plaques in two different mouse models of AD (tgAPPSwe and tgAPPArcSwe) with varying degrees of intrinsic properties affecting amyloid aggregation. Integration of the multimodal imaging data and multivariate data analysis identified characteristic patterns of plaque-associated lipid- and peptide localizations across both mouse models. Correlative fluorescence microscopy using structure-sensitive amyloid probes identified intra-plaque structure-specific lipid- and Aβ patterns, including Aβ 1-40 and Aβ 1-42 along with gangliosides (GM), phosphoinositols (PI), conjugated ceramides (CerP and PE-Cer), and lysophospholipids (LPC, LPA, and LPI). Single plaque correlation analysis across all modalities further revealed how these distinct lipid species were associated with Aβ peptide deposition across plaque heterogeneity, indicating different roles for those lipids in plaque growth and amyloid fibrillation, respectively. Here, conjugated ceramide species correlated with Aβ core formation indicating their involvement in initial plaque seeding or amyloid maturation. In contrast, LPI and PI were solely correlated with general plaque growth. In addition, GM1 and LPC correlated with continuous Aβ deposition and maturation. The results highlight the potential of this comprehensive multimodal imaging approach and implement distinct lipids in amyloidogenic proteinopathy.

Comparative Evaluation of Surface Roughness and Wettability of an Alkasite with Nano Bulk-Fill and Nanofilled Resin Composite Restorative Materials: In vitro Study.

Surface characteristics of resin-based composites (RBCs) can change with polishing and over time. The aim of the study was to compare the surface roughness and wettability of three different posterior RBCs after polishing and the change in these surface characteristics over time, after aqueous aging. Experimental in vitro study. Eleven disc-shaped RBC specimens were fabricated. The RBCs used were, alkasite composite, bulk-fill nanocomposite, conventional nanofilled composite. All the specimens underwent polishing with Soflex Diamond Polishing System and then analyzed for roughness and wettability at baseline and after aqueous aging for 3 months with the help of an atomic force microscope and a contact angle goniometer respectively. One-way ANOVA and Tamhane test were used for the multiple comparisons. Alkasite composite showed significantly higher surface roughness (P = 0.028 and P < 0.001, respectively) and lower wettability (P = 0.023 and P = 0.020, respectively) than conventional nanofilled composite at baseline and 3 months. Surface roughness of alkasite composite was also significantly higher than bulk-fill nanocomposite (P = 0.009 and P < 0.001, respectively) at both the time points. Alkasite has higher surface roughness in comparison to conventional nanocomposite and bulk-fill nanocomposite and lower wettability than conventional nanocomposite after polishing and aqueous aging over a 3-month period. In terms of surface characteristics, alkasite composite may be advantageous in preventing initial plaque adhesion to the material surface, but the lower surface roughness of nano-filled composites may be more advantageous in terms of plaque retention prevention.

Arterial stiffness and atherosclerosis in systemic lupus erythematosus patients

IntroductionSystemic lupus erythematosus (SLE) is characterized by early atherothrombosis. Pulse wave velocity (PWV) is a promising tool for the diagnosis of early vascular remodelling and initial atherosclerotic plaque formation. Our objective was to evaluate PWV and its relationship with coronary atherosclerosis and thrombotic biomarkers in patients with SLE.Material and methodsIn 26 patients with SLE with stable clinical conditions, mean age of 39.1 ±11.7 years and without a history of coronary artery disease, multidetector computed tomography (MDCT)-based coronary calcium scoring (CACS) was performed and PWV measured.Laboratory evaluation included serum levels of anticardiolipin and anti-β2-glycoprotein antibodies (anti-β2-GPI), lupus anticoagulant (LA), D-dimers, thrombin–antithrombin complexes (TAT), and von Willebrand factor (vWF).ResultsMultidetector computed tomography revealed coronary calcifications in 8 (30.8%) patients and the median CACS was 52.4 HU (range 2–843.2). The mean PWV was 9.0 ±3.2 m/s and was higher in patients aged > 50 years (+33.7% vs. < 50 years), those with positive LA (+28.2% vs. LA negative), TAT ≥ 10 μg/l (+18.1% vs. < 10 μg/l), vWF ≥ 200 IU/dl (+51.8% vs. < 200 IU/dl) and with coronary atherosclerosis (CACS > 0; +21.4% vs. CACS = 0).In contrast, the duration of the disease, D-dimers, anticardiolipin, and anti-β2-GPI antibodies did not influence PWV. In the group without atherosclerosis (CACS = 0, n =18), patients with vWF ≥ 200 IU/dl had a 19.3% higher PWV compared to the rest.ConclusionsIn patients with SLE, PWV was associated with the presence of coronary atherosclerotic lesions in MDCT. Furthermore, arterial stiffness was higher in patients with markers of endothelial dysfunction and a prothrombotic state, suggesting their contribution to the early stages of arterial remodelling in SLE.

Pathophysiological evaluations of initial plaque development after heart transplantation via serial multimodality imaging and cytokine assessments.

Detailed morphological characteristics of de novo and donor-transmitted plaques and the association of serum T-lymphocyte cytokine levels with plaque progression of coronary allograft vasculopathy within 1 year after heart transplantation are unknown. In this retrospective analysis of data in a prospectively maintained database, 40 heart transplant recipients were included. We performed serial 3 vessel optical coherence tomography and intravascular ultrasound analyses, at the 8 week (baseline) and 12 month post-transplantation follow-ups, and serum cytokine measurements (n=23). The correlation between serum cytokines and Δplaque burden (between baseline and follow-up) was evaluated depending on plaque morphology. Thirteen de novo plaques (maximum intimal thickness ≥0.5 mm at the 12 month follow-up without plaques at baseline) were identified in 8 recipients, and 31 donor-transmitted plaques (maximum intimal thickness ≥0.5 mm at baseline) were detected in 17 recipients. Compared with donor-transmitted plaques, the Δplaque burden in the de novo plaques, with mainly fibrous morphology, was high (38.8% [29.6%-41.2%] vs 8.7% [1.33%-13.6%], p < 0.001). Stratification of the morphology of donor-transmitted plaques revealed that the Δplaque burden in fibrous plaques (10.6% [7.0%-18.0%]) was similar to that in fibroatheroma (10.3% [8.7%-23.8%]). Serum interleukin-31 levels at baseline correlated with fibrous plaque proliferation (r=0.73, p=0.007) even under immunosuppressive conditions, whereas other cytokines (interleukin-1β, interleukin-17, and interferon-gamma) were mostly undetectable. Intimal fibrous proliferation contributed to the progression of donor-transmitted and de novo plaques. Serum interleukin-31 levels at baseline may contribute to intimal fibrous proliferation within 1 year after heart transplantation.

Predicting Stenosis Aggravation in Follow-Up High-Resolution Magnetic Resonance Images of Patients with Intracranial Atherosclerosis

Background: High-resolution magnetic resonance imaging (HRMRI) can provide information on the histopathological characteristics of intracranial atherosclerotic lesions causing arterial stenosis; however, its clinical application in intracranial atherosclerosis lacks standardization for predicting stenosis. Therefore, this study investigated the characteristics of HRMRI that can predict progression based on comparisons of follow-up HRMRI. Methods: We retrospectively enrolled patients who underwent HRMRI within 7 days of symptom onset to evaluate the characteristics associated with intracranial stenotic lesions. Among them, patients diagnosed with severe stenosis due to atherosclerosis and who underwent follow-up HRMRI 12–24 months after initial HRMRI were included in the final study. We analyzed distinct features, such as stenosis aggravation, the presence of initial plaque enhancement, increment of plaque enhancement, the existence of both eccentric and concentric plaques, and the presence of initial intraplaque hematoma on initial and follow-up HRMRI. Results: Among 442 patients who underwent HRMRI for severe stenosis due to atherosclerosis, 35 underwent follow-up HRMRI 12–24 months later. Patients with stenosis aggravation showed a higher incidence of plaque enhancement (87.5% vs. 3.7%, p < 0.001) and the presence of both concentric and eccentric plaques (75.0% vs. 11.1%; p = 0.001). The area under the curve for the increment of plaque enhancement was 0.92 (95% confidence interval [CI] 0.78–1.00, p ≤ 0.001), while that for the presence of both concentric and eccentric plaques was 0.82 (95% CI 0.63–1.00, p < 0.007). Conclusions: The presence of both concentric and eccentric plaques and an increase in plaque enhancement were the strongest predictors of aggravation of intracranial artery stenosis.

734 Have I lost my large rupture cavity? The fingerprint of atherosclerotic plaque healing detected by serial optical coherence tomography imaging

Abstract A 64-year-old man, prior smoker, with a history of paroxysmal atrial fibrillation was referred to our hospital due to worsening dyspnoea, progressively worsening angina, and a positive stress EKG testing. Coronary angiography (CAG) showed an angiographically intermediate stenosis of the mid left anterior descending (LAD) artery and a focal, complex lesion of the distal right coronary artery (RCA) (Figure 1A and B, red arrow). Treatment of the LAD stenosis was deferred based on a negative fractional flow reserve value (i.e. 0.85). Optical coherence tomography (OCT) imaging (ILUMIEN OPTIS, Abbott Vascular, Santa Clara, CA) was performed to better characterize the RCA lesion, which disclosed a ruptured thin-cap fibroatheroma (TCFA) with a large ‘empty’ cavity (Figure 1C–G, red arrows) and overlying ‘layered’ tissue (Figure 1H, white arrowheads). Based on these OCT findings, suggestive of initial plaque healing, and on a large residual lumen dimension (i.e. minimum lumen area, MLA, at the rupture site: 7.7 mm2), this lesion was not treated with percutaneous coronary intervention. The patient was discharged on aspirin, edoxaban, metoprolol, rosuvastatin, and ezetimibe, and remained clinically stable for more than 1 year. Due to angina recurrence, a new CAG was performed 18 months after the first admission, revealing a progression of the mid LAD stenosis that was treated with a 2.5/28 mm drug-eluting stent, and an improvement of the RCA lesion angiographic appearance (smooth contour) (Figure 1A′–B′). RCA OCT imaging was repeated demonstrating a complete healing of the large rupture cavity with all the hallmarks of the reparative process (Figure 1C′–H′): (1) re-established fibrous cap integrity and smooth vessel lumen profile; (2) thickening of the fibrous cap and reduction of lipid burden (i.e., transformation of TCFA into thick-cap fibroatheroma, ThCFA); (3) replacement of the ‘empty’ cavity with new ‘granulation tissue’; (4) initial calcification of the plaque; (5) heterogeneous signal-rich layers with distinct optical-signal intensity (layered, ‘onion-like’ pattern); and (6) mild lumen narrowing (MLA at the rupture site: 6.9 mm2).

Effectivity of homecare and professional biofilm removal procedures on initial supragingival biofilm on laser-microtextured implant surfaces in an ex vivo model

BackgroundThe aim of the current study was the evaluation of initial biofilm adhesion and development on laser-microtextured implant collar surfaces and the examination of effectivity of different biofilm management methods.MethodsInitial biofilm formation was investigated on hydrophobic machined and laser-microtextured (Laser-Lok) titanium surfaces and hydrophobic machined and laser-microtextured (Laser-Lok) titanium aluminium vanadium surfaces and compared to hydrophobic smooth pickled titanium surfaces, hydrophilic smooth and acid etched titanium surfaces, hydrophobic sandblasted large grid and acid etched titanium surfaces (titanium Promote) via erythrosine staining and subsequent histomorphometrical analysis and scanning electron microscopic investigations. After decontamination procedures, performed via tooth brushing and glycine powder blasting, clean implant surface was detected via histomorphometrical analysis.ResultsAfter 24 h mean initial plaque area was detected in the following descending order: smooth pickled titanium > titanium Promote > hydrophilic smooth and acid etched titanium > Laser-Lok titanium > Laser-Lok titanium aluminium vanadium. The same order was determined after 48 h of biofilm formation. After glycine powder blasting all samples depicted almost 100% clean implant surface. After tooth brushing, Laser-Lok titanium (67.19%) and Laser-Lok titanium aluminium vanadium (69.80%) showed significantly more clean implant surface than the other structured surfaces, hydrophilic smooth and acid etched titanium (50.34%) and titanium Promote (33.89%). Smooth pickled titanium showed almost complete clean implant surface (98.84%) after tooth brushing.ConclusionsBoth Laser-Lok surfaces showed less initial biofilm formation after 24 and 48 h than the other implant surfaces. In combination with the significant higher clean implant surfaces after domestic decontamination procedure via tooth brushing, both Laser-Lok surfaces could be a candidate for modified implant and abutment designs, especially in transmucosal areas.

Ozone Therapy in the Prevention of Dental Plaque Formation in Dogs.

This study aims to assess ozonized mineral oil ointment application as an antiplaque therapy for dogs. Domestic healthy dogs received dental scaling and polishing under general anesthesia. Under standard feeding and homecare during 7 days, 20 dogs were randomly placed into 2 different groups for dental treatment. The control group (CG) was given a single placebo application and the ozone group (O3G) received daily ozonized ointment application. The average age (CG = 4.4; O3G = 5.7 years old), body weight (CG = 15.7; O3G = 15.3 kg) and the gingivitis index obtained on the first day (D0) allowed initial homogeneity between the groups. The dental plaque index, including clinical and computerized analysis on the seventh day, was obtained from the buccal aspect of specific dental locations. Both analyses revealed significant statistical association between daily application of ozone and antiplaque effect. There was no evidence of toxicity during the study. These results suggest that ozone therapy may be an efficient adjuvant to conventional periodontal treatment in decreasing initial dental plaque formation.

Histologic Findings of Choroidal Vasculopathy in Eyes Enucleated following Radiation Therapy for Uveal Melanoma: Radiation Choroidopathy.

Little has been published about the choroidal vascular changes that occur years after radiation exposure. The aim of this study was to review the histological changes observed in the choroidal vasculature following radiotherapy for uveal melanoma. Records from a single institution were retrospectively reviewed from June 7, 2007 to June 7, 2017; 101 patients with a diagnosis of uveal melanoma that underwent enucleation had their records reviewed. Out of these, a total of 26 eyes had undergone plaque brachytherapy prior to enucleation, which had been performed at a mean time of 7.2 years (range from 0 years to 30 years) after the initial plaque placement. A histopathologic analysis was conducted on all 26 eyes with special emphasis on the choroidal changes. Of these 26 eyes, 18 demonstrated evidence of radiation-induced vasculopathy. Of the 18 eyes, 10/18 (55%) had radiation retinopathy and 16/18 (89%) had radiation choroidal vasculopathy. One patient had a phthisical eye, and the choroid could not be evaluated because the characteristics of the vasculature could not be determined. Nine cases had vitreous hemorrhage (50%), all cases had radiation retinopathy, and 8/9 (89%) had radiation choroidopathy. Of the 16 cases with radiation choroidal vasculopathy, 3/16 (19%) had only intratumoral radiation choroidal vasculopathy, 3/16 (19%) had only extratumoral radiation choroidal vasculopathy, and, thus, 10/16 (32%) had both intratumoral and extratumoral radiation choroidal vasculopathy. In patients with radiation choroidal vasculopathy, 2/16 (13%) had hyalinization of the choroidal vessels. Another 3/16 (19%) cases with radiation choroidal vasculopathy had ectatic vessels. The other 11/16 (68%) had evidence of both hyalinization of the choroidal vessels as well as ectatic vessels in the choroid. Histological evidence of radiation retinopathy and choroidopathy were seen in 69% of eyes enucleated after receiving radiation therapy, which, in some cases, also had vitreous hemorrhage. Polypoidal choroidal vasculopathy, choroidal neovascularization, and retinal choroidal anastomoses (RAP-type lesions) were seen in 12 of the 16 eyes (75%). Irradiation of malignant tumors of the eye causes not only radiation retinopathy but also radiation choroidopathy. The role of radiation choroidopathy in the subsequent visual loss following radiotherapy and the role of anti-VEGF therapy needs to be recognized and distinguished from radiation retinopathy. Our data adds to the prior limited knowledge that radiation affects the choroid and can induce specific phenotypes similar to the clinical spectrum of CNV, PCV, and RAP.

Antimicrobial Efficacy of Vaccinium macrocarpon mouthwash against Steptococcus mutans in dental plaque of caries active children – A randomized controlled trial

Cranberry (Vaccinium macrocarpon) extracts have been found to be rich in polyphenols specifically, including flavonoids, that have been found to exhibit beneficial properties to human health. Considering the recent inclination in the preference of people towards herbal based products and remedies, and taking into account the possible side-effects of chlorhexidine, the current study was undertaken to comparatively evaluate the antimicrobial efficacy of Vaccinium macrocarpon and chlorhexidine mouthwash on the Streptococcus mutans count in the dental plaque of caries, active children. The study follows a parallel design involving 50 children divided into two groups of 25 each - Group 1: chlorhexidine mouthwash; Group 2: cranberry mouthwash. The initial plaque samples and the samples were taken after 14 days were evaluated using a digital colony counter for determining the streptococcal colony count/ml. A statistically significant difference was found in both the groups with respect to the Streptococcal colony count when the intra-group comparison was made comparing the baseline values to the values after 14 days. However, no significant difference was seen in the percentage of reduction in the microbial CFU/ml between the two groups. Cranberry mouthwash can be considered to be an effective alternative to Chlorhexidine mouthwash, given its additional systemic effects apart from local beneficial effects in the oral region. Future scope in research should be aimed at evaluating its long term health benefits and any possible adverse effects.

Efficacy of PerioTabs, a NitrAdine-based gingiva brushing solution, on periodontally affected patients treated with fixed partial dentures: a randomized controlled study.

Objectives: Recent data show that teeth prepared with horizontal finishing lines supporting crowns and fixed partial dentures present more periodontal disorders than untreated control teeth. Several studies have shown that NitrAdine (bonyf) induces a significant reduction of dental biofilm. The aim of this study was to demonstrate that 10-day use of PerioTabs (bonyf), a NitrAdine-based gingiva brushing solution, is effective in treating gingival inflammation of prosthodontic patients. Method and materials: Forty-nine subjects were instructed to brush their teeth, gingivae, and prostheses with the PerioTabs solution for 10 days (treatment group) and 49 with any toothpaste (control group). The initial and 11-day Plaque Index and Bleeding Index were recorded. A five-point Likert scale was used to evaluate the level of patient satisfaction. The Shapiro-Wilk statistical test was used to compare the results for the two groups. Results: Highly significant differences between the treatment and control group (P < .001) for the Plaque Index and Bleeding Index resulted. The treatment group patients' satisfaction was high: 31 (63.3%) reported the highest level, 5, on the Likert scale, and 18 (36.7%) declared they were satisfied (level 4). Conclusions: The use of a NitrAdine-based gingiva brushing solution (PerioTabs) was effective in reducing the gingival inflammation in periodontally affected patients treated with fixed partial dentures. Clinical relevance: The NitrAdine-based gingiva brushing solution (PerioTabs) was highly accepted by the patients and seems to be a promising alternative to the solutions widely used.

Initial Progressions of Carotid Artery Plaque Are Associated with Risk Factors of Cardiovascular Disease.

Background:Carotid artery plaque, white matter disease (WMD), and silent lacunae infarcts (initial indicators) are associated with symptomatic cerebral infarction (CI) caused by atherosclerosis. We retrospectively examined the association between the initial indicators and risk factors for cerebrovascular disease, considering the primary prevention of symptomatic CI.Methods:We divided 1503 individuals who were neurologically healthy and enrolled in a brain screening program (brain dock) at our institution, into three initial plaque grades (grade 0, 1, and 2) based on having no plaques, having plaques on the right or left carotid artery, or having plaques on both carotid arteries, respectively. We analyzed the risk factors according to the presence/absence of the initial indicators.Results:WMD and the risk factors (low-density lipoprotein [LDL], hemoglobin A1c, systolic blood pressure [BP], and smoking cigarettes) were positively correlated with the initial plaque grades, even when their laboratory values were within normal ranges. Systolic BP (116.5 ± 14.0 mmHg) was significantly lower in group 00 (without carotid plaque and WMD) than that in age-adjusted others (with carotid plaque or WMD). In young participants aged between 40 and 52 years, LDL (132.8 ± 24.5 mg/dl) was significantly higher in subgroup ++ (with carotid plaque and WMD) compared to others (without carotid plaque or WMD).Conclusion:Initial plaque grade and WMD grade as clinical initial indicators of symptomatic CI are associated with risk factors. To avoid deterioration of the initial indicators, it was suggested that the risk factors should be maintained at the lower ends of normal ranges and smoking cessation should be recommended.

Hierarchical involvement of molecular players in human neocortex in the course of preclinical and symptomatic Alzheimer’s disease

AbstractBackgroundProteomic profile changes have been reported in the brains from individuals having Alzheimer’s disease. However, it is not yet clear whether they represent a continuous process from mild to severe changes, or whether the proteins become involved step‐by‐step in a hierarchal manner. Additionally, in previous studies, cases with initial Aβ plaque and NFT pathology were considered as controls, and brain homogenates were not separated into distinct fractions. Therefore, there is a gap of knowledge regarding the initial steps of AD pathogenesis and the spatial resolution of the respective protein changes in terms of subcellular distribution.MethodWe analyzed soluble, dispersible (insoluble proteins and vesicles in mixtures with the intra‐/extracellular fluid), membrane‐associated (SDS‐soluble), and plaque‐associated (formic‐acid‐soluble) fractions of brain homogenates from 19 control cases without AD pathology, 17 pathologically preclinical AD (p‐preAD), and 17 symptomatic AD (symAD) cases by label‐free liquid chromatography coupled to tandem mass spectrometry. Proteomic changes and related pathways involved in p‐preAD and symAD were determined by integrated analyses combining quantitative proteomics, neuropathological measurements, regression analysis, and gene ontology overrepresentation tests.ResultThree hierarchical classes of proteins, namely early‐ and late‐responding proteins and gradually changing proteins were identified across control, p‐preAD and symAD samples. Additionally, five proteins exhibited reduced abundance in the soluble fraction accompanied by increase in the membrane‐associated fraction between symAD and the group of p‐preAD + control cases, suggesting pathological alterations in their functions. Gene ontology analysis showed that the synaptic vesicle cycle and other endocytosis‐related pathways were overrepresented by early‐responding and gradually changing proteins, whereas caspase‐mediated cleavage of cytoskeletal proteins were enriched in the late‐responding protein class.ConclusionWe identified an apparent hierarchy of key proteins in the human brain during AD pathogenesis, from which the early responding proteins point to pathways that are not yet a main focus in AD research. This hierarchy of proteome change in the neocortex clearly distinguished the preclinical phase from the symptomatic phase and identified the synaptic vesicle cycle as a likely primary affected function in AD initiation. Our results may open new roads for therapies by intervening on those key proteins and their respective pathways.

Applied Aspect of Saliva in Orthodontics

Saliva influences oral health both through its non-specific physicochemical properties, as well as throughmore specific effects. The proline-rich proteins, statherin and the histatins are salivary proteins that influencecalcium phosphate chemistry, initial plaque formation and candida infection. Increases or decreases inmastication may affect saliva output. Fixed orthodontic appliances introduce an additional constituent to theoral cavity complex that may enhance the environment in a variety of ways. On the other hand, Orthodontictreatment leads to changes in the oral environmental factors that encourage changes in salivary flow rate,viscosity, pH, bacterial count, increased plaque index, and other more things which all are factors supplementthe risk of caries activity and shake the stability of the oral environment. This manuscript highlights theeffect of saliva on orthodontic treatment.