Plaque removal using powered and manual toothbrushes in children with and without attention deficit hyperactivity disorder: a randomized controlled trial.

Omega-3 fatty acids and oral and systemic inflammation: A secondary analysis of a randomized trial in patients with coronary artery disease.

Introduction: Uncontrolled elevated intraocular pressure (IOP) during brachytherapy for posterior choroidal tumors is unreported. We present two patients who both experienced intractable elevated IOP during plaque brachytherapy. Case Presentations: Both patients experienced persistent elevated IOP unresponsive to all pressure-lowering agents following surgery that included transvitreal retinochoroidal biopsy and Ruthenium-106 plaque application for posterior choroidal tumors in the superior quadrants. During plaque placement in patient 1, a large, dilated vortex vein was observed in the area where the plaque was to be placed. After plaque removal in both patients, IOP normalized without the need for additional pressure-lowering therapy. Conclusion: We hypothesize that the clinical presentation in both patients was primarily attributable to two factors. First, pre-existing venous congestion, and second, the application of a plaque, which obstructed the superior vortex vein. This left the remaining vortex veins unable to compensate for the obstruction, leading to intractable IOP during plaque brachytherapy.

The effect of culturally adapted oral hygiene dental visual aids on plaque removal in autistic children: A randomized clinical trial.

Surgical removal of bacterial plaque and antibiotic therapy have been widely used for the clinical treatment of periodontitis, which is driven by microbial dysbiosis and usually causes the loss of alveolar bone. However, key restrictions including drug resistance, poor anti-inflammatory effects, and limited bone repair capacity exist in antibiotic therapy, presenting challenges for periodontitis treatment. Consequently, it is urgently required to develop novel systems to combat antimicrobial resistance and enhance bone regeneration ability. Here, a MOF-based multicomponent system is developed, containing a cationic antimicrobial peptide GF for antimicrobial purpose and the adipomyokine Irisin for anti-inflammation, antioxidation, and promoting bone regeneration. The obtained composite Irisin/GF@NH2-MIL-101(Fe) exhibits pH-responsive release of GF and irisin. In vitro and vivo experiments demonstrate this multicomponent system has robust antimicrobial activity and could attenuate inflammation while stimulating bone regeneration. Remarkably, the antimicrobial mechanism of GF is explored, revealing a distinct binding mode at the ribosomal A-site, which establishes more stable interactions than tetracycline, thereby disrupting protein synthesis and effectively reducing the risk of antibiotic resistance. This study not only reveals a novel antibacterial mechanism of antimicrobial peptide, but also provides a novel cascade therapy for the treatment of periodontitis with multiple functions.

Single vs Triple-Headed Toothbrushes in Children With Special Needs: A Randomised Crossover Trial of Brushing Efficacy

Handgrip strength and dental plaque removal performance in older primary care patients: A cross-sectional study

To evaluate the efficacy of professional mechanical plaque removal (PMPR) for treating naturally occurring dental biofilm-induced gingivitis (i) compared to no treatment or oral hygiene instructions (OHI) (FQ1), (ii) when performed through different modalities (FQ2) or (iii) when combined with professionally administered local adjuncts (FQ3). A structured literature search was conducted for randomised or non-randomised controlled trials (RCTs and CTs) assessing gingival inflammation at patient level within 2-6 weeks after treatment in adults with gingivitis. Heterogeneous evidence shows with low certainty that PMPR has no efficacy in patients continuing with ineffective self-performed oral hygiene regimens but enhances OHI outcomes (FQ1; three RCTs, one CT). Split-mouth RCTs consistently indicated with very low certainty that ultrasonic scaling (US) plus air polishing is as effective but less time consuming than US plus polishing with rubber cup and prophylaxis paste. Furthermore, diode laser shows no adjunctive benefit (FQ2; five RCTs). Although some professionally administered local adjuncts have shown positive outcomes in patients receiving PMPR, their broader clinical application is limited due to unresolved clinical issues and uncertain cost effectiveness (FQ3; two RCTs). OHI should be the first-line treatment for dental biofilm-induced gingivitis. Combination of PMPR and OHI provides an adjunctive benefit over OHI alone. Air polishing may be combined with US to reduce the time for PMPR administration.

Background/Objectives: The novel wave electric toothbrush is considered potentially helpful in removing subgingival plaque to prevent the occurrence of periodontal diseases. This study aimed to assess the cleaning efficacy of a novel wave electric toothbrush on subgingival plaque and its safety profile for oral soft tissues. Methods: In vitro cleaning efficacy evaluations were conducted using oral dental models. The wave electric toothbrushes were divided into low-, medium-, and high-swing parameter groups, with manual brushing (Bass technique) as the control. Simulated plaque was applied to the buccal and gingival sulcus sites of the four first molars, and the plaque removal area and sulcus cleaning depth were measured. For safety evaluation, Sprague Dawley (SD) rats were brushed on their molars daily for 30 days, with bleeding incidents recorded. Oral soft tissues were analyzed through H&E staining and immunohistochemical analysis. Statistical analysis included ANOVA and Kruskal–Wallis (p < 0.05). Results: Medium- and high-swing groups demonstrated superior gingival sulcus cleaning efficacy, showing significant differences compared with the low-swing and control groups (p < 0.05). All swing parameters achieved complete plaque removal on buccal surfaces. No significant differences were observed between the low-swing and manual groups, or between the medium- and high-swing groups, regarding sulcus cleaning efficacy and maximum sulcus depth. During the 30-day in vivo experiment, medium- and high-swing groups showed low bleeding frequencies, primarily at the palatal gingiva and vestibule. Histological analyses indicated that higher swing parameters increased the likelihood of soft tissue injury. Conclusions: Wave electric toothbrushes enhance subgingival plaque removal, with higher swing parameters improving gingival sulcus cleaning. However, stronger parameters may increase the risk of soft tissue damage. Further clinical studies are required to establish optimal guidelines.

Nanorobots are nanoscale devices engineered to perform precise diagnostic or therapeutic tasks in the body. This narrative review synthesizes advances in nanorobot design (materials, propulsion, navigation, and communication) and highlights applications in drug delivery, imaging/diagnostics, surgery, and immune system modulation. We searched PubMed and Google Scholar using keywords “nanorobots,” “nanorobotics,” “drug delivery,” “diagnostics,” and “theranostics,” including peer-reviewed English original research and review articles and excluding non-peer-reviewed. In drug delivery, targeted nanocarriers have enabled precise chemotherapy delivery; a stimulus-responsive DNA-origami nanobot delivered ligands to cluster death receptors on breast cancer cells, yielding ~70% tumor reduction in a mouse model. Other designs use magnetic or chemical propulsion to traverse barriers (e.g., blood–brain barrier) and release drugs via triggers (pH, temperature, enzymes). In imaging/diagnostics, magnetically actuated nanorobots carrying radiopaque materials (barium sulfate/magnetite) have been navigated for micro-Computed Tomography tracking of gastrointestinal targets, and sensor-equipped nanobots can detect tumor biomarkers and relay signals for early disease detection. In microsurgery, remotely controlled microdrills and soft robots enable minimally invasive procedures such as plaque removal and targeted thrombectomy. Nanorobots can also modulate immunity: polymeric nanocarriers deliver immunosuppressants to inflamed tissue, and artificial antigen-presenting nanobots expand regulatory T cell populations in vivo. These advances demonstrate high-precision capabilities, but findings remain largely preclinical, and we have tempered language about “imminent” translation. Clinical readiness requires overcoming biocompatibility, powering, manufacturability, and safety hurdles; regulatory classification is unclear, and many may be high-risk (Class III) devices requiring full premarket approval. Ethical and societal issues (patient autonomy, data privacy, long-term persistence, equitable access) also demand attention, while bio-hybrid designs (cell-membrane coatings, living cell robots) seek to mitigate immune clearance. Conclusion: nanorobots hold transformative potential for personalized medicine, but cautious optimism is warranted.

Periodontitis is a chronic inflammatory disease driven by microbial dysbiosis and host immune responses, where microRNAs (miRNAs) play regulatory roles. This study evaluated the effects of systemic adjunctive therapies with epigallocatechin-3-gallate (EGCG) or curcumin on gingival miRNA expression and clinical out-comes in patients undergoing conventional periodontal therapy. In a short-term randomized clinical trial, 47 patients with moderate-to-severe periodontitis were stratified into three groups (EGCG, Curcumin, and pro-fessional mechanical plaque removal [PMPR]) and monitored at baseline, three months, and six months. Gingival biopsies were analyzed for miR-138-5p, miR-155-5p, miR-142-3p, and miR-27a-3p expression, alongside standard periodontal indices including probing pocket depth, clinical attachment level, bleeding on probing, plaque index, and OHIP-14 scores. The results demonstrated that both EGCG and curcumin can significantly modulated miRNA expression in gingival tissues, with curcumin inducing a more pronounced decreasing effect on four miRNAs, while EGCG showed increases in miR-138-5p, miR-155-5p, and miR-142-3p at three months. Clinically, EGCG primarily reduced shallow pockets and enhanced pocket closure, whereas curcumin was more effective in reducing deeper pockets, improving clinical attachment, and decreasing bleeding on probing. Both agents achieved higher pocket closure rates compared with PMPR alone. Patient-reported OHIP-14 scores indi-cated improved oral health perception in the adjunctive therapy groups. By six months, only miR-27a-3p re-mained significantly downregulated in the curcumin group, suggesting a sustained regulatory effect. These findings provide the first in vivo evidence that systemic EGCG and curcumin can modulate gingival miRNA expression in periodontitis, translating into measurable clinical benefits. Future research should in-vestigate long-term effects, optimize dosing strategies, and explore molecular pathways linking miRNA regu-lation with periodontal tissue regeneration.

BackgroundThe positive study results and approvals for first‐generation anti‐amyloid‐beta (Aβ)‐targeting therapies are an important advancement in the treatment of Alzheimer’s disease (AD), offering new hope for people living with AD and important learnings for the field. We know from existing anti‐amyloid therapy data that rapid and efficient removal of amyloid is needed to achieve significant clinical effects. In addition, the range of targets and modes of action of biologics being explored in AD is increasing. However, delivering large molecules across the blood–brain barrier (BBB) is challenging. The objective of this presentation is to provide an overview of emerging biologic therapeutics and innovative drug delivery methods to actively transport drugs across the BBB.MethodWe will focus on active transport mechanisms in development, which consist of an antibody fragment that binds to the transferrin receptor and harnesses a process called receptor‐mediated transcytosis.ResultThese novel active transport mechanisms have been applied to different modalities, including monoclonal antibodies and antisense oligonucleotides, and have shown clear improvements in the distribution of drugs in preclinical models, such as the Brainshuttle™ and TransportVehicle™ technology described here.In humans, trontinemab is the first amyloid‐directed Brainshuttle™ antibody fusion to show proof of concept in people living with AD; demonstrating increased brain penetration and amyloid plaque removal with improved safety to date. Latest results from the Phase Ib/IIa Brainshuttle™M AD study in people with mild cognitive impairment due to AD or mild‐to‐moderate AD (NCT04639050) will be presented at this conference.ConclusionUtilizing active transport mechanisms, such as the Brainshuttle™ technology, to achieve rapid and efficient amyloid clearance may unlock the full potential of disease modification with Aβ‐targeting monoclonal antibodies in AD. Active transport mechanisms could also be used in other large molecule delivery systems to improve distribution of drugs as well as efficacy and safety profiles.

Background: The present study aimed to evaluate the effectiveness of three decontamination methods on the surface alterations of dental implants and the removal of bacterial plaque from their surfaces. Materials and Methods: In this experimental in vitro study, 24 titanium cylinders with sandblasted, large-grit, acid-etched (SLA) surfaces were contaminated with Staphylococcus aureus to simulate biofilm formation. Samples were randomly assigned to four groups (n = 6): titanium curette, diode laser, titanium brush, and saline flush control. Surface roughness (Ra and Rz) was measured using scanning electron microscopy (SEM) before and after cleaning. Colony-forming units (CFUs) were quantified post-treatment to assess bacterial removal. Statistical analyses included Kruskal-Wallis tests, Mann-Whitney pairwise comparisons, and one-way ANOVA with post hoc LSD tests (α = 0.05). Results: Surface roughness differed significantly among groups after cleaning (Ra, p = .002; Rz, p = .002). Titanium curette and titanium brush produced smoother surfaces than diode laser and control, with the curette achieving the greatest reduction in roughness. CFU analysis revealed significant differences among groups (F = 3.26, p = .043). Contrary to expectations, the saline flush control showed the lowest CFU counts, whereas titanium curette and titanium brush exhibited higher bacterial counts than control (p &lt; .05), and diode laser did not differ significantly from control (p = .151). Conclusion: The titanium curette and titanium brush caused the samples' most significant surface roughness changes. However, the effectiveness of these methods for bacterial plaque removal was lower than that of the control group and the Diode laser group.

Abstract Introduction Peyronie’s disease is a debilitating condition characterized by the formation of fibrotic plaques within the tunica albuginea of the penis, leading to abnormal penile curvature, deformity, and often significant compromise of sexual function and psychological well-being. While conservative management may be sufficient in mild cases, surgical intervention becomes necessary in patients with severe or complex deformities, especially when curvature exceeds 60 degrees or impairs penetrative intercourse. Among various surgical approaches, tunical excision with grafting has emerged as a standard option for plaque removal and restoration of penile straightness. Bovine pericardial grafts are frequently used due to their favorable characteristics, including strength, elasticity, low antigenicity, and ease of intraoperative manipulation. Objective This video aims to provide a detailed, step-by-step overview of the surgical technique of tunical excision and grafting using bovine pericardial patches in the correction of severe dorsal penile curvature associated with Peyronie’s disease. The focus is on technical precision, complication avoidance, neurovascular preservation, and optimization of functional outcomes. Methods The procedure begins with circumferential penile degloving to expose the tunica albuginea, followed by meticulous dissection and lateral mobilization of the dorsal neurovascular bundle to allow safe access to the underlying plaque. The fibrotic segment of tunica is then excised, creating a defect which is reconstructed using a custom-shaped bovine pericardial graft. The graft is carefully sutured into place with a non-absorbable monofilament, ensuring anatomic alignment, appropriate sizing, and a tension-free closure to promote optimal graft integration and healing. Intraoperative artificial erection testing confirms the correction of curvature and absence of penile instability or buckling. Results In the presented case, the surgical correction successfully resolved a 90-degree dorsal curvature with complete penile straightening. Erectile function was preserved, and there were no intraoperative or postoperative complications such as hematoma, infection, graft rejection, or penile shortening. Postoperative assessments revealed high levels of patient satisfaction regarding penile appearance, rigidity, and sexual performance. Conclusions Tunical excision with bovine pericardial grafting is a safe, reproducible, and effective surgical option for managing severe Peyronie’s disease with significant penile curvature. It enables precise plaque removal and anatomic reconstruction, yielding excellent functional and cosmetic outcomes. This technique should be strongly considered in patients requiring advanced penile straightening and structural tunical repair. Disclosure No

Oral health is a critical factor in maintaining overall health, and its association with systemic diseases, including cardiovascular disease and diabetes mellitus, has been extensively investigated. Effective plaque removal through proper toothbrushing techniques is fundamental for preventing dental caries and periodontal diseases. Despite standardized guidelines, many individuals fail to adhere to correct brushing techniques, thereby increasing the risk of oral diseases. To address this issue, this study proposes a fine-grained toothbrushing region recognition approach incorporating six machine learning classifiers and two inertial measurement units (IMUs), which are embedded in the toothbrush holder and mounted on the right wrist of the participant, respectively. By analyzing the continuous motion signals, the proposed hierarchical approach is capable of identifying brushing and transition activities and subsequently recognizing specific toothbrushing regions based on the predicted brushing activities. To further improve recognition reliability, post-processing strategies such as contextual smoothing and majority voting are applied. Experimental results demonstrate that random forest achieves the highest recognition accuracy of 96.13%, sensitivity of 96.10%, precision of 95.51%, and F1-score of 95.60%. The results indicate that the proposed approach is both effective and feasible for providing fine-grained toothbrushing region recognition in toothbrushing monitoring.

Healing after oral surgeries can be affected by infection and plaque accumulation. This study evaluated the cytotoxic effect of chlorhexidine through an integrative literature review. A total of 44 articles were found in PubMed, of which 5 were selected using the keywords “Chlorhexidine,” “healing,” and “soft tissue,” including randomized clinical trials and animal studies published in English over the last 10 years. Chlorhexidine reduces bacterial load and controls infection, especially in the early healing phase, but prolonged use can cause tooth staining, taste alteration, tartar formation, and cytotoxicity to fibroblasts and keratinocytes, potentially delaying tissue repair. Alternatives such as PHMB and antioxidant gels have shown similar efficacy with lower cytotoxicity. Safer and effective substances are still needed to optimize healing and clinical outcomes. Chlorhexidine is an important solution for plaque removal and inflammation reduction; however, it also acts as a cytotoxic agent, exerting a negative effect on fibroblasts and keratinocytes, which are essential for the healing of surgical wounds. Based on the selected studies, its use in the context of surgical wound healing should be prescribed with caution due to the potential adverse effects of this substance.

BackgroundDeveloping potent therapies that reduce amyloid plaques has been shown as one means of producing clinical benefit in the early stages of symptomatic Alzheimer’s disease (AD). Trontinemab is a novel amyloid‐targeting Brainshuttle™ antibody specifically engineered for efficient transferrin receptor 1‐mediated transport across the blood–brain barrier. Trontinemab has demonstrated robust and rapid mean amyloid plaque removal of 107 centiloids after 28 weeks of 3.6 mg/kg treatment in the Phase Ib/IIa Brainshuttle AD study (n=12; NCT04639050), coupled with a low incidence of amyloid‐related imaging abnormalities (ARIA). Based on the results from the Brainshuttle AD study, to be presented at AAIC 2025 by Kulic et al., a pivotal program with trontinemab in early AD will be discussed.MethodTRONTIER 1 and 2 are two identically designed global, randomized, double‐blind, placebo‐controlled, parallel‐group Phase III studies designed to investigate the efficacy, safety, tolerability, pharmacokinetics (PK), and pharmacodynamics of trontinemab following intravenous infusion in participants with early AD who have confirmed amyloid pathology. A pre‐screener study, Traveller, based on a brief clinical assessment and a plasma biomarker will also be initiated to enable broader community outreach and extend access to these trials to more diverse populations.ResultThe primary endpoint is the change from baseline on the Clinical Dementia Rating – Sum of Boxes at 18 months’ treatment duration. Secondary outcome measures include assessments of cognition, function, behavioral symptoms, and quality of life. PD effects of trontinemab will be evaluated using amyloid and tau positron emission tomography, magnetic resonance imaging, and fluid biomarkers. Additional important objectives include assessment of safety, PK, and immunogenicity.ConclusionThe recent Phase Ib/IIa interim results suggest that rapid and robust amyloid plaque clearance and fluid biomarker changes may be achieved with low ARIA incidence. The overall favorable safety and interim biomarker results to date support the rationale for moving into the pivotal Phase III studies TRONTIER 1 and TRONTIER 2. These studies will provide the opportunity to assess whether treatment with trontinemab slows disease progression in people living with early symptomatic AD.

Abstract Periodontal disease (PD) is common in dogs, and there is a lack of treatments that preserve the carnassial teeth. This study investigated the effects of a microscope‐assisted modified minimally invasive nonsurgical technique (M‐MINST) on attachment levels and furcation involvement in dogs with PD. Overall, six dogs with Stage 3 furcation exposure (F3) and/or Stage 4 PD (&gt;50% bone loss on radiography) of the maxillary fourth premolar were treated with M‐MINST. The main outcome was improvement in dental health after initial treatment under anaesthesia. Dental health improved in all six dogs. In two dogs, furcation exposure improved from F3 to F0. The M‐MINST can improve PD without tooth extraction in dogs. Microscope assistance allows identification and removal of plaque and calculus without damaging the root surface. This approach avoids significant gingival recession, thereby promoting the maintenance of blood clots and enabling better healing and tissue regeneration.

INTRODUCTIONEffect on amyloid plaque as measured by positron emission tomography imaging with Centiloid standardization of two therapeutic approaches targeting amyloid beta (Aβ) was investigated using exposure‐response modeling.METHODSIndividual‐level verubecestat data from the APECS trial were pooled with summary‐level data from the literature for amyloid monoclonal antibodies (mAbs) and fitted in a joint non‐linear mixed‐effects model.RESULTSAn indirect‐response (turnover) model with verubecestat inhibiting plaque formation and mAbs stimulating plaque removal well represented the data. The estimated plaque elimination half‐life was 6.4 years. Daily verubecestat 40 mg was estimated to reduce formation by 91.8%. Aducanumab 10 mg/kg every 4 weeks (Q4W), donanemab 1400 mg Q4W, gantenerumab 1200 mg Q4W, and lecanemab 10 mg/kg Q2W were estimated to increase the removal rate by 9.3‐, 18.6‐, 5.3‐, and 13.8‐fold, respectively.DISCUSSIONThe model provides a fundamental measure of drug effects on plaque, independent of disease stage and study‐design factors, improving cross‐study comparisons and enabling predictions.HighlightsThe plaque turnover model describes natural progression and BACE and mAb intervention.The model estimation of the underlying plaque elimination half‐life is 6.4 years.Approach improves cross‐study comparison independently of population and study design.Predictions of alternative regimens/therapeutic approaches will aid future study design.

BackgroundAbrasive agents in toothpaste play a crucial role in plaque removal and stain reduction; however, excessive abrasivity may compromise enamel integrity. Zirconium oxide has recently been proposed as a polishing additive, but its optimal concentration remains unclear. This in vitro study aimed to identify the optimal concentration of zirconium oxide particles in toothpaste for effective cleaning through abrasion of natural dental tissues. The study evaluated enamel substance loss (wear) and surface alteration (roughness) across different zirconium oxide concentrations, highlighting both the advantages and potential risks associated with their use in dental care.Materials and methodsFifty caries-free third molars with intact crowns were randomly allocated into five groups (n = 10). Four groups were brushed with toothpaste containing zirconium oxide particles at concentrations of 0.5%, 1%, 2%, and 5%, while the control group was brushed with distilled water. Tooth wear and surface roughness were measured before and after brushing using profilometry and intraoral scanning. Statistical analysis included the paired t-test, Wilcoxon matched-pairs signed-rank test, Kruskal–Wallis test, and Dunn’s multiple comparisons test.ResultsAll zirconium oxide concentrations caused significant tooth wear. Wear analysis revealed significant differences between the 0.5% and 5% groups (p < 0.001) and between the 0.5% and 2% groups (p < 0.05), with no other significant intergroup differences. The 5% concentration produced the greatest increase in surface roughness, with an average rise of 91% (p = 0.002). Conversely, the 0.5% concentration resulted in a significant reduction in roughness (p = 0.002). No significant changes were observed for the 1% (p = 0.375) or 2% (p = 0.105) concentrations.ConclusionToothpaste containing 5% zirconium oxide particles markedly increases enamel wear and surface roughness, whereas lower concentrations (0.5–2%) provide a polishing effect with minimal damage. Optimizing the abrasive properties of toothpaste is crucial to achieve effective cleaning without compromising enamel integrity. Further research is warranted to establish the long-term effects of zirconium oxide-based formulations.