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Objectives: To in-vitro evaluate the feasibility and accuracy (trueness and precision) of various intraoral scanners (IOS) to digitize maxillectomy defect models with exposed zygomatic implants in situ., Material and Methods: Six partially edentulous and edentulous maxillectomy defect models with 2 zygomatic implants each were obtained. References scans were obatined by using a laboratory scanner (inEos X5; Dentsply Sirona). Three IOS, Trios 3, Trios 4 (3Shape A/S), and Primescan (Dentsply Sirona) were used first to digitize the entire model including implants and then to only scan the exposed part of zygomatic implants. The feasibility was assessed by evaluating the intraoral scanner's ability to accurately capture the maxillectomy defects and zygomatic implants, compared to a reference standard. Trueness and precision were evaluated using software's global best-fit alignment (GOM Inspect, GOM GmbH). Multifactorial analysis of variance (ANOVA) was used to compare the mean 3D deviation according to different scanners, groups, and model types. The significance level used in the analyses was 5 % (α=0.05)., Results: All scanners showed adequate feasibility to scan the entire maxillectomy defects and exposed implants regardless of the structural complexity. The results of trueness showed that Primescan has the smallest 3D deviations (0.0252 mm) followed by Trios 4 (0,0275 mm), and then Trios 3 (0.0318 mm) (p < 0.001). The results of precision showed that Primescan had the smallest 3D deviations (0.0026 mm) followed by Trios 3 (0,0080 mm), and then Trios 4 (0,0097 mm) (p < 0.001)., Conclusion: Intraoral scanners differ in feasibility, trueness and accuracy of all scans, with Primescan providing the best combination of feasibility, trueness and accuracy, followed by Trios 4 and Trios 3., Clinical Significance: Scanning maxillectomy defects with various exposed zygomatic implants can be feasible and accurate using intraoral scanners (Trios 3, Trios 4, and Primescan). The use of intraoral scanners for implant-prosthetic rehabilitation of maxillectomy defect can be a feasible alternative that can improve and simplify the workflow., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2025 Elsevier Ltd. All rights reserved.)

Producing oral soft tissues using tissue engineering could compensate for the disadvantages of autologous grafts (limited availability and increased patient morbidity) and currently available substitutes (shrinkage). However, there is a lack of in vitro-engineered oral tissues due to the difficulty of obtaining stable pre-vessels that connect to the host and enable graft success. The main objective was to assess the connection of pre-vascularised 3D-bioprinted gingival substitutes to the host vasculature when subcutaneously implanted in immunodeficient mice. This study produced vascularised connective tissue substitutes using extrusion-based 3D-bioprinting of primary human gingival fibroblasts (hGF) and fluorescent human endothelial cells (RFP-HUVEC) cocultures. Pre-vascularised (hGF+RFP-HUVEC -CC grids) and control (hGF only -HG grids) grids were bioprinted and pre-cultivated for 14 days to enable pre-vessels formation. In vitro vessel formation follow-up was performed. Eight-week-old female NOG mice were used for in vivo experiments. One grid per mouse was subcutaneously implanted in 20 mice (10HG/10CC). The fluorescent activity of RFP-HUVEC was monitored. Samples were retrieved at 7, 14 and 21 days. Histological, immunohistochemical, and immunofluorescent staining was performed. CC-grids formed efficient and stable pre-vessel networks within 14 days of static pre-culture. HG-grids did not contain any vessel, while CC-grids successfully connected to the host vasculature by presenting erythrocytes within the vessel lumen inside the grids starting day 7. From days 7 to 21, vessel density was stable. Human pre-vessels were present at 7 days and were progressively replaced by murine endothelial cells. This study showed that primary hGF-HUVEC co-cultures can be successfully 3D-bioprinted within biomimetic hydrogels having a close composition to the gingival connective tissue, and HUVEC organise themselves into pre-vessel networks that connect to the murine vasculature when implanted in vivo. This approach represents a promising strategy to enhance current and future oral soft tissue substitutes for prospective clinical applications., (© 2025 IOP Publishing Ltd. All rights, including for text and data mining, AI training, and similar technologies, are reserved.)

Purpose: The bone-implant interface plays a crucial role in obtaining sufficient primary stability for dental implants in weak bone supports. The aim of this human cadaver study was to evaluate the primary stability of new thin-threaded implants when placed in type IV bone right after maxillary sinus floor elevation., Materials and Methods: The study followed the CACTUS (ChAracteristics of Cadaver Training and sUrgical Studies) guidelines. Twenty-four edentulous maxillary posterior zones with type IV bone and a residual bone height of 4 mm were selected using computed tomography scans. First, an osteotome sinus floor elevation was performed (C.M.C Tech, IBS IMPLANT, Daejeon, South Korea). Implants with thin threads (MagiCore, IBS IMPLANT, Daejeon, South Korea) were placed simultaneously. Samples were divided into two groups: Group 1 (G1): 11 mm-long implants with an elevation of 8 mm; Group 2 (G2): 7 mm-long implants with an elevation of 4 mm. Primary stability was assessed using resonance frequency analysis (RFA)., Results: The average primary stability values in the mesiodistal (MD) direction were 45.67 ± 3.09 Implant Stability Quotient (ISQ) for G1 and 38.76 ± 16.94 ISQ for G2, and in the buccolingual direction were 43.33 ± 13.23 ISQ for G1 and 38.47 ± 16.14 ISQ for G2., Conclusions: The primary stability of the thin-threaded implants was compatible with clinical osseointegration in sinus sites with limited bone contact area in both experimental situations. Clinical studies are needed to confirm these encouraging results., (© 2024 The Author(s). Journal of Prosthodontics published by Wiley Periodicals LLC on behalf of American College of Prosthodontists.)

Statement of Problem: Additive manufacturing is used in prosthodontics for producing casts, surgical guides, and interim and definitive prostheses. Printed resin components that will be in contact with the oral mucosa must meet biocompatibility requirements in accordance with current standards for medical devices. Despite such approvals being obtained by the manufacturer, the dentist remains responsible for following the manufacturer recommendations. Evidence for the effect of postprocessing 3-dimensionally (3D) printed resin components on biocompatibility is lacking PURPOSE: The purpose of this systematic review was to assess the effectiveness of 3D printing postprocessing on the biocompatibility of resins that will be in contact with the oral mucosa., Material and Methods: The PubMed, Scopus, and DOSS search engines were used to identify articles. Two independent researchers conducted the systematic review by following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and by following a combination of keywords., Results: Of a total of 249 articles, 27 were selected, including only 1 in vivo study. Thirty-two commercially available and a few experimental resins were tested. The main applications were removable denture bases and denture teeth, interim and definitive fixed restorations, occlusal splints, and surgical guides. Postprocessing procedures were those recommended by the manufacturer, experimental, or not implemented and involving alcohol, ultrasonic or centrifugal rinsing, photopolymerization at different UV wavelengths, a nitrated atmosphere chamber with air drying or compressed air drying and with heat treatment. The majority of postprocessed 3D printed resins were reported to be noncytotoxic, implying sufficient biocompatibility., Conclusions: The heterogeneity of materials and methods did not allow the identification of an ideal postprocessing protocol or of the need for additional steps after following the manufacturer's recommendations., (Copyright © 2024 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Introduction: Developing professionalism notably involves learning how to make professional judgements in ambiguous situations. The Concordance of Judgement Test (CJT) is a learning tool that was proposed to develop professionalism competencies, but it was never performed in dentistry or used with a synchronous methodology. The present study evaluated the feasibility of the use of CJT in the context of dental education, to foster professionalism and stimulate reflexivity and discussion., Materials and Methods: After different steps of optimization, a questionnaire presenting 12 vignettes was submitted to 33 Canadian students. Second, after an additional optimization, a questionnaire of 7 vignettes was submitted to 87 French students. An immediate educational feedback was proposed after each vignette to promote reflexivity and discussions during the experience., Results: The overall experience of the students was reported as good, thanks to the feedback of real-life situations. This promoted reflexivity and stimulated discussion between students and educators regarding professionalism issues. The students considered CJT as a relevant and well-adapted tool, and reported positive feelings regarding the inter-university aspect of the activity. The mean score of the panel members was close to 80/100 and the mean score of the students was 5 to 10 points lower, which is in agreement with docimological performance., Conclusion: The results suggested that the use of CJT in a synchronous way was a feasible and relevant tool to motivate the students to improve their professionalism, and to stimulate their reflexivity and discussion. The students reported positive experience with CJT, and we believe that this tool can be integrated in the dental curriculum., (© 2024 The Authors. European Journal of Dental Education published by John Wiley & Sons Ltd.)

Preliminary impressions must record the periphery and height of maxillary defects to allow for an eventual extension of the master impression tray. These impressions are usually made with irreversible hydrocolloid. Carrying the impression material into the defect can be complex, especially in the case of a limited oral opening. Moreover, the patient can be harmed during the removal procedure, and material may be stuck in anatomical structures. The technique presented in this article avoids these issues in any maxillary defect with a two-step preliminary impression. An elastomeric material ball is first placed in the defect until full setting. Then, this "obturator bulb" is removed and eventually relined until it is retentive. Retentions are designed on the oral side of the bulb and the bulb is placed back into the defect. Finally, an alginate over-impression of the maxillary is made. The alginate is removed after full setting, and the obturator can be reassembled on the maxillary impression to provide a full recording of the maxillary. This protocol can safely be used for defects of any size, despite eventual limitations in oral opening., (© 2023 by the American College of Prosthodontists.)

Developing an in vitro model of gingival connective tissue that mimics the original structure and composition of gingiva for clinical grafting is relevant for personalized treatment of missing gingiva. Using tissue engineering techniques allows bypassing limitations encountered with existing solutions to increase oral soft tissue volume. This review aims to systematically analyze the different currently existing cellularized materials and technologies used to engineer gingival substitutes for in vivo applications. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. An electronic search on PubMed, Scopus, Web of Science, and Cochrane Library databases was conducted to identify suitable studies. In vivo studies about gingival substitutes and grafts containing oral cells compared with a control to investigate the graft remodeling were included. Risk of bias in the included studies was assessed using the Systematic Review Center for Laboratory animal Experimentation (SYRCLE) 10-item checklist. Out of 631 screened studies, 19 were included. Animal models were mostly rodents, and the most used implantation was subcutaneous. According to the SYRCLE tool, low-to-unclear risk of bias was prevalent. Studies checked vascularization and extracellular remodeling up to 60 days after implantation of the cellularized biomaterial. Cells used were mostly fibroblasts and stem cells from oral origin. Grafts presenting vascularization potential after implantation were produced by tissue engineering technologies including cell seeding or embedding for 14, cell sheets for 2, microsphere for 1, and extrusion 3D bioprinting for 2. Components used to build the scaffold containing the cells are all naturally derived and are mainly fibrin, gelatin, collagen, agarose, alginate, fibroin, guar gum, hyaluronic acid, and decellularized extracellular matrix. The most recurring crosslinking method was using chemicals. All studies except one reported vascularization of the graft after implantation, and some detailed extracellular matrix remodeling. Current solutions are not efficient enough. By assessing the relevant studies on the subject, this systematic review showed that a diversity of cellularized biomaterials substituting gingival connective tissue enables vascularization and extracellular remodeling. Taking the results of this review into account could help improve current bio-inks used in 3D bioprinting for in vivo applications compensating for gingival loss.

Statement of Problem: The increasing use of computer-aided design and computer-aided manufacturing (CAD-CAM) systems has led to the development of resin-ceramic materials that meet the requirements of minimally invasive dentistry, including the resin nanoceramic (RNC) and polymer-infiltrated ceramic network (PICN). The wear characteristics of these materials are unclear., Purpose: The purpose of this systematic review was to compare the wear resistance of resin-ceramic materials when compared with one another or with lithium disilicate glass-ceramics., Material and Methods: The PubMed, Scopus, and DOSS search engines were used to identify articles published between 2013 and 2021. Two independent researchers conducted the systematic review by following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and by following a combination of keywords., Results: Of a total of 310 articles, 26 were selected, including only 1 clinical study. Among these, 15 compared resin-ceramic materials with each other, while 11 compared resin-ceramic materials with lithium disilicate ceramics. Two types of wear were used to compare the materials: attrition and abrasion. The most commonly studied materials were 2 RNCs (Lava Ultimate and Cerasmart), 1 PICN (Vita Enamic), and 1 ceramic (IPS e.max CAD). Among the resin-ceramic materials, the PICN (Vita Enamic) showed less wear than the RNCs. Of the RNCs, Cerasmart had less attrition wear and less wear of the opposing teeth., Conclusions: Lithium disilicate glass-ceramics have a higher wear resistance than resin-ceramic materials, but they cause more wear of the opposing teeth., (Copyright © 2022 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Objectives: To determine the optimal level of mesh reduction that would maintain acceptable levels of geometrical trueness while also minimizing the impact on other parameters such as file size and processing time., Methods: Intraoral and extraoral maxillofacial defects were created on 8 cadaver heads and scanned by using a CBCT scanner (NewTom 3D Imaging, Verona). DICOM data were segmented to produce head (n=8) and skull models (n=8) saved as standard tessellation language (STL) files. A further processing of head models was preformed to produce face (n=8) and ear models (n=8). A mesh reduction process was performed for each STL model (reference, R 0 ) by generating 50% (R 1 ), 75% (R 2 ), and 90% (R 3 ) reductions. The 3 datasets were compared to the R 0 file using 3D evaluation software (GOM Inspect) using a global best-fit algorithm, to calculate the root mean square (RMS) deviations. Statistical analyses were performed at a level of significance of α=0.05., Results: There was no 3D deviation after the 50% triangular mesh reduction in the 4 datasets. Minor 3D deviations were observed after 75% reduction, in all groups. After 90% reduction, higher 3D deviations were observed, and especially in head and skull. Statistically significant increase in 3D deviations was observed with higher degrees of mesh reduction (p < 0.001)., Conclusion: The resolution of CBCT-based maxillofacial defect models can be reduced up to 50%, with neglectable concern to inaccuracy., Clinical Significance: Accurate maxillofacial models can be obtained from CBCT DICOM files after segmentation and export as STL files, even when the mesh resolution is reduced up to 50%. This information can be valuable for practitioners and researchers working with 3D models of maxillofacial defects., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)

Purpose: To assess the implant survival rate in mandibles reconstructed with free fibula flap after oral tumor resection after 1 year of prosthetic loading. A secondary objective was to compare immediate or delayed implant placement protocols in this population., Materials and Methods: Electronic and manual searches were performed on different databases for controlled and prospective trials that indicated implant survival rate. This systematic review followed PRISMA guidelines. Risk of bias was evaluated using Cochrane Collaboration tools. Meta-analyses heterogeneity source assessment and GRADE evaluation were performed among studies with identical follow-ups., Results: Among 305 primarily selected articles, 109 were eligible after reading the title and abstract, and 8 were included after full-text reading: 2 randomized controlled trials and 6 prospective studies comprising 140 patients and 507 implants. Meta-analyses estimated an overall survival rate of 97% (95% CI: 94% to 99%) after 1 year of prosthetic loading. The survival rate was 98% (95% CI: 94% to 100%) with immediate implantation and 97% (95% CI: 90% to 99%) with delayed implantation. Only 3 studies reported radiotherapy treatment, with no real impact on implant survival rate. Overall, 69% of tumors were benign., Conclusions: Implant placement in vascularized fibula flaps in the mandible is recommended for patients undergoing segmental mandibular reconstruction after tumor resection. Within the limitations of this study, no significant difference in survival rates was found between immediate and delayed implant placement.

Statement of Problem: Techniques for determining occlusal vertical dimension (OVD) have limitations, including the lack of reproducibility or invasiveness. Recently, a craniometry-based predictive model comparing OVD with eye-ear distance (EED) was developed in Chile. However, this study included a specific population and excluded patients with a history of orthodontics. For verification, studies on other populations are required., Purpose: The purpose of this clinical study was to follow the previously described protocol to obtain an equation for determining OVD in a French cohort (mostly White with an orthodontic history)., Material and Methods: Dentate adults with a stable occlusion and no known maxillofacial, otolaryngeal, or temporomandibular problems were included in this study. Demographic information, including participant age, sex, and history of orthodontic treatment, was collected. Facial height and width were measured with digital calipers, and the left EED and OVD were recorded with a craniometer. The facial index was calculated to classify participants into euryprosopic, mesoprosopic, or leptoprosopic types., Results: Of the 300 included participants (28 ±11 years), 60% were women, and 67% reported a history of orthodontic treatment. Euryprosopic represented 17% of participants, mesoprosopic 48%, and leptoposopic 35%. A positive correlation was found between the left EED and OVD in all facial types, but it was more important in women. The following equation was obtained: OVD=44.58+(0.45×left EED)+sex (women=-4.57; men=0)+facial type (leptoprosopic=0; mesoprosopic=-3.35; euryprosopic=-7.27)., Conclusions: The occlusal vertical dimension is correlated with sex, left EED, and facial type. This straightforward method can be applied in conjunction with other techniques to determine the OVD in the French population., (Copyright © 2023 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

The purpose of this clinical report was to describe the use of a piezographic impression associated with computer-aided design and computer-aided manufacturing (CAD-CAM) for teeth setup and of digital tools for neuro-musculo-kinetic analyses. An edentulous patient with hemiglossectomy and heavily resorbed mandible consulted for complete denture rehabilitation to improve their masticatory function and speech. Master casts, wax rims, and piezographic impression were scanned for digital prosthetic work. Two digital try-ins were performed to respect the neutral zone: try-in 1 with posterior crossbite and try-in 2 without crossbite. Muscle activity and mandibular kinetics were performed for each try-in following the MAC2 protocol (six criteria): muscular tone, contraction synchrony, contraction efficiency, interocclusal rest distance, amplitude of mandibular movement, and velocity. Try-in 2 showed better data than try-in 1 in all criteria: muscle tone (respectively 71% vs. 59%), contraction synchrony (79% vs. 75%), contraction efficiency (85% vs. 77%), an increase in range of motion of 3.3 mm, and a better velocity (0.35 ± 0.12 s vs. 0.57 ± 0.14 s, p = 0.008). The piezographic impression, in combination with CAD-CAM, allowed the comparison of two prosthetic designs and the selection of the try-in with the best neuro-musculo-kinetic results., (© 2023 by the American College of Prosthodontists.)

Statement of Problem: Maxillary bone resorption after multiple extractions can jeopardize the success of an immediate denture, but whether bone volume preservation techniques are effective is unclear., Purpose: The purpose of this randomized controlled trial was to evaluate the efficacy of socket grafting with a xenogenic bone substitute in participants receiving maxillary immediate removable complete dentures in terms of bone volume preservation (height and width of the bone ridge)., Material and Methods: The study was a single-blinded, randomized controlled clinical trial with 2 balanced parallel arms. Thirty-six participants who had Kennedy Class I edentulous posterior areas bilaterally for at least 3 months and required maxillary immediate removable complete dentures were enrolled. Duplicates of the removable complete denture were made and converted into radiographic and surgical guides. Participants allocated to the test group received deproteinized bovine bone mineral blended with 10% porcine collagen (DBBM-C) in the extraction sockets, and participants in the control group received no grafting material. With a radiographic guide in place, cone beam computed tomography scans were made 10 days after tooth extraction, when the immediate removable complete denture was delivered (D10, baseline), after 3 months (D90), and after 1 year (D365). The scans were superimposed, and measurements were made on the cross-sectional plane of each extraction site. The influence of various prognosis factors associated with bone volume preservation, including the location of tooth extraction, smoking habits, periodontal disease, and operator team, were analyzed., Results: Of 36 participants, 3 were lost to follow-up. The mean ±standard deviation loss of height of the buccal crest was 1.2 ±1.8 mm in the control group and 0.3 ±1.2 mm in the test group after 3 months of healing (P<.001) and 2.1 ±2.0 mm in the control group and 0.7 ±1.4 mm in the test group after 1 year of follow-up (P<.001). Mean ±standard deviation horizontal ridge width change was 1.3 ±1.4 mm in the control group and 0.5 ±0.8 mm in the test group after 3 months (P<.001) and 2.2 ±1.4 mm in the control group and 0.9 ±1.1 mm in the test group after 1 year of follow-up (P<.001). None of the other prognostic factors had a significant effect at either time period., Conclusions: Grafting DBBM-C into the extraction socket after removing anterior teeth for immediate removable denture therapy resulted in significantly less vertical buccal crest and horizontal ridge resorption as compared with spontaneous socket healing after 1 year of follow-up. This procedure may be useful for preserving bone, especially when a fixed implant-supported prosthesis is planned., (Copyright © 2021 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Arsenic (As) is one of the main toxic elements of geogenic origin that impact groundwater quality and human health worldwide. In some groundwater wells of the Sologne region (Val de Loire, France), drilled in a confined aquifer, As concentrations exceed the European drinking water standard (10 μg L -1 ). The monitoring of one of these drinking water wells showed As concentrations in the range 20-25 μg L -1 . The presence of dissolved iron (Fe), low oxygen concentration and traces of ammonium indicated reducing conditions. The δ 34 S SO4 was anticorrelated with sulphate concentration. Drilling allowed to collect detrital material corresponding to a Miocene floodplain and crevasse splay with preserved plant debris. The level that contained the highest total As concentration was a silty-sandy clay containing 26.9 mg kg -1 As. The influence of alternating redox conditions on the behaviour of As was studied by incubating this material with site groundwater, in biotic or inhibited bacterial activities conditions, without synthetic organic nutrient supply, in presence of H 2 during the reducing periods. The development of both AsV-reducing and AsIII-oxidising microorganisms in biotic conditions was evidenced. At the end of the reducing periods, total As concentration strongly increased in biotic conditions. The microflora influenced As speciation, released Fe and consumed nitrate and sulphate in the water phase. Microbial communities observed in groundwater samples strongly differed from those obtained at the end of the incubation experiment, this result being potentially related to influence of the sediment compartment and to different physico-chemical conditions. However, both included major Operating Taxonomic Units (OTU) potentially involved in Fe and S biogeocycles. Methanogens emerged in the incubated sediment presenting the highest solubilised As and Fe. Results support the hypothesis of in-situ As mobilisation and speciation mediated by active biogeochemical processes., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

As the need for efficient, sustainable, customizable, handy and affordable substitute materials for bone repair is critical, this systematic review aimed to assess the use and outcomes of silica-derived inks to promote in vivo bone regeneration. An algorithmic selection of articles was performed following the PRISMA guidelines and PICO method. After the initial selection, 51 articles were included. Silicon in ink formulations was mostly found to be in either the native material, but associated with a secondary role, or to be a crucial additive element used to dope an existing material. The inks and materials presented here were essentially extrusion-based 3D-printed (80%), and, overall, the most investigated animal model was the rabbit (65%) with a femoral defect (51%). Quality (ARRIVE 2.0) and risk of bias (SYRCLE) assessments outlined that although a large majority of ARRIVE items were "reported", most risks of bias were left "unclear" due to a lack of precise information. Almost all studies, despite a broad range of strategies and formulations, reported their silica-derived material to improve bone regeneration. The rising number of publications over the past few years highlights Si as a leverage element for bone tissue engineering to closely consider in the future.

Background: Cocultures of human gingival fibrobasts (hGF) and endothelial cells could enhance regeneration and repair models as well as improve vascularization limitations in tissue engineering. The aim of this study was to assess if hGF could support formation of stable vessel-like networks., Methods: Explant primary hGF were isolated from gum surgical wastes collected from healthy patients with no history of periodontitis. Human umbilical vein endothelial cells (HUVEC) were two-dimensional (2D) and three-dimensional (3D) cocultured in vitro with hGF at a cell ratio of 1:1 and medium of 1:1 of their respective media during at least 31 days. Vessel quantification of HUVEC networks was performed. In order to investigate the pericyte-like properties of hGF, the expression of perivascular markers α-SMA, NG2, CD146 and PDGFR-β was studied using immunocytochemistry and flow cytometry on 2D cultures., Results: hGF were able to support a long-lasting HUVEC network at least 31 days, even in the absence of a bioreactor with flow. As observed, HUVEC started to communicate with each other from day 7, constructing a network. Their interconnection increased significantly between day 2 and day 21 and lasted beyond the 31 days of observation. Moreover, we tried to explain the stability of the networks obtained and showed that a small population of hGF in close vicinity of HUVEC networks expressed perivascular markers., Conclusion: These findings highlight a new interesting property concerning hGF, accentuating their relevance in tissue engineering and periodontal regeneration. These promising results need to be confirmed using more 3D applications and in vivo testing., (© 2021. The Korean Tissue Engineering and Regenerative Medicine Society.)

In this article we discuss findings from a community based, participatory action research study. The aim was to understand how Indigenous youth describe, experience, manage pain and hurt and how they seek care. A critical analysis guided by Two-Eyed Seeing and Medicine Wheel frameworks highlighted important clinical strategies for Indigenous youth to balance their health and reduce pain. This study is a partnership project with an Aboriginal Health Centre in Southern Ontario and the Canadian Institute of Health Research funded Aboriginal Children's Hurt and Healing Initiative (ACHH). The study gathered perspectives of Indigenous youth, Elders, and health clinicians using conversation sessions guided by a First Nations doctoral student and nurse researcher. Using the medicine wheel framework three main thematic areas emerged across the three groups and include (1) Predictors of Imbalance; (2) Indicators of Imbalance; and (3) Strategies to re-establish balance health in relation to pain. The main strategy includes considerations for clinicians using the acronym LISTEN ( Language, Individual, Share, Teachable moments, Engage, and Navigate ) approach that outlines strategies for clinicians that will be a safe guide to manage pain and hurt., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 VanEvery, Latimer and Naveau.)

Background: Soft palate defects created during oral cancer surgery may prevent complete palatal closure and trigger palatopharyngeal insufficiency. One current treatment employs a rigid obturator prosthesis; an extension of acrylic resin at the level of the hard palate ensures surface contact with the remaining musculature. Unfortunately, airflow escape often causes hypernasality, compromises speech intelligibility, and creates swallowing problems (including leakage of food and fluid into the nasal airway). We plan to test a new removable denture featuring a thick dental dam that serves as a membrane obturator. The principal objective of the clinical trial is a comparison of speech handicap levels after 1 month in patients with acquired velar insufficiencies who wear either the new device or a conventional, rigid obturator. The secondary objectives are between-device comparisons of the swallowing handicaps and the health-related qualities of life., Methods: The VELOMEMBRANE trial is a superiority, open-labeled, two-way, random crossover clinical trial. Adult patients exhibiting velar or palatovelar substance loss after tumor excision and who are indicated for rigid obturator-mediated prosthetic rehabilitation will be recruited in two teaching hospitals in France. Fourteen participants will be randomly allocated to wear both prostheses for 1-month periods in either order. The new membrane obturator is a removable resin prosthesis incorporating a rigid extension that holds a dental dam to restore the soft palate. The primary outcome will be the extent of phonation-related disability (the overall score on the Voice Handicap Index [VHI]). The secondary outcomes will be the Deglutition Handicap Index and health-related quality of life scores of the European Organization for Research and Treatment of Cancer (EORTC)., Discussion: High-quality evidence will be provided to document the utility of a new medical device that may greatly improve the management and quality of life of patients with acquired velar insufficiency., Trial Registration: ClinicalTrials.gov NCT04009811 . Registered on 4 July 2019., (© 2022. The Author(s).)

Objectives: To evaluate the accuracy of two different surgical guides (small extent = single implant and large extent = full arch) fabricated by five additive manufacturing technologies (SLA=Stereolithography, DLP= Digital Light Processing, FDM=Fused Deposition Modeling, SLS=Selective Laser Sintering, Inkjet)., Methods: Overall, 72 guides (6 per type) were obtained with the different machines (SLA=Form2; DLP=Rapid Shape D40 and Cara Print 4.0; FDM=Raise 3D Pro2; SLS=Prodways P1000; Polyjet®=Stratasys J750). The guides were surface-scanned with an optical dental scanner, and the resulting files were compared with the initial design files using a surface matching software. Root Mean Square (RMS) and standard deviation were calculated, representing respectively trueness and precision. Kruskall-Wallis non-parametric test was used to compare trueness and precision between small-extent and large-extent guides and 3D printer by pairs. The threshold for significance was α=0.05, except for the comparison of printers by pairs where a Bonferroni-corrected level of 0.0033 was used., Results: Significant differences were observed for trueness and precision between small-extent and large-extent guides, regardless the printer except for DLP (trueness and precision) and SLS (precision). SLA, DLP and Polyjet® technologies showed similar results in terms of trueness and precision for both small-extend and large-extend guides (P>0.05)., Conclusions: The size affected the accuracy of CAD-CAM surgical guides. The different additive manufacturing technologies had a limited impact on the accuracy., Clinical Significance: This study is of clinical interest as it shows that the 3D printing technology (SLA/DLP) has a limited impact on 3D printed surgical guides accuracy. However, the size of the guide can have a significant impact, as small-extent guides were more accurate than large-extent guides., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Petrographic and mineralogical analyses combined with sequential extractions and leaching experiments as a function of pH were performed on black clayey sediments fulfilling karsts in the Hydrogeological Experimental Site (HES) of Poitiers (France) to investigate the behavior of arsenic and selenium in a fractured limestone aquifer. Sequential extractions showed that arsenic is mainly associated with pyrite (about 35%) and secondary iron oxyhydroxides (around 13%), along with a substantial exchangeable fraction (about 13%). The soluble fraction and the fraction associated to organic matter are ∼2% and ∼5%, respectively. The distribution of selenium is mainly pyritic (around 39%) or associated with organic matter (about 18%). Its association to secondary iron oxyhydroxides minerals is low (around 2%), whereas its soluble fraction is around 5%. SEM analyses revealed the presence of arsenic "hot spots" into euhedral pyrite crystals surrounded by a halo of iron oxyhydroxides resulting from their alteration, and both are enriched with arsenic. Selenium has a similar pyritic origin but after alteration, it is predominantly associated with organic matter. Despite different distributions, the leaching experiment as a function of pH showed that the mobilization of arsenic and selenium overlapped below pH 2 and above pH 8. The main differences were observed between pH 2 and 8 with a plateau at 5% of released selenium, whereas the amount of mobilized arsenic continuously decreased. The pH-dependence of both elements is attributed to the partial dissolution of pyrite in acidic conditions combined with desorption processes at higher pH values., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Three-dimensional files featuring patients' geometry can be obtained through common tools in dental practice, such as an intraoral scanner (IOS) or Cone Beam Computed Tomography (CBCT). The use of 3D files in medical education is promoted, but only few methodologies were reported due to the lack of ease to use and accessible protocols for educators. The aim of this work was to present innovative and accessible methodologies to create 3D files in dental education. The first step requires the definition of the educational outcomes and the situations of interest. The second step relies on the use of IOS and CBCT to digitize the content. The last "post-treatment" steps involve free software for analysis of quality, re-meshing and simplifying the file in accordance with the desired educational activity. Several examples of educational activities using 3D files are illustrated in dental education and discussed. Three-dimensional files open up many accessible applications for a dental educator, but further investigations are required to develop collaborative tools and prevent educational inequalities between establishments.

Enamel renal syndrome (ERS) is a rare recessive disorder caused by loss-of-function mutations in FAM20A (family with sequence similarity 20 member A, OMIM #611062). Enamel renal syndrome is characterized by amelogenesis imperfecta, delayed or failed tooth eruption, intrapulpal calcifications, gingival overgrowth and nephrocalcinosis. Although gingival overgrowth has consistently been associated with heterotopic calcifications the pathogenesis, structure and interactions of the mineral deposits with the surrounding connective tissue are largely unknown. We here report a novel FAM20A mutation in exon 1 (c.358C > T) introducing a premature stop codon (p.Gln120*) and resulting in a complete loss of FAM20A. In addition to the typical oral findings and nephrocalcinosis, ectopic calcified nodules were also seen in the cervical and thoracic vertebrae regions. Histopathologic analysis of the gingiva showed an enlarged papillary layer associated with aberrant angiogenesis and a lamina propria displaying significant changes in its extracellular matrix composition, including disruption of the collagen I fiber network. Ectopic calcifications were found throughout the connective gingival tissue. Immunomorphological and ultrastructural analyses indicated that the calcification process was associated with epithelial degeneration and transformation of the gingival fibroblasts to chondro/osteoblastic-like cells. Mutant gingival fibroblasts cultures were prone to calcify and abnormally expressed osteoblastic markers such as RUNX2 or PERIOSTIN . Our findings expand the previously reported phenotypes and highlight some aspects of ERS pathogenesis., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2020 Simancas Escorcia, Diarra, Naveau, Dessombz, Felizardo, Cannaya, Chatziantoniou, Quentric, Vikkula, Cases, Berdal, De La Dure-Molla and Kozyraki.)

Purpose: To introduce an augmented reality (AR) application for students, patients, and practitioners to use to visualize a maxillectomy defect, the associated obturator prosthesis, and the eventual effects on the patient's facial appearance., Materials and Methods: Various 3D virtual models related to maxillectomy defects and their prosthetic rehabilitations were used to illustrate the handheld AR application. The AR "scene" was created using Vuforia and Unity3D software. Within this scene, 3D virtual models were linked to the target image by detecting a symbol track marker. The final file was saved as an installable application and exported for Android smart devices., Results: The target image containing the maxillectomy defect and the prosthetic rehabilitation were successfully visualized interactively in 3D mode using the handheld AR maxillofacial prosthetic application., Conclusion: An AR application for visualizing maxillofacial prosthetic data could interestingly be developed as a pedagogic tool to explain prosthetic treatments.

Aim: This systematic review aimed to evaluate the use of three-dimensional (3D) printed bone models for training, simulating and/or planning interventions in oral and cranio-maxillofacial surgery., Materials and Methods: A systematic search was conducted using PubMed® and SCOPUS® databases, up to March 10, 2019, by following the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) protocol. Study selection, quality assessment (modified Critical Appraisal Skills Program tool) and data extraction were performed by two independent reviewers. All original full papers written in English/French/Italian and dealing with the fabrication of 3D printed models of head bone structures, designed from 3D radiological data were included. Multiple parameters and data were investigated, such as author's purpose, data acquisition systems, printing technologies and materials, accuracy, haptic feedback, variations in treatment time, differences in clinical outcomes, costs, production time and cost-effectiveness., Results: Among the 1157 retrieved abstracts, only 69 met the inclusion criteria. 3D printed bone models were mainly used as training or simulation models for tumor removal, or bone reconstruction. Material jetting printers showed best performance but the highest cost. Stereolithographic, laser sintering and binder jetting printers allowed to create accurate models with adequate haptic feedback. The cheap fused deposition modeling printers exhibited satisfactory results for creating training models., Conclusion: Patient-specific 3D printed models are known to be useful surgical and educational tools. Faced with the large diversity of software, printing technologies and materials, the clinical team should invest in a 3D printer specifically adapted to the final application.

Statement of Problem: Scanning of completely edentulous arches remains a challenge because of the large surface to scan and the lack of anatomic indexes. Whether the presence of impression transfer copings with digital scanning provides enough markers for acceptable precision and clinical use has not been determined., Purpose: The purpose of this systematic review was to assess the accuracy of digital scanning for complete-arch implant-supported restorations., Material and Methods: A systematic review of peer-reviewed literature was conducted to analyze articles published between 2008 and 2019. Among the 208 retrieved articles, 20 were selected for review., Results: Five articles reported the use of digital scanning in clinical situations and satisfying short-term results. Fifteen in vitro studies were also included for complementary information, including measurement accuracy. Most of the intraoral scanners used in vitro provided acceptable accuracy below a threshold of 150 μm. When directly compared, the digital technique was at least equivalent to conventional impression techniques., Conclusions: In vitro, intraoral scanners have shown acceptable accuracy. The main parameters identified for their influence on precision were interimplant distance, body scan design, scanning pattern, and operator experience. Clinical evidence is limited by the lack of a definitive method of assessing the fit of the framework., (Copyright © 2019 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Extensive dental and periodontal defects are frequent and with a limited regenerative potential. Tissue engineering could be a promising tool to obtain personalized oral grafts. However, current research shows a lack of in vitro engineered oral tissues. This is explained by the difficulty to engineer blood vessel systems, impairing the connection to the host tissue and the graft success. Various strategies were used to engineer vascularized tissues and reported successful results, thus needing a clear analysis of the current state of art in oral tissue engineering. This systematic review aimed at studying the critical factors and techniques used to engineer a prevascularized oral tissue graft. PubMed, Cochrane Library, and SCOPUS databases were searched over the last 5 years following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Out of 638 screened studies, 24 were included in the systematic review according to strict inclusion and exclusion criteria and focusing on higher connection to the host vasculature. Animal models were all rodents, and subcutaneous implantation was the most used intervention. Studies presented low-to-unclear risk of bias according to the Systematic Review Center for Laboratory Animal Experimentation tool. Endothelial cells were mainly human umbilical vein endothelial cells, while stromal cells were most of the time oral or mesenchymal stem cells. Coculture of both types of cells at a 1:1 ratio was the most common technique used to obtain vascular networks, and some studies precultured grafts up to 3 weeks to enable network formation before implantation. Prevascularized grafts were produced by various tissue engineering technologies, including cell seeding and/or embedding, cell sheets, and spheroids. All studies reported a statistically significant faster and higher connection to host of prevascularized constructs compared to controls. Vessel networks were indeed denser, with a higher portion of lumen containing erythrocytes and blood flow increased. By assessing the relevant studies on the subject, this systematic review showed that engineered prevascularization proved to be an interesting approach to improve graft connection to the host vasculature and respective specific cell and scaffold criteria. Further studies on enhanced scaffolds and larger animals seem necessary to confirm these promising results with more voluminous grafts and get closer to native human tissues and applications. Impact statement Autologous oral grafts display limitations in terms of revascularization and morbidity of donor sites, despite being the gold standard. This systematic review aimed at clarifying existing data regarding techniques to engineer prevascularized oral grafts. Tissue engineering techniques, using cocultures of endothelial and oral stromal cells, proved to be an efficient way to enhance and accelerate the connection of the graft to the host vasculature. Engineered prevascularization appears to be a promising way to improve the connection to the host and the vascularization of grafts, especially when voluminous. Large animal and human studies are necessary to allow clinical translation.

An appropriate presentation of maxillofacial defects and their prosthetic rehabilitation concepts using traditional two-dimensional educational materials is challenging for dental students and prosthodontics residents. This technique article introduces a simple approach to visualize and communicate three-dimensional (3D) virtual models embedded into a portable document format (PDF) file for presenting maxillofacial prosthetics concepts and enhancing students' spatial ability when learning maxillofacial prosthetics. MeVisLab software was used to combine various maxillofacial models and save them as a single 3D model. Adobe Acrobat Pro DC software was used to import the 3D model and create interactive visualization PDF documents. Adobe reader software was then used to visualize the content of the PDF documents. This approach allows educators to develop PDF files with multiple 3D models for teaching maxillofacial prosthetics concepts and communicate them with their students. Students can simply open the PDF file, activate the 3D mode, and interactively manipulate the 3D models to enhance their spatial ability for learning maxillofacial prosthetics., (© 2020 by the American College of Prosthodontists.)

One of the greatest challenges in the field of biofabrication remains the discovery of suitable bioinks that satisfy physicochemical and biological requirements. Despite recent advances in tissue engineering and biofabrication, progress has been limited to the development of technologies using polymer-based materials. Here, we show that a nucleotide lipid-based hydrogel resulting from the self-assembly of nucleotide lipids can be used as a bioink for soft tissue reconstruction using injection or extrusion-based systems. To the best of our knowledge, the use of a low molecular weight hydrogel as an alternative to polymeric bioinks is a novel concept in biofabrication and 3D bioprinting. Rheological studies revealed that nucleotide lipid-based hydrogels exhibit suitable mechanical properties for biofabrication and 3D bioprinting, including i) fast gelation kinetics in a cell culture medium and ii) shear moduli and thixotropy compatible with extruded oral cell survival (human gingival fibroblasts and stem cells from the apical papilla). This polymer-free soft material is a promising candidate for a new bioink design.

Applications in additive manufacturing technologies for bone tissue engineering applications requires the development of new biomaterials formulations. Different three-dimensional (3D) printing technologies can be used and polymers are commonly employed to fabricate 3D printed bone scaffolds. However, these materials used alone do not possess an effective osteopromotive potential for bone regeneration. A growing number of studies report the combination of polymers with minerals in order to improve their bioactivity. This review exposes the state-of-the-art of existing 3D printed composite biomaterials combining polymers and minerals for bone tissue engineering. Characterization techniques to assess scaffold properties are also discussed. Several parameters must be considered to fabricate a 3D printed material for bone repair (3D printing method, type of polymer/mineral combination and ratio) because all of them affect final properties of the material. Each polymer and mineral has its own advantages and drawbacks and numerous composites are described in the literature. Each component of these composite materials brings specific properties and their combination can improve the biological integration of the 3D printed scaffold. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B:2579-2595, 2019., (© 2019 Wiley Periodicals, Inc.)

Statement of Problem: The success of single, anterior, implant-supported restorations relies on mechanical and esthetic outcomes. Titanium has been the most commonly used material for abutments, but zirconia is increasingly chosen for its appearance despite its unclear mechanical performance. Today, manufacturers market prefabricated, computer-aided design and computer-aided manufacturing (CAD-CAM) custom and zirconia abutments with titanium connections., Purpose: The purpose of this study was to systematically review the mechanical and esthetic outcomes of implant zirconia abutments used in the anterior region, considering the design changes of the past 5 years., Material and Methods: An electronic search was conducted in Medline (PubMed) for studies on zirconia abutments. All clinical studies with at least a 1-year follow-up and case series (>5 abutments) published after 2013 were included. Mechanical and esthetic outcomes were collected., Results: Of the 231 retrieved studies, 20 remained for quantitative analysis. Twelve described mechanical outcomes, and 15 focused on esthetics, using mainly the pink esthetic score. Five articles reported abutment fractures and no chipping. No difference was found between prefabricated and custom abutments or internal and external implant connections regarding fractures or screw loosening. All authors reported "good to excellent" esthetic integration in terms of restorations and soft-tissue color and the presence and height of papillae. The most difficult esthetic parameters to achieve were root convexity, soft-tissue color, and texture and level of mucosa., Conclusions: Esthetics remain the major advantage of zirconia abutment when compared with titanium, despite reservations concerning the risk of mechanical complications. Data are lacking for zirconia abutments with titanium inserts, although the prospects for this design are promising., (Copyright © 2018 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

The etiology of peri-implant crestal bone loss is today better understood and certain factors proposed in the past have turned out to not be of concern. Regardless, the incidence of crestal bone loss remains higher than necessary and this paper reviews current theory on the etiology with a special emphasis on traditional and innovative methods to assess the level of crestal bone around dental implants that will enable greater sensitivity and specificity and significantly reduce variability in bone loss measurement.

Purpose: This 10-year retrospective study aimed to report implant bone changes in completely edentulous patients after a mandibular immediate loading protocol using two ball attachments., Materials and Methods: This study was initially designed as a prospective 1-year cohort study, then extended with a 10-year retrospective evaluation of implant bone change. In the first part of the study, 43 edentulous patients wearing satisfactory maxillary and mandibular dentures for at least 3 months were included. Two interforaminal implants (Brånemark system, Nobel Biocare) were placed symmetrically in the anterior mandible using a surgical template and a torque greater than 40 Ncm. Immediately following surgery, 2.25-mm-diameter ball abutments were screwed to the implants, and their matrices (Dalbo Plus, Cendres et Métaux) were incorporated in the denture base. In an initial 1-year study, clinical recalls were scheduled 3, 6, and 12 months after implant placement with a team of two investigators. The follow-up consisted of a clinical examination and a standardized radiographic assessment of the vertical bone change. Implant stability was then monitored. The patient satisfaction was evaluated with a questionnaire before and 3 months after loading. The second part of the study occurred 10 years after the inclusion, as patients were recalled for an implant bone change monitoring., Results: The included patients were 28 to 80 years of age (mean: 61 ± 11.4 years). Three out of 86 implants failed during the healing phase (survival rate of 96.5% [90.1%, 99.2%]). Implant stability was maintained all along the 1-year follow-up (Δ = 73.33, 95% CI [72.39 to 74.26], P = .032). The mean radiographic bone loss was 0.27 ± 0.35 mm at 3 months after surgery, 0.47 ± 0.42 mm after 1 year, and 0.95 ± 0.98 mm after 10 years. General visual analog scale satisfaction was increased by 25 units with the treatment. No patients were lost to follow-up at 1 year, but five were lost at 10 years., Conclusion: This protocol of immediate loading of two unsplinted mandibular implants in overdenture patients using ball attachments is a clinically viable treatment with a high implant success rate and improved satisfaction.

Purpose: To study the evolution of recent topics in maxillofacial prosthetics (MP) research., Materials and Methods: Science mapping analyses were used to measure bibliometric similarities among articles extracted from the Web of Science from the last three decades., Results and Conclusion: Keyword co-occurrence highlighted the rise of computer-aided design/computer-assisted manufacturing, mandibular reconstruction, and extraoral prostheses during the last decade. Citation analysis showed that surgery journals kept the leadership on MP publications, but that prosthodontics journals were closing the gap. The United States was the leading country in MP publications over the last three decades, but their lead is fast dissolving worldwide.

When soft palate defects lead to palatal insufficiency, the patient's quality of life is affected by difficulties swallowing, hypernasality, and poor intelligibility of speech. If immediate surgical reconstruction is not an option, the patient may benefit from the placement of a rigid obturator prosthesis. Unfortunately, the residual muscle stumps are often unable to adequately move this stiff and inert obturator to properly restore the velopharyngeal valve function. In the present case history report, a new membrane obturator concept is described: Using a dental dam to compensate for the soft palate defect, swallowing and speech were significantly improved.

Background: Oropharyngeal features are frequent and often understated in the treatment clinical guidelines of systemic sclerosis in spite of important consequences on comfort, aesthetics, nutrition and daily life. The aim of this systematic review was to assess a correlation between the oropharyngeal manifestations of systemic sclerosis and patients' health-related quality of life., Methods: A systematic search was conducted using four databases [PubMed ® , Cochrane Database ® , Dentistry & Oral Sciences Source ® and SCOPUS ® ] up to January 2018, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Grey literature and hand search were also included. Study selection, risk bias assessment (Newcastle-Ottawa scale) and data extraction were performed by two independent reviewers. The review protocol was registered on PROSPERO database with the code CRD42018085994., Results: From 375 screened studies, 6 cross-sectional studies were included in the systematic review. The total number of patients included per study ranged from 84 to 178. These studies reported a statistically significant association between oropharyngeal manifestations of systemic sclerosis (mainly assessed by maximal mouth opening and the Mouth Handicap in Systemic Sclerosis Scale) and an impaired quality of life (measured by different scales). Studies were unequal concerning risk of bias mostly because of low level of evidence, different recruiting sources of samples and different scales to assess the quality of life., Conclusion: This systematic review demonstrates a correlation between oropharyngeal manifestations of systemic sclerosis and impaired quality of life, despite the low level of evidence of included studies. Large-scaled studies are needed to provide stronger evidence of this association., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Orofacial involvement is common and often understated in the treatment clinical guidelines of systemic sclerosis. It impairs daily life by having repercussions on comfort, nutrition, aesthetics and self-confidence. This review aimed at describing exhaustively the different orofacial consequences of systemic sclerosis. A systematic search was conducted using four databases (PubMed, Cochrane Library, Dentistry & Oral Sciences Source and SCOPUS) up to December 2016 according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses. Grey literature and hand search were also included. To be eligible for the inclusion, studies needed to meet the following criteria: randomised controlled trials, cross-sectional studies, case-control studies, pilot studies or cohort studies and full text available in English or French, with abstract. The studies had to concern at least 30 patients suffering from systemic sclerosis and having clinical and radiological oropharyngeal examination. The diagnosis of systemic sclerosis had to be determined according to precise recommendations; the retrieved oropharyngeal manifestations had to affect hard or soft tissues of the mouth and/or pharynx and needed to be evaluated with clinical measures. Study selection, risk bias assessment (Newcastle-Ottawa scale) and data extraction were performed by two independent reviewers. The retrieved features were microstomia and xerostomia associated with real hyposialia, temporomandibular joint symptoms, high caries experience, periodontal diseases as well as an increased risk of oral cavity and pharynx cancer. Early diagnosis enabling early management, prevention and oral hygiene is the key to avoid complicated and invasive procedures. Studies with higher level of evidence remain necessary to create standardised protocols., Competing Interests: Disclosures: Financial support: No grants or funding have been received for this study. Conflict of interest: None of the authors has financial interest related to this study to disclose., (© The Author(s) 2018.)

The aim of this study was to evaluate the role of epithelial signal transducer and activator of transcription 3 (STAT3) in mouse incisor amelogenesis. Since Stat3 is expressed in the epithelial component of developing and adult mouse teeth, we generated and analyzed Krt14Cre/+;Stat3fl/fl mutant mice in which Stat3 was inactivated in epithelia including ameloblast progenitors and ameloblasts, the cells responsible for enamel formation. Histological analysis showed little enamel matrix in mutant incisors compared to controls. Delayed incisor enamel mineralization was demonstrated using micro-computed X-ray tomography analysis and was supported by an increase in the pre-expression distance of enamel-enriched proteins such as amelogenin, ameloblastin, and kallikrein-4. Lastly, scanning electron microscopy analysis showed little enamel mineralization in mutant incisors underneath the mesial root of the 1st molar; however, the micro-architecture of enamel mineralization was similar in the erupted portion of control and mutant incisors. Taken together, our findings demonstrate for the first time that the absence of epithelial Stat3 in mice leads to delayed incisor amelogenesis., (© 2018 S. Karger AG, Basel.)

Dental rehabilitation of acute cases of enamel renal syndrome is challenging due to the absence of clinical reports. In the present case history report, examination of an 18-year-old patient revealed a complete lack of permanent teeth, as well as irregular and swollen bone and gingival morphology. Radiographs showed multiple impacted teeth in both arches. Creating a 1.5- to 2-cm interarch space was necessary for setting complete dentures. The ideal occlusal plane was chosen by combining two techniques (cephalometric radiograph and modification of the mandibular occlusal rim according to anatomical guidelines). Extraction of impacted teeth and recontouring of the alveolar process were performed simultaneously. The mandibular denture was connected through Locator abutments to two symphyseal implants. This pioneering clinical report will provide guidance to practitioners in the surgical intervention of patients with FAM20A (family with sequence similarities 20 A) gene mutations.

Rodents are characterized by continuously renewing incisors whose growth is fueled by epithelial and mesenchymal stem cells housed in the proximal compartments of the tooth. The epithelial stem cells reside in structures known as the labial (toward the lip) and lingual (toward the tongue) cervical loops (laCL and liCL, respectively). An important feature of the rodent incisor is that enamel, the outer, highly mineralized layer, is asymmetrically distributed, because it is normally generated by the laCL but not the liCL. Here, we show that epithelial-specific deletion of the transcription factor Islet1 (Isl1) is sufficient to drive formation of ectopic enamel by the liCL stem cells, and also that it leads to production of altered enamel on the labial surface. Molecular analyses of developing and adult incisors revealed that epithelial deletion of Isl1 affected multiple, major pathways: Bmp (bone morphogenetic protein), Hh (hedgehog), Fgf (fibroblast growth factor), and Notch signaling were upregulated and associated with liCL-generated ectopic enamel; on the labial side, upregulation of Bmp and Fgf signaling, and downregulation of Shh were associated with premature enamel formation. Transcriptome profiling studies identified a suite of differentially regulated genes in developing Isl1 mutant incisors. Our studies demonstrate that ISL1 plays a central role in proper patterning of stem cell-derived enamel in the incisor and indicate that this factor is an important upstream regulator of signaling pathways during tooth development and renewal. © 2017 American Society for Bone and Mineral Research., (© 2017 American Society for Bone and Mineral Research.)

Background and objective: FAM20A gene mutations result in enamel renal syndrome (ERS) associated with amelogenesis imperfecta (AI), nephrocalcinosis, gingival fibromatosis, and impaired tooth eruption. FAM20A would control the phosphorylation of enamel peptides and thus enamel mineralization. Here, we characterized the structure and chemical composition of unerupted tooth enamel from ERS patients and healthy subjects. Methods: SEM revealed that prisms were restricted to the inner-most enamel zones. The bulk of the mineralized matter covering the crown was formed by layers with varying electron-densities organized into lamellae and micronodules. Tissue porosity progressively increased at the periphery, ending with loose and unfused nanonodules also observed in the adjoining soft tissues. Thus, the enamel layer covering the dentin in all ERS patients (except a limited layer of enamel at the dentino-enamel junction) displayed an ultrastructural globular pattern similar to one observed in ectopic mineralization of soft tissue, notably in the gingiva of Results: SEM revealed that prisms were restricted to the inner-most enamel zones. The bulk of the mineralized matter covering the crown was formed by layers with varying electron-densities organized into lamellae and micronodules. Tissue porosity progressively increased at the periphery, ending with loose and unfused nanonodules also observed in the adjoining soft tissues. Thus, the enamel layer covering the dentin in all ERS patients (except a limited layer of enamel at the dentino-enamel junction) displayed an ultrastructural globular pattern similar to one observed in ectopic mineralization of soft tissue, notably in the gingiva of Fam20a knockout mice. XRD analysis confirmed the existence of alterations in crystallinity and composition (vs. sound enamel). XRF identified lower levels of calcium and phosphorus in ERS enamel. Finally, EDS confirmed the reduced amount of calcium in ERS enamel, which appeared similar to dentin. Conclusion: This study suggests that, after an initial normal start to amelogenesis, the bulk of the tissue covering coronal dentin would be formed by different mechanisms based on nano- to micro-nodule aggregation. This evocated ectopic mineralization process is known to intervene in several soft tissues in FAM20A gene mutant.

To better understand selenium's dynamics in environmental systems, the present study aims to investigate selenium speciation and distribution in black argillaceous sediments, partially fulfilling karstic cavities into the Hydrogeological Experimental Site of Poitiers. These sediments are suspected to be responsible for selenium concentrations exceeding the European Framework Directive's drinking water limit value (10 μg L(-1)) in some specific wells. A combination of a sequential extractions scheme and single parallel extractions was thus applied on a representative argillaceous sample. Impacts of the extractions on mineral dissolution and organic matter mobilization were followed by quantifying major cations and total organic carbon (TOC) in the aqueous extracts. The nature of the released organic matter was characterized using thermochemolysis coupled with gas chromatography-mass spectrometry (GC-MS). About 10 % of selenium from the black argillaceous studied matrix could be defined as 'easily mobilizable' when the majority (around 70 %) revealed associated with the aliphatic and alkaline-soluble organic matter's fraction (about 20 %). In these fractions, selenium speciation was moreover dominated by oxidized species including a mixture of Se(VI) (20-30 %) and Se(IV) (70-80 %) in the 'easily mobilizable' fraction, while only Se(IV) was detected in alkaline-soluble organic matter fraction.

Purpose: This study compared tissue three-dimensional (3D) displacements during the material setting phase of two maxillary impression tray-holding techniques: clinician manual pressure and patient occlusal pressure., Materials and Methods: The resultant two maxillary casts for each of 10 edentulous patients were compared using an optical 3D measurement system., Results: The junction between the hard and soft palates acted like a rotation center during impression making. The vertical displacements were significantly lower and posteriorly set when the impression was taken with the patient's occlusion, in contrast to being located at the anterior two-thirds during the manual impression technique., Conclusion: Use of patient's occlusion as a tray-holding technique may be preferred during the material setting phase of maxillary impressions.

Purpose: The purpose was to provide a longitudinal overview of published studies that use finite element analysis in dental research, by using the SCI-expanded database of Web of Science(®) (Thomson Reuters)., Material and Methods: Eighty publications from 1999-2000 and 473 from 2009-2010 were retrieved. This literature grew faster than the overall dental literature. The number of publishing countries doubled. The main journals were American or English, and dealt with implantology. For the top 10 journals publishing dental finite element papers, the mean impact factor increased by 75% during the decade., Results: Finite elements generate an increasing interest from dental authors and publishers worldwide.

The continuously growing rodent incisor is an emerging model for the study of renewal of mineralized tissues by adult stem cells. Although the Bmp, Fgf, Shh, and Wnt pathways have been studied in this organ previously, relatively little is known about the role of Notch signaling during incisor renewal. Notch signaling components are expressed in enamel-forming ameloblasts and the underlying stratum intermedium (SI), which suggested distinct roles in incisor renewal and enamel mineralization. Here, we injected adult mice with inhibitory antibodies against several components of the Notch pathway. This blockade led to defects in the interaction between ameloblasts and the SI cells, which ultimately affected enamel formation. Furthermore, Notch signaling inhibition led to the downregulation of desmosome-specific proteins such as PERP and desmoplakin, consistent with the importance of desmosomes in the integrity of ameloblast-SI attachment and enamel formation. Together, our data demonstrate that Notch signaling is critical for proper enamel formation during incisor renewal, in part by regulating desmosome-specific components, and that the mouse incisor provides a model system to dissect Jag-Notch signaling mechanisms in the context of mineralized tissue renewal., (© 2015 American Society for Bone and Mineral Research.)

The vertebrate ectoderm gives rise to organs that produce mineralized or keratinized substances, including teeth, hair, and claws. Most of these ectodermal derivatives grow continuously throughout the animal׳s life and have active pools of adult stem cells that generate all the necessary cell types. These organs provide powerful systems for understanding the mechanisms that enable stem cells to regenerate or renew ectodermally derived tissues, and remarkable progress in our understanding of these systems has been made in recent years using mouse models. We briefly compare what is known about stem cells and their niches in incisors, hair follicles, and claws, and we examine expression of Gli1 as a potential example of a shared stem cell marker. We summarize some of the features, structures, and functions of the stem cell niches in these ectodermal derivatives; definition of the basic elements of the stem cell niches in these organs will provide guiding principles for identification and characterization of the niche in similar systems., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Understanding the cellular and molecular mechanisms that underlie tooth regeneration and renewal has become a topic of great interest(1-4), and the mouse incisor provides a model for these processes. This remarkable organ grows continuously throughout the animal's life and generates all the necessary cell types from active pools of adult stem cells housed in the labial (toward the lip) and lingual (toward the tongue) cervical loop (CL) regions. Only the dental stem cells from the labial CL give rise to ameloblasts that generate enamel, the outer covering of teeth, on the labial surface. This asymmetric enamel formation allows abrasion at the incisor tip, and progenitors and stem cells in the proximal incisor ensure that the dental tissues are constantly replenished. The ability to isolate and grow these progenitor or stem cells in vitro allows their expansion and opens doors to numerous experiments not achievable in vivo, such as high throughput testing of potential stem cell regulatory factors. Here, we describe and demonstrate a reliable and consistent method to culture cells from the labial CL of the mouse incisor.

Objective: The purpose of this study was to evaluate the benefit of Oncoplastic Breast Conserving Surgery (BCS) compared to standard BCS after primary CT, in terms of oncologic safety and cosmetic outcomes., Background: The development of new drugs has led to greater use of primary chemotherapy (CT) for bulky breast cancer (BC) and has allowed wider indications for conservative surgery., Patients and Methods: We identified 259 patients consecutively treated with BCS for primary BC from January 2002 to November 2010. All patients had undergone Oncoplastic Breast Surgery (OBS) or standard BCS after primary CT. Mastectomy rates, and oncological and cosmetic outcomes were compared., Results: A total of 45 OBS and 214 standard BCS were analyzed. The median tumor size was 40 mm in the two groups (p = 0.66). The median operative specimen volumes were larger in the OBS group than in the standard group (respectively, 180 cm3 and 98 cm3, p < 0.0001). Re-excision (9% vs. 2%) and mastectomy (24% vs. 18%) rates were similar (p = 0.22 and p = 0.30) in the standard BCS group and in the OBS group respectively. At a median follow-up of 46 months, local relapse (p = 0.23) and distant relapse (p = 0.35) rates were similar., Conclusion: OBS allows excision of larger volumes of residual tumor after primary CT. OBS outcomes results were similar to those of standard BCS. Oncoplastic Breast Conserving Surgery (BCS) after primary chemotherapy allows wider breast resection than standard BCS. Survival and relapse probabilities are similar in both groups., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Objective: To compare complication rates and short-term outcomes of laparoscopic sacrocolpopexy among obese and non-obese women., Methods: A retrospective multicenter study of 39 obese women and 111 non-obese women was conducted. Obesity was defined as a body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) above 30. Operative parameters (length of operation, associated procedures, complication rate, and length of hospitalization) and short-term (2 months) objective and subjective results were evaluated., Results: The median BMI in the obese group was 30.5 (interquartile range [IQR] 30-32) versus 23 (IQR 21-25) in the non-obese group (P<0.0001). Short-term anatomic results (postoperative stage of prolapse) were comparable in the obese and non-obese groups: stage 0-1, 87.1% versus 91.6% (P=0.60); stage 2, 10.2% versus 5.5% (P=0.60); stage 3-4, 2.5% versus 2.5% (P=0.60). Complication rates were also similar in the obese and non-obese groups: bladder injury, 2.5% versus 5.4% (P=0.77); laparoconversion, 5.1% versus 4.5% (P=0.77). Rates of reoperation (excluding women with de novo urinary stress incontinence) were 12.8% in the obese group and 8.1% in the non-obese group (P=0.58)., Conclusion: Laparoscopic sacrocolpopexy has similar complication rates and short-term outcomes among both obese and non-obese women., (Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)

Objective: Vascular Ehlers-Danlos syndrome (vEDS) is a rare genetic condition related to mutations in the COL3A1 gene, responsible of vascular, digestive and uterine accidents. Difficulty of clinical diagnosis has led to the design of diagnostic criteria, summarised in the Villefranche classification. The goal was to assess oral features of vEDS. Gingival recession is the only oral sign recognised as a minor diagnostic criterion. The authors aimed to check this assumption since bibliographical search related to gingival recession in vEDS proved scarce., Design: Prospective case-control study., Setting: Dental surgery department in a French tertiary hospital., Participants: 17 consecutive patients with genetically proven vEDS, aged 19-55 years, were compared with 46 age- and sex-matched controls., Observations: Complete oral examination (clinical and radiological) with standardised assessment of periodontal structure, temporomandibular joint function and dental characteristics were performed. COL3A1 mutations were identified by direct sequencing of genomic or complementary DNA., Results: Prevalence of gingival recession was low among patients with vEDS, as for periodontitis. Conversely, patients showed marked gingival fragility, temporomandibular disorders, dentin formation defects, molar root fusion and increased root length. After logistic regression, three variables remained significantly associated to vEDS. These variables were integrated in a diagnostic oral score with 87.5% and 97% sensitivity and specificity, respectively., Conclusions: Gingival recession is an inappropriate diagnostic criterion for vEDS. Several new specific oral signs of the disease were identified, whose combination may be of greater value in diagnosing vEDS.