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Recurrent benign gingival lesions occurring in the anterior dentition are clinical dilemmas. While complete removal of such lesions is required to prevent recurrence, this can result in a poor esthetic outcome. Relative to this conundrum, this report discusses the diagnosis, psychologic management, and clinical treatment of two patients with recurring lesions on the facial gingiva of the mandibular and maxillary incisors, respectively. Patient A, a 55-year-old woman, presented with a recurrent peripheral ossifying fibroma (POF); Patient B, a 76-year-old man, presented with a recurrent pyogenic granuloma (PG). Both patients underwent multiple procedures and were ultimately treated without lesion recurrence. The efficacious surgical treatment of recurrent gingival lesions like POF and PG requires an aggressive approach involving lesion removal of the lesion as well as a 1.0- to 2.0-mm margin of normal tissue, underlying alveolar bone, and associated periodontal ligament (PDL). The rationale for this approach stresses the potential periodontal and esthetic ramifications that were considered. In summary, when recurrent benign gingival lesions are localized to the anterior part of the mouth, the approach to their surgical removal should be modified to minimize the extent of gingival recession and other potential esthetic issues. [ABSTRACT FROM AUTHOR]

Purpose: To determine and compare the mechanical properties of 3D-printed yttria-stabilized zirconia to milled isostatic pressed yttria-stabilized zirconia, with the following hypotheses: (1) The flexural strength of 3D-printed yttria-stabilized zirconia is comparable to milled yttria-stabilized isostatic pressed zirconia; and (2) thermocycling and chewing simulation do not affect the flexural strength of 3D-printed yttria-stabilized zirconia. Materials and Methods: A total of 30 bars of an experimental 3D-printed 3 mol% yttria-stabilized zirconia (LithaCon 3Y 230, Lithoz) and 10 bars of milled isostatic pressed zirconia (Prettau Zirconia, Zirkonzahn) were utilized. The printed zirconia bars were divided into three groups (n = 10 bars per group): (1) untreated (control); (2) thermocycled; and (3) tested after chewing simulation. A flexural strength test was performed on all samples using a three-point bending test in an Instron Universal testing machine. One-way analysis of variance on ranks was used to compare milled to printed zirconia. The effects of thermocycling and load cycling on 3D-printed zirconia were also determined. Results: The flexural strength values for milled and printed zirconia were 936.3 ± 255.0 MPa and 855.4 ± 112.6 MPa, respectively. There was no statistically significant difference in flexural strength between the milled and printed zirconia (P = .178). No statistically significant differences were observed between the control 3D-printed zirconia group and the thermocycled (888.4 ± 59.3 MPa) or load-cycled printed zirconia (789.6 ± 133.8 MPa; P = .119). Conclusion: Printed 3 mol% yttria-stabilized zirconia has comparable flexural strength to milled yttria-stabilized isostatic pressed zirconia. The thermocycling and chewing simulation used in this study did not significantly alter the flexural strength of the printed 3 mol% yttria-stabilized zirconia. These results indicate a promising role for 3D printing in the fabrication of zirconia restorations. Additional studies are needed to explore the full potential of this technology. [ABSTRACT FROM AUTHOR]

Purpose: This systematic review aimed to assess the clinical efficacy of antibiotics when used as an adjunct in treating peri-implant diseases. Materials and Methods: A systematic search of papers published between January 1980 and March 2020 was conducted. Randomized clinical trials with at least 10 patients who had peri-implant diseases, treated with or without adjunctive antibiotics in combination with surgical or nonsurgical therapies, and with a minimum of at least 3 months of follow-up were included. Meta-analyses were conducted to analyze weighted mean differences in probing depth reduction, radiographic bone level gain, and odds ratio of treatment success. Results: From the 856 articles identified, 10 articles met the inclusion criteria and were selected. Of these, 7 articles were used for the meta-analysis. The adjunctive use of antibiotics in the treatment of peri-implant diseases yielded significantly greater probing depth reduction (weighted mean differences = 0.56 mm at 3 months, P = .001; 0.77 mm at 6 months, P < .00001; 0.92 mm at 12 months, P < .00001), radiographic bone level gain (weighted mean differences = 0.64 mm, P = .03), and treatment success (odds ratio = 1.74, P = .04) compared to the same treatment without antibiotics. Conclusion: Based on the existing evidence, the use of adjunctive antibiotics to treat peri-implant diseases, especially peri-implantitis, provided potential benefits in clinical outcomes for up to 12 months posttherapy. [ABSTRACT FROM AUTHOR]

Recently, we reported that oral-epithelial cells (OE) are unique in their response to Aggregatibacter actinomycetemcomitans cytolethal distending toxin (Cdt) in that cell cycle arrest (G2/M) occurs without leading to apoptosis. We now demonstrate that Cdt-induced cell cycle arrest in OE has a duration of at least 7 days with no change in viability. Moreover, toxin-treated OE develops a new phenotype consistent with cellular senescence; this includes increased senescence-associated β-galactosidase (SA-β-gal) activity and accumulation of the lipopigment, lipofuscin. Moreover, the cells exhibit a secretory profile associated with cellular senescence known as the senescence-associated secretory phenotype (SASP), which includes IL-6, IL-8 and RANKL. Another unique feature of Cdt-induced OE senescence is disruption of barrier function, as shown by loss of transepithelial electrical resistance and confocal microscopic assessment of primary gingival keratinocyte structure. Finally, we demonstrate that Cdt-induced senescence is dependent upon the host cell protein cellugyrin, a homologue of the synaptic vesicle protein synaptogyrin. Collectively, these observations point to a novel pathogenic outcome in oral epithelium that we propose contributes to both A. actinomycetemcomitans infection and periodontal disease progression. [ABSTRACT FROM AUTHOR]

Background: Dental caries is a microbe and sugar-mediated biofilm-dependent oral disease. Of particular significance, a virulent type of dental caries, known as severe early childhood caries (S-ECC), is characterized by the synergistic polymicrobial interaction between the cariogenic bacterium, Streptococcus mutans, and an opportunistic fungal pathogen, Candida albicans. Although cross-sectional studies reveal their important roles in caries development, these exhibit limitations in determining the significance of these microbial interactions in the pathogenesis of the disease. Thus, it remains unclear the mechanism(s) through which the cross-kingdom interaction modulates the composition of the plaque microbiome. Here, we employed a novel ex vivo saliva-derived microcosm biofilm model to assess how exogenous pathogens could impact the structural and functional characteristics of the indigenous native oral microbiota. Results: Through shotgun whole metagenome sequencing, we observed that saliva-derived biofilm has decreased richness and diversity but increased sugar-related metabolism relative to the planktonic phase. Addition of S. mutans and/or C. albicans to the native microbiome drove significant changes in its bacterial composition. In addition, the effect of the exogenous pathogens on microbiome diversity and taxonomic abundances varied depending on the sugar type. While the addition of S. mutans induced a broader effect on Kyoto Encyclopedia of Genes and Genomes (KEGG) ortholog abundances with glucose/fructose, S. mutans-C. albicans combination under sucrose conditions triggered unique and specific changes in microbiota composition/diversity as well as specific effects on KEGG pathways. Finally, we observed the presence of human epithelial cells within the biofilms via confocal microscopy imaging. Conclusions: Our data revealed that the presence of S. mutans and C. albicans, alone or in combination, as well as the addition of different sugars, induced unique alterations in both the composition and functional attributes of the biofilms. In particular, the combination of S. mutans and C. albicans seemed to drive the development (and perhaps the severity) of a dysbiotic/cariogenic oral microbiome. Our work provides a unique and pragmatic biofilm model for investigating the functional microbiome in health and disease as well as developing strategies to modulate the microbiome. 7vqKFKr_A75FzMGKU9ihFH Video Abstract [ABSTRACT FROM AUTHOR]

The article presents a comparative study on the bending strength of 3D printed and milled Yttriumdioxid-stabilized Zirconia, aiming to determine if there are significant differences between the two fabrication methods. Additionally, the study found that thermocycling and chewing simulation did not significantly affect the bending strength of 3D-printed Zirconia.