Search

Background: Fibrous dysplasia (FD) is a benign fibro-osseous lesion, a skeletal developmental anomaly of the bone-forming mesenchyme. The diagnosis of fibro-osseous lesions, particularly those of the jaw bones, poses significant challenges to clinicians and pathologists since it requires a correlation of clinical, radiological, histological, and surgical findings. Accurate and specific diagnosis is crucial as treatment modalities differ with different fibro-osseous lesions. Methods: This retrospective analysis presents a case series of a rare condition of monostotic FD in the maxillofacial region affecting jaw bones diagnosed and/or treated over period of 10 years. Results: Five cases of monostotic FD were diagnosed and treated between a period of 2013 and 2023. The cases from the 2nd to 8th decade were included in the analysis with equal involvement of males and females. Out of five cases, four cases were involving maxilla and 1 showed involvement of mandible. Conclusion: FD is a rare entity affecting the jaw bones which often lead to disfigurement of face. Early detection is warranted to decrease potential complications. In addition, genetic analysis could help in understanding the occurrence in certain population. Highlights: Fibrous dysplasia presents clinically in varied forms which may appear as the collision of different pathologic processes. We present a case series of a rare condition of monostotic fibrous dysplasia in the maxillofacial region affecting jaw bones- over the period of 10 years of an institutional database. We discussed the present knowledge on fibrous dysplasia, emphasizing the need to understand its clinical, radiographic, and histological characteristics, as well as essential aspects relevant to differential diagnosis and patient management. [ABSTRACT FROM AUTHOR]

Dry socket or alveolar osteitis is a common postoperative complication following tooth extraction, characterized by severe pain due to the disintegration of the blood clot within the socket. Various factors contribute to its development, such as traumatic extraction, patient age and sex, smoking, and anesthetic use. To mitigate this condition, socket preservation techniques, including the use of bone substitute materials, have been employed. Platelet-rich fibrin (PRF) has emerged as a promising biomaterial, enhancing healing and reducing the incidence of dry socket. Materials and Methods: This systematic review, adhering to the PRISMA guidelines and registered with PROSPERO (ID: CRD 578018), examines the efficacy of PRF in managing dry socket by analyzing studies from PubMed, Scopus, and Web of Science published between January 2013 and May 2024. Boolean keywords have been used in the search strategy: ("Treatment") AND ("Dry Socket") AND ("Platelet Rich Fibrin" OR "PRF"). A total of 738 publications were found using the electronic database search. After the screening phase, 13 records were chosen for qualitative analysis. The results from multiple clinical trials and comparative studies indicate that PRF significantly reduces postoperative pain, expedites healing, and lowers the incidence of Alveolar Osteitis. Despite promising results, further large-scale, randomized studies are needed to validate PRF as a standard treatment for dry socket. [ABSTRACT FROM AUTHOR]

The dynamics of tissue wound healing associated with dental implants placed in fresh extraction sockets or in healed alveolar ridges are not fully understood. Therefore, the aim of this preclinical in vivo investigation was to evaluate soft tissue healing and osseointegration after immediate implant placement, compared with delayed implant placement, using histomorphometric and immunohistochemical analyses. Methods: In 8 dogs, immediate postextraction implants and delayed implants were evaluated. After 2 and 8 weeks of healing, dissected tissue blocks were processed for calcified and decalcified histological analysis. Histometric measurements for soft tissue height and width were performed. Immunohistochemical analysis for the evaluation of bone metabolism, immune response and angiogenesis was performed. Results: At 2 weeks, histometric analysis showed that peri-implant soft tissue height was significantly greater in the immediate implant group (4.47 mm ± 0.78) compared to the delayed implant group (2.92 mm ± 0.51, p = 0.028), primarily due to the connective tissue height. Immunohistochemical analysis indicated significantly higher alkaline phosphatase (ALP) (6.85 ± 5.17 vs. 3.56 ± 2.31, p < 0.05) and matrix metalloproteinase (MMP2) activity (1.59 ± 1.64 vs. 0.58 ± 0.48, p < 0.05) in immediate implants, suggesting increased osteogenic and matrix metalloproteinase activity. At 8 weeks, the peri-implant soft tissue height remained higher in the immediate implant group (3.43 mm ± 0.83) compared to the delayed implant group (2.4 mm ± 0.37, p = 0.088), although the difference was less pronounced. Immunohistochemical differences between groups diminished in late healing stages. Conclusions: Soft tissue dimensions around immediate implants differ from those established around staged implants placed on healed alveolar ridges. Moreover, osseointegration dynamics around immediate implants may occur at a different rate compared with staged implants. [ABSTRACT FROM AUTHOR]

Ridge preservation is an important technique for maintaining the dimensions of the alveolar bone following tooth extraction, which is crucial for successful tooth rehabilitation. The combination of bovine amniotic membrane and hydroxyapatite has shown promise as a scaffold material containing growth factors that can stimulate osteogenic‐related factors such as bone morphogenetic protein 2 (BMP2), Runt‐related transcription factor 2 (RUNX2), and osteocalcin. This stimulation leads to collagen production and osteoblast proliferation, resulting in new bone formation. In this study, bovine amniotic membrane‐hydroxyapatite (BAM‐HA) composites were prepared using three different ratios of bovine amniotic membrane and hydroxyapatite (2 : 3, 3 : 7, 7 : 13). Thirty Sprague–Dawley rats had their first incisors extracted, and different types of BAM‐HA were applied for ridge preservation. The control group received no treatment, while the positive control group was given xenograft. After 14 and 28 days, the animals were sacrificed, and immunohistochemical analysis was performed to evaluate the expression of BMP2, RUNX2, and osteocalcin. Additionally, a histological examination was conducted to analyse collagen thickness and osteoblast cell proliferation. The results demonstrated that the application of BAM‐HA significantly increased collagen density, osteoblast cell proliferation, and the expression of BMP2, RUNX2, and osteoclacin compared to the control group (p < 0.05) on both days 14 and 28. Furthermore, increasing the hydroxyapatite content in the composite was found to enhance collagen thickness, osteoblast cell proliferation, and the expression of osteogenic‐related factors. These preliminary findings suggest that the combination of BAM‐HA can be used for ridge preservation to prevent further bone resorption following tooth extraction. [ABSTRACT FROM AUTHOR]

Purpose Materials and Methods Results Conclusion This experiment aimed to observe the differences in biological properties by producing BGS‐7 + PCL scaffolds with different weight fractions of BGS‐7 through 3D printing and to confirm whether using the scaffold for vertical bone augmentation is effective.Cube‐shaped bioglass (BGS‐7) and polycaprolactone (PCL) scaffolds with different weight fractions (PCL alone, PCL with 15% and 30% BGS‐7) are produced using 3D printing. The surface hydroxyapatite (HA) apposition, the pH change, proliferation and attachment assays, and various gene expression levels are assessed. After a 7‐mm implant was inserted 3 mm into the rabbit calvaria, vertical bone augmentation is performed around the implant and inside the scaffold in four ways: scaffold only, scaffold+bone graft, bone graft only, and no graft. Sacrifice is performed at 6, 12, and 24 weeks, and the various parameters are compared radiographically and histologically.HA apposition, cell proliferation, cell attachment, and expression of osteogenic genes increase as the proportion of BGS‐7 increase. In the in vivo test, a higher bone–implant contact ratio, bone volume ratio, bone mineral density, and new bone area are observed when the scaffold and bone grafts were used together.The 3D‐printed scaffold, a mixture of BGS‐7 and PCL, exhibit higher biological compatibility as the proportion of BGS‐7 increase. Additionally, the use of scaffold is effective for vertical bone augmentation. [ABSTRACT FROM AUTHOR]

ABSTRACT Background and Aim Methods Results Conclusion The study ‘Periodontitis and Its Relation to Coronary Artery Disease’ (PAROKRANK) reported an association between periodontitis (PD) and the first myocardial infarction (MI). This follow‐up study aims to test the hypothesis that those with PD—compared to periodontally healthy individuals—are at increased risk for cardiovascular (CV) events and death.A total of 1587 participants (age <75 years; females 19%) had a dental examination including panoramic radiographs between 2010 and 2014. PD was categorized as healthy (≥80% alveolar bone height), mild/moderate (79%–66%) or severe (<66%). A composite CV event (first of all‐cause death, non‐fatal MI or stroke and hospitalization following to heart failure) was investigated during a mean follow‐up period of 9.9 years (range 0.2–12.5 years). Participants were divided into two groups: those with and without PD. The primary event rate, stratified by periodontal status at baseline, was calculated using the Kaplan–Meier method and Cox regression.The number of events was 187 in the 985 periodontally healthy participants (19%) and 174 in the 602 participants with PD (29%; p < 0.0001). Those with PD had a higher likelihood for a future event (hazard ratio [HR] = 1.26; 95% CI: 1.01–1.57; p = 0.038), following adjustment for age, smoking and diabetes.The PAROKRANK follow‐up revealed that CV events were more common among participants with PD, which supports the assumption that there might be a direct relation between PD and CV disease. [ABSTRACT FROM AUTHOR]

Background-objective(s): This randomized, split-mouth study aimed to compare postoperative complications following the surgical extraction of impacted lower third molars using piezosurgery versus conventional rotary instruments. Materials and methods: Twenty-one patients, aged 18–35 years, with bilaterally and symmetrically impacted lower third molars, were randomly assigned to undergo extraction using piezosurgery on one side and conventional rotary instruments on the other. Results: The piezosurgery method required a longer operation time. However, it resulted in quicker resolution of postoperative swelling by the 7th day compared to the conventional method, where swelling persisted longer. Mandibular angle-tragus measurements were significantly higher with the conventional method on the 1st, 3rd, and 7th postoperative days. Although mouth opening decreased significantly after piezosurgery, it returned to preoperative levels by the 7th day, outperforming the conventional method. Postoperative pain was notably higher with the conventional method during the first four days but showed no significant difference from the 5th day onward. Alveolar bone healing was significantly better with piezosurgery at the 3rd and 6th months. Temporary paresthesia occurred in one patient from the conventional group, resolving within four weeks. Neither method resulted in alveolar osteitis. Conclusion(s): Within the study's limitations, piezosurgery demonstrated a reduction in postoperative discomfort, suggesting its advantage in enhancing patient recovery following lower third molar extractions. Clinical significance: Piezosurgery, when used appropriately, can reduce postoperative complications compared to conventional methods. Clinicians should be aware of its indications, benefits, and potential challenges. Trial registration This study was registered as a clinical trial to the ClinicalTrials.gov, and the registration ID is NCT06262841 (https://clinicaltrials.gov/study/NCT06262841). [ABSTRACT FROM AUTHOR]

Chronic inflammatory processes in the oral mucosa and periodontitis are common disorders caused by microflora and microbial biofilms. These factors activate both the innate and adaptive immune systems, leading to the production of pro-inflammatory cytokines. Cytokines are known to play a crucial role in the pathogenesis of gingivitis and periodontitis and have been proposed as biomarkers for diagnosis and follow-up of these diseases. They can activate immune and stromal cells, leading to local inflammation and tissue damage. This damage can include destruction of the periodontal ligaments, gingiva, and alveolar bone. Studies have reported increased local levels of pro-inflammatory cytokines, such as interleukin-1beta (IL-1beta), tumor necrosis factor (TNF), IL-6, IL-17, and IL-23, in patients with periodontitis. In experimental models of periodontitis, TNF and the IL-23/IL-17 axis play a pivotal role in disease pathogenesis. Inactivation of these pro-inflammatory pathways through neutralizing antibodies, genetic engineering or IL-10 function has been demonstrated to reduce disease activity. This review discusses the role of cytokines in gingivitis and periodontitis, with particular emphasis on their role in mediating inflammation and tissue destruction. It also explores new therapeutic interventions that offer potential for research and clinical therapy in these chronic inflammatory diseases. [ABSTRACT FROM AUTHOR]

Introduction: Oligodontia is a rare dental developmental pathology that requires prolonged, complex and multidisciplinary treatment. Although bone augmentation is frequently required during a complete implant treatment of oligodontia. Therefore, we evaluated the ability to predict pre-implant surgery complexity based on age, number of missing teeth, and number of implants required to achieve implant-supported prosthetic rehabilitation. Material and methods: This retrospectively registered study included all patients who underwent surgical treatment for oligodontia in our Oral and Maxillofacial Surgery Department between January 2012 and May 2023. Demographic data, number and location of missing teeth, pre- and per-implant surgical procedures, and the number of planned implants were recorded. A quantitative variable called "complexity score of pre-implant surgery" was created. This 10-point score was calculated by adding one point for each preimplant surgical procedure registered. A simple linear regression was calculated to explain the number of targeted implants based on number of missing teeth. A multiple linear regression model was used to explain the complexity score of pre-implant surgery and age, number of missing teeth and number of targeted implants. Results: 119 oligodontia patients were included in the study. The median number of tooth agenesis was 10. A total of 825 implants were placed, 14 (1.7%) of which failed. A significant regression equation was used (F(1,118) = 1098,338; p < 0.0001) to explain the number of targeted implants based on number of missing teeth, with a R2 of 0.903. A significant regression equation was found (F(3,116) = 107,229; p < 0.0001) to explain the complexity score of pre-implant surgery and age, number of missing teeth and number of targeted implants, with a R2 of 0.735. Discussion: These results based on patient data indicate that age, number of missing teeth and number of targeted implants could reliably explain the complexity of pre-implant surgery. [ABSTRACT FROM AUTHOR]

Background: Alveolar Bone loss occurs frequently during the first six months after tooth extraction. Various studies have proposed different methods to reduce as much as possible the atrophy of the alveolar ridge after tooth extraction. Filling the socket with biomaterials after extraction can reduce the resorption of the alveolar ridge. We compared the height of the alveolar process at the mesial and distal aspects of the extraction site and the resorption rate was calculated after the application of HA/β-TCP or synthetic co-polymer polyglycolic - polylactic acid PLGA mixed with blood to prevent socket resorption immediately and after tooth extraction. Methods: The study was conducted on 24 extraction sockets of impacted mandibular third molars bilaterally, vertically, and completely covered, with a thin bony layer. HA/β-TCP was inserted into 12 of the dental sockets immediately after extraction, and the synthetic polymer PLGA was inserted into 12 of the dental sockets. All sockets were covered completely with a full-thickness envelope flap. Follow-up was performed for one year after extraction, using radiographs and stents for the vertical alveolar ridge measurements. Results: The mean resorption rate in the HA/β-TCP and PLGA groups was ± 1.23 mm and ± 0.1 mm, respectively. A minimal alveolar bone height reduction of HA/β-TCP was observed after 9 months, the reduction showed a slight decrease to 0.93 mm, while this rate was 0.04 mm after 9 months in the PLGA group. Moreover, the bone height was maintained after three months, indicating a good HA/β-TCP graft performance in preserving alveolar bone (1.04 mm) while this rate was (0.04 mm) for PLGA. Conclusion: The PLGA graft demonstrated adequate safety and efficacy in dental socket preservation following tooth extraction. However, HA/β-TCP causes greater resorption at augmented sites than PLGA, which clinicians should consider during treatment planning. [ABSTRACT FROM AUTHOR]

Background: The analgesia after lower third molar alveolectomy is based on the use of non-steroidal anti-inflammatory drugs (NSAIDs) that have significant risks, and are contraindicated in the third trimester of pregnancy. Aiming to reduce NSAIDs use after this surgery, we quantified analgesic effects of ultrasound (US)-guided extraoral mandibular nerve block. Methods: Thirty-six patients were equally allocated to the experimental or control group, based on their willingness to receive experimental US-guided extraoral mandibular nerve block for postoperative analgesia. The experimental block applied prior to lower third molar alveolectomy, was followed by standard intraoral inferior alveolar nerve block. In the control group, patients received only intraoral block of inferior alveolar nerve. All patients reported pain level (visual analogue scale, VAS) right after the application of blocks. The next day, patients reported duration of pain-free time and the use of analgesic. Results: The US-guided extraoral mandibular nerve block prolonged the pain-free time to 8 h (vs. 4 in control group, P < 0.001) and reduced NSAIDs use (12 patients needed analgesic in experimental vs. 17 patients in control group, P = 0.038). The application of experimental block was less painful (VAS = 2) than the application of intraoral inferior alveolar nerve block (VAS = 4, P = 0.011). In 8/18 patients in the experimental group US-guided extraoral mandibular nerve block solely achieved adequate surgical anesthesia. Conclusion: US-guided extraoral mandibular nerve block prolonged pain-free period and reduced the use of NSAIDs after lower third molar alveolectomy, thus proving to be successful analgesia method for this dental surgery. Clinical trial registration: https://classic.clinicaltrials.gov/ct2/show/NCT06009302, identification number: NCT06009302, date of registration: 18/08/2023. [ABSTRACT FROM AUTHOR]

Objective: To discuss the anti-inflammatory and antioxidant effect of mesalazine (MSZ) in the RAW264. 7 cell model, and to elucidate its therapeutic effect on periodontitis in the rats. Methods: The proliferation rates of RAW264. 7 cells stimulated by different concentrations (0, 62. 5, 125. 0, 250. 0, 500. 0, 1 000. 0, and 2 000. 0 mg·L-1 )of MSZ were detected by CCK-8 method to determine the optimal concentration of MSZ for cell treatment. Porphyromonas gingivalis lipopolysaccharide (P. g-LPS) and MSZ were used to treat the RAW264. 7 cells, and the cells were divided into control group, P. g-LPS group, and MSZ+P. g-LPS group. The levels of reactive oxygen species (ROS) in the cells in various groups were detected by the DCFH-DA fluorescent probe assay; the malondialdehyde (MDA) levels, glutathione (GSH) levels and superoxide dismutase (SOD) activities in the cells in various groups were detected by ELISA method; the expression levels of inflammatory factors interleukin-8 (IL-8) and interleukin-1β (IL-1β) mRNA in the cells in various groups were detected by real-time fluorescence quantitative PCR (RT-qPCR) method. The periodontitis rat model was established by the ligation method combined with the injection of P. g bacterial fluid. A total of 18 rats were randomly divided into control group (without treatment), model group (making periodontits model), and drug administration group (making periodontits model and given MSZ), and there were 6 rats in each group. Micro-CT was used to assess the alveolar bone destruction of the rats in various groups; HE staining was used to observe the morphology of periodontal tissue of the rats in various groups. Results: Compared with control group, the proliferation rate of the cells in 500. 0 mg·L-1 MSZ group was significantly increased (P<0. 01), so 500. 0 mg·L-1 MSZ was subsequently selected to treat the cells. Compared with control group, the levels of ROS and MDA in the cells in P. g-LPS group were significantly increased (P<0. 01), and the level of GSH and activity of SOD were significantly decreased (P<0. 01), and the expression levels of IL-1β and IL-8 mRNA were significantly increased (P<0. 01); compared with P. g-LPS group, the levels of ROS and MDA in the cells in MSZ+P. g-LPS group were significantly decreased (P<0. 01), the level of GSH and activity of SOD were significantly increased (P<0. 01), and the expression levels of IL-1β and IL-8 mRNA were significantly decreased (P<0. 01). The micro-CT assay results showed that compared with control group, the distance from the cemento-enamel junction to alveolar bone crest (CEJ-ABC) of the rats in model group was significantly increased (P<0. 01), and the bone volume fraction (BV/TV) was significantly decreaced (P<0. 05); compared with model group; the CEJ-ABC of the rats in drug administration group was decreased (P<0. 01), and the BV/TV was increased (P<0. 05). The HE staining results showed that the inflammatory cell infiltration in periodontal tissue of the rats in drug administration group was reduced, and epithelial attachment was restored. Conclusion: MSZ effectively inhibits the production of pro-inflammatory factors and peroxides in the P. g-LPS-induced RAW264. 7 cells, improves the cellular anti-inflammatory and antioxidant capacity, inhibits the alveolar bone resorption, and alleviates the inflammation of periodontal tissues in the periodontitis rats. [ABSTRACT FROM AUTHOR]

Introduction. Periodontal regeneration is defined histologically as the new formation of tooth-supporting tissues, which includes alveolar bone, periodontal ligament and cementum, on a previously lost root surface. The application of protein derivatives of the enamel-derived matrix (EDM) was introduced as an alternative to obtain periodontal regeneration, in furcation affectations and intraosseous periodontal defects. Furcation involvement is bone resorption in the bifurcation or trifurcation area of a multirooted tooth. Case report. 38-year-old, female patient, ASA I, who presented for consultation for a restoration change in OD 36. On clinical and radiographic examination revealed a grade II furcation defect according to Hamp, with loss of horizontal support > 3 mm, but without passing the probe and vertical probing depth < 3 mm at the vestibular and lingual midpoint, presence of bleeding on probing. Once the hygienic phase was completed, periodontally regeneration with EDM (Emdogain®). Reduction of a grade II furcation defect to grade I was achieved after six months, with radiographic bone filling in the furcation area and vertical and horizontal probing < 3 mm. Conclusions. Class II furcation defects are the most predictable to obtain complete furcation closure or Class II to I. [ABSTRACT FROM AUTHOR]

Respiratory Distress Syndrome (RDS) remains a significant challenge in neonatal intensive care, particularly in preterm infants who suffer from surfactant deficiency, leading to alveolar collapse, decreased lung compliance, and impaired gas exchange. While conventional mechanical ventilation (CMV) is the current standard of care, it often involves cyclic alveolar recruitment and derecruitment, which can contribute to ventilator-induced lung injury (VILI). Airway Pressure Release Ventilation (APRV) is a mode of ventilation that maintains continuous alveolar recruitment through prolonged high-pressure phases while allowing spontaneous breathing, potentially reducing VILI. This protocol outlines the rationale, initial settings, adjustments, monitoring, and weaning strategies for using APRV to manage RDS in preterm infants. The paper also emphasizes the importance of adjusting Tlow (time at low pressure) to maintain the T-PEFR (peak expiratory flow rate termination point) at 75% with changes in lung compliance to prevent overinflation and underinflation, highlighting the need for further studies to validate APRV's safety, efficacy, and optimal use in this population. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this systematic review and meta‐analyses was to evaluate the outcomes of alveolar ridge preservation (ARP) following extraction of non‐molar teeth in comparison to early implant placement (EIP) in terms of clinical and radiographic changes, need for additional augmentation at the time of implant placement, patient‐reported outcomes, and implant failure rate. Methods: Electronic databases were searched to identify randomized and non‐randomized studies that compared ARP to EIP. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. Data were analyzed using a statistical software program. Results: A total of 106 studies were identified, of which five studies with 198 non‐molar extraction sockets in 198 participants were included. Overall meta‐analysis showed significant differences in changes in midfacial mucosal margin (mean difference (MD) −0.09; 95% confidence interval (CI) −0.17 to −0.01; p =.03) and ridge width (MD −1.70; 95% CI −3.19 to −0.20; p =.03) in favor of ARP. The use of ARP was also associated with less need for additional augmentation at implant placement, but the difference was not statistically significant. Conclusions: Within the limitation of this review, ARP following extraction of non‐molar teeth has short‐term positive effects on soft tissue contour, mucosal margin and thickness, and alveolar ridge width and height. It can also simplify future implant treatment by minimizing the need for additional augmentation. [ABSTRACT FROM AUTHOR]

Objectives: The incorporation of retromolar bone grafts used for alveolar ridge augmentation is not well understood. This prospective observational study aims to supply histomorphometrical data from bone graft biopsies taken at the time of retrieval and after a 3‐month healing period using patient‐matched biopsies. Materials and Methods: In 17 patients, trephine biopsies of the graft were acquired at the time of graft retrieval and after a 3‐month healing period. The biopsies were compared histomorphometrically regarding the number of osteocytes, appearance of osteocyte lacunae, quantity, surface area, and activity of the Haversian canals. Results: All grafts appeared clinically stable after screw removal and 17 implants were placed. Histomorphometric analysis revealed no significant difference in the number of osteocytes (p =.413), osteocyte lacunae (p =.611), the ratio of filled/empty osteocyte lacunae (p =.467) and active Haversian canals (p =.495) between the biopsies retrieved after a 3‐months healing period with those at the time of grafting. The only significant difference was noted in the mean surface area of the Haversian canals (p =.002). Specifically, the grafts post 3‐month healing showed a significantly larger mean area (0.069 mm2) compared to the time of grafting (0.029 mm2). Conclusion: This study demonstrates, compared to other data, a high rate of vital structures in retromolar bone block grafts after 3 months of healing, exhibiting the same histological features in comparison to the biopsies from the native alveolar ridge. Standard histomorphometrical parameters, e.g., the amount of filled or empty osteocyte lacunae for the description of the vitality of the graft need to be reappraised. [ABSTRACT FROM AUTHOR]

Objectives: To analyze changes in bone dimensions and their modulating factor in bone dimensions 6 months after horizontal ridge augmentation using autogenous bone grafts. Materials and methods: Thirty‐eight patients with horizontally atrophic alveolar ridges of a single edentulous tooth at the maxillary anterior site were divided into two groups based on the fixation position of the bone block during ridge augmentation surgery (H0, vertical distance from the upper edge of the bone block to the alveolar crest). Patients were classified into a crestal level (CL) group if H0 ≤ 1 mm and a sub‐crestal level (SCL) group if H0 > 1 mm. The width and height of the alveolar ridge were recorded using CBCT both before and 6 months after the augmentation procedure. Results: The CL group comprised 20 patients with 23 implants, whereas the SCL group comprised 18 patients with 22 implants. All the augmentation sites exhibited vertical bone resorption. Vertical bone resorption in the SCL group (1.94 ± 2.11 mm) was significantly higher than that of the CL group (0.61 ± 0.64 mm). The SCL group showed significantly lower horizontal bone gain than the CL group (SCL: 1.02 ± 2.30 mm; CL: 3.19 ± 3.17 mm) at the cervical level. Peri‐implant marginal bone loss increased significantly in the SCL group (1.00 ± 2.71 mm) compared to the CL group (0.64 ± 0.40 mm). Conclusion: The bone height decreased after horizontal ridge augmentation using autogenous onlay grafting. The fixation position of the bone block was a modulating factor. The SCL group showed more vertical bone loss, less horizontal bone gain 6 months after surgery, and more marginal bone loss after restoration. [ABSTRACT FROM AUTHOR]

Simple Summary: Toll-like receptor (TLR) signaling contributes to the pathogenesis of inflammatory oral diseases, such as periodontal disease by stimulating osteoclast differentiation and function. Recent reports suggest that various components from bacteria, viruses, and autologous cells act as TLR ligands. Lipopolysaccharide (LPS), a TLR4 ligand, induces osteoclast differentiation and bone resorption; however, blocking PGE2 synthesis or antagonizing PGE2 receptor signaling abrogates LPS-induced inflammatory bone resorption. In addition, other ligands for TLR2/1, TLR2/6 and TLR3 facilitate PGE2 production, leading to osteoclastic bone resorption. This review introduces the latest findings regarding the relationship between TLR signaling pathways and inflammatory bone resorption. Toll-like receptors (TLRs) are pattern recognition receptors expressed in immune cells, including neutrophils, macrophages, and dendritic cells. Microbe-associated molecular patterns, including bacterial components, membranes, nucleic acids, and flagella are recognized by TLRs in inflammatory immune responses. Periodontal disease is an inflammatory disease known to cause local infections associated with gingival inflammation, subsequently leading to alveolar bone resorption. Prostaglandin E2 (PGE2) is a key mediator of TLR-induced inflammatory bone resorption. We previously reported that membrane-bound PGE synthase (mPGES-1)-deficient mice failed to induce bone resorption by lipopolysaccharide (LPS), a major pathogenic factor involved in periodontal bone resorption. Further experiments exploring specific pathogen-promoting osteoclast differentiation revealed that various TLR ligands induced osteoclast differentiation in a co-culture model. The ligands for TLR2/1, TLR2/6, TLR3, and TLR5, as well as TLR4, induce osteoclast differentiation associated with the production of PGE2 and the receptor activator of nuclear factor-kappa B ligand (RANKL), an inevitable inducer of osteoclast differentiation in osteoblasts. In vivo, local injection of TLR ligands, including TLR2/1, TLR2/6, and TLR3, resulted in severe alveolar bone resorption. This review summarizes the latest findings on TLR-mediated osteoclast differentiation and bone resorption in inflammatory diseases, such as periodontal diseases. [ABSTRACT FROM AUTHOR]

Objective: Diabetes mellitus is increasing worldwide. Photobiomodulation (PBM) is proposed as a therapeutic method in various medical concerns. This study aimed to compare the effects of PBM at the wavelengths of 660, 808, or 660 + 808 nm on alveolar bone healing in diabetic rats. Methods: Bilateral maxillary first molars were extracted from diabetic Wistar rats (n = 36). Right-sided sockets were treated by an In-Ga-Al-P laser at 660 nm (7.2 J/cm², 24 s; DM660), Ga-Al-As laser at 808 nm (7 J/cm², 14 s; DM808), or a combination of these two sets (DM-dual) (n = 12). Left sides served as controls. On days 7 or 14, specimens were assigned for histomorphometric or real-time PCR analysis of runt-related transcription factor 2, osteocalcin, collagen I, and vascular endothelial growth factor expression. Results: Irradiated sockets of groups DM-808 and DM-dual showed a significant increase in bone tissue and blood vessel establishment as compared to DM-660. Further, group DM-dual exhibited the least amount of fibrotic tissue as compared to the other groups. Conclusions: Within our study limits, the present experiment suggested PBM at 808 nm, alone or combined with 660 nm irradiation, could promote alveolar bone healing, along withminimal fibrosis induction, in diabetic rats. [ABSTRACT FROM AUTHOR]

Background: A previous case study reported periimplantitis and concomitant perigraftitis of a second implant placed at a site that had alveolar ridge preservation three decades earlier. Infection at the site persisted 4 months after implant removal by flapless implant reversal. A flap was subsequently reflected, the grafted bone was removed, and a second alveolar ridge preservation was performed with a freeze‐dried bone allograft. The publication reported infection resolved, and the site healed uneventfully. However, it is unknown if placement of another implant at the site would be successful. The purpose of this paper is to report on the findings at surgical reentry and outcome of the third implant. Methods: Eleven months after the second alveolar ridge preservation, the site was reentered. The bone graft was found to be partially soft tissue encapsulated. All encapsulated graft materials and soft tissue were removed. An implant was placed, and the alveolar defect was grafted with a demineralized bone allograft. Seventeen months after implant placement, a buccal free gingival graft was performed during which the crestal bone adjacent to the implant was found to be hard and corticated. The implant was deemed to be osseointegrated and restored after soft tissue healing. Results: Twenty‐five months after implant placement, the third implant remained functional and asymptomatic with the peri‐implant bone exhibiting normal trabeculation. Conclusions: Implant therapy can be successful following treatment and resolution of perigraftitis. Key points: Perigraftitis may play a contributing role in the biologic complications of implants that have been placed into grafted bone.Perigraftitis may be successfully resolved by completely removing all grafted bone.Once perigraftitis has been eliminated, an implant may be successfully placed. [ABSTRACT FROM AUTHOR]

Background: The importance of an adequate amount of peri‐implant keratinized tissue and attached mucosa has recently been emphasized. This manuscript presents preliminary findings of a novel approach for increasing the width of keratinized mucosa (KM) around dental implants using a mesh free gingival graft (mesh‐FGG). Methods: Two healthy adults were treated as part of this study. After implant placement, a large edentulous alveolar ridge with shallow vestibule and minimal amount of KM was treated in both subjects (one in the posterior mandible and the other in the anterior mandible) with the combination of an apically positioned flap and a mesh‐FGG. Clinical, esthetic and patient‐reported outcomes were observed at approximately 4‐month time points. Results: All sites healed uneventfully after the treatments. In both cases, increased vestibule depth, soft‐tissue thickness, and width of peri‐implant KM were obtained. The patients did not report any accessory discomfort. Four months following the grafting procedure, good overall esthetic outcome was observed with minimal color disparity and graft demarcation. Conclusions: Width of KM around dental implants can be increased using a mesh‐FGG. Randomized controlled clinical studies comparing mesh‐FGG to conventional FGG and other commonly applied techniques are required to assess the long‐term efficacy of this novel technique in terms of soft‐tissue thickness, width of peri‐implant KM, and patient‐reported outcomes. Key points: Principal Findings: Meshed‐FGG allowed an expansion of the length of the harvested graft. This results in coverage of large recipient sites, increase in height of KM and good aesthetic integration of the graft. [ABSTRACT FROM AUTHOR]

Bone tissue regeneration is a critical aspect of dental surgery, given the common occurrence of bone resorption leading to alveolar bone defects. The aim of this paper was to conduct a systematic review to provide a comprehensive summary of the evidence regarding the regenerative properties of dentin biomaterial. This systematic review was conducted through comprehensive searches in the PubMed, Scopus, and Web of Science databases, as well as an extensive exploration of the gray literature sources, including WorldCat, The New York Academy of Medicine Library, and Trip Database, following the established PRISMA protocol. Keywords such as tooth, dentin, grinder, and autograft guided the search, with a focus on a standardized procedure involving dentin grinders within laboratory, experimental, and clinical settings. Initially, a pool of 1942 articles was identified with 452 duplicates removed. An additional 1474 articles were excluded for not aligning with the predefined topics, and three more were excluded due to the unavailability of the full text. Ultimately, 13 articles met the strict inclusion criteria and were included in the review. The chemical composition of the dentin particles was similar to natural bone in terms of oxygen, carbon, calcium, phosphorus, sodium, and magnesium content, as well as in terms of the Ca/P ratio. In addition, the dentin also contained amide I and amide II structures, as well as aliphatic and hydroxyl functional groups. The chemically treated dentin was free of microorganisms. The dentin had characteristic tubules that opened after chemical treatment. At the cellular level, dentin released bone morphogenetic protein 2, induced significant cell growth, and stimulated the reorganization of the fibroblast cytoskeleton. Most clinical studies have focused on alveolar bone regeneration. After the transplantation of demineralized dentin particles, studies have observed new bone formation, a reduction in residual bone, and an increase in connective tissue. Clinical reports consistently indicate uncomplicated healing and recovery post-transplantation. However, there is a notable gap in the evidence concerning complication rates, patient-reported outcomes, and the presence of pro-inflammatory factors. In conclusion, dentin biomaterial emerges as a versatile bone substitute, demonstrating high biocompatibility and ease of acquisition. The preservation of its internal structure containing organic matter and growth factors enhances its potential for effective bone regeneration. Particularly, in dental surgery, dentin-derived materials present a promising alternative to traditional autologous bone autografts, offering the potential to reduce patient morbidity and treatment costs. [ABSTRACT FROM AUTHOR]

Background/Objectives: Alveolar bone augmentation before implant placement is a safe and effective treatment option for the reconstruction of a deficient alveolar ridge. According to recent research, permanent teeth have been used as bone graft materials, with studies confirming their clinical and histological results. This study aimed to evaluate the efficacy of alveolar ridge augmentation with autogenous tooth roots and staged implant placement, and peri-implant tissue stability in augmented sites. Methods: A total of 20 augmentations with autogenous tooth roots on mandibular alveolar ridges in 15 patients were performed. After 6 months, the ridge width (RWa) and ridge width gain (RWg) were measured. Titanium dental implants were placed in grafted sites and loaded 10 weeks after placement. Clinical parameters (bleeding on probing—BOP; probing depth—PD; mucosal recession—MR; and clinical attachment level—CAL) were assessed 2 months (T1), 3 years (T2), and 5 years (T3) after implant loading. Results: The mean RWa was 6.71 ± 0.74 mm, and the RWg was 3.15 ± 0.54 mm, respectively. No statistically significant differences were observed for clinical parameters (BOP, PD, MR, and CAL) among different time points (p > 0.05). Conclusions: Autogenous tooth roots represent a viable solution for alveolar ridge augmentation and implant placement, providing a stable environment for peri implant tissues. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to systematically evaluate the efficacy of autologous platelet concentrate products in the preservation of the alveolar ridge after tooth extraction through meta‐analysis and provide a theoretical basis for the clinical application of autologous platelet concentrates to reduce alveolar bone resorption. Methods: This study conducted a meta‐analysis of clinical trials between 2013 and 2023, focusing on autologous platelet concentrate products (e.g., PRP, PRF, CGF, and PRCF) used for alveolar ridge preservation after tooth extraction. The analysis included 122 articles and 371 extraction sockets. All statistical analyses were performed using Review Manager version 5.4. Results: Results indicate that these platelet concentrates effectively reduced changes in horizontal width 1 mm below the alveolar crest and vertical socket height. They also promoted a higher percentage of new bone formation in extraction sockets compared with control groups. However, they did not significantly prevent horizontal bone resorption at 3 and 5 mm below the alveolar crest. Conclusion: In conclusion, autologous platelet concentrates are useful for alveolar ridge preservation, but larger clinical studies are needed to confirm these findings due to the relatively small sample size in this study. [ABSTRACT FROM AUTHOR]

Aim: To investigate the effects of high‐intensity interval training (HIIT) on periodontitis (PD) progression and behavioural outcomes. Materials and Methods: Forty‐eight Wistar rats were divided into four groups: non‐trained (NT); non‐trained with PD; HIIT with PD; and HIIT. The HIIT protocol, involving daily treadmill sessions, spanned 8 weeks, with PD induced by ligature after the 6th week. Behavioural tests were conducted to assess anxiety and memory. Post euthanasia, we evaluated the systemic inflammatory profile and oxidative stress markers in the hippocampus and amygdala. A morphological evaluation and elemental composition analysis of the mandibular alveolar bone were performed. Results: PD exacerbated alveolar bone level, bone surface damage and alterations in calcium and phosphorus percentages on the bone surface (p <.05), while HIIT attenuated these changes (p <.05). HIIT improved systemic inflammatory markers altered by PD (tumour necrosis factor [TNF]‐α, interleukin [IL]‐10, TNF‐α/IL‐10 and IL‐1β/IL‐10 ratios, p <.05). PD animals exhibited lower total antioxidant capacity and levels of thiobarbituric acid reactive substances in the amygdala and hippocampus, respectively (p <.05). HIIT maintained these parameters at levels similar to those in NT animals. HIIT improved anxiety and memory outcomes altered by PD (p <.05). Conclusions: HIIT attenuates systemic inflammation, anxiety and memory outcomes promoted by PD. [ABSTRACT FROM AUTHOR]

Copyright of Dental Press Journal of Orthodontics is the property of Dental Press International and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Large-volume autologous iliac cancellous bone grafting for alveolar cleft may lead to undesirable bone resorption and susceptible donor-site morbidity, whereas the addition of deproteinized bovine bone (DBB) could optimize outcomes. This study aimed to evaluate the effectiveness of combining autologous iliac bone with DBB using three-dimensional cone beam computed tomography (3D-CBCT) for better analysis of bone generation than conventional evaluation methods. Thirty-six patients with unilateral alveolar cleft were assigned into two groups. Group A (n = 21) underwent autogenous cancellous bone graft harvested from the anterior iliac crests, while Group B (n = 15) received a composite of autogenous iliac cancellous bone and DBB. Patients in Group B displayed higher bone filling rates (P < 0.0001) and lower bone absorption rates (P < 0.001) than those in Group A at both 6 months and 1 year postoperatively. Additionally, there were directional differences in bone absorption within the bone grafts, with more absorption observed on the alveolar crest and palatal sides than that on the nasal and labial sides (P < 0.001). This study demonstrates that employing a combination of DBB and autologous bone in alveolar cleft repair achieves better outcomes of bone grafting. [ABSTRACT FROM AUTHOR]

This study was performed to compare the amount of marginal bone loss (MBL) and the success rate of implants placed following maxillary ridge expansion with two surgical techniques. A non-randomized prospective study was designed. The patients underwent either bone expansion or ridge splitting, and simultaneous implant placement. The implants were loaded according to the delayed loading protocol with single crowns. Each study group included 35 implants placed in 31 patients. One year after loading, the implant success rate was 100 % in both groups. The median MBL was 1.00 mm in both groups (interquartile range 0.10 mm in the bone expansion group and 0.30 mm in the ridge splitting group) (no significant difference, P = 0.749). The median MBL around implants placed in sites with D2, D3, and D4 density bone was 1.40 mm, 1.00 mm, and 0.80 mm in the expansion group and 1.50 mm, 1.00 mm, and 0.85 mm in the splitting group, respectively. There was a significant difference in MBL between the different bone density types within both groups (P < 0.001). In conclusion, no significant difference in the amount of MBL or the success rate was observed between implants placed simultaneously with ridge splitting and those placed simultaneously with bone expansion, in the maxilla. [ABSTRACT FROM AUTHOR]

Copyright of Anatolian Clinic Journal of Medical Sciences is the property of Hayat Saglik ve Sosyal Hizmetler Vakfi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Alveolar bone augmentation is a complex process influenced by a multitude of factors. The materials applied in augmentation procedures must be confirmed as non-toxic, and their physicochemical properties should allow proper bone reconstruction. The specifics of oral surgical procedures require the use of regenerative biomaterials with antimicrobial properties. This study focuses on the physicochemical characteristics of chosen nanosized biomaterials, as well as their cytotoxicity and antimicrobial properties. Methods: nanosized hydroxyapatite and fluorapatite (abbreviated as nHAp and nFAp) pellets were manufactured using a microwave hydrothermal synthesis method. The impact on Candida albicans, Streptococcus mutans, and Lactobacillus rhamnosus strains activity and adherence to apatites was tested. Cytotoxic evaluation was performed based on the differentiation process of MC3T3 cells. The effectiveness of MC3T3 differentiation was confirmed by Alizarin Red staining. Results: Contact with both biomaterials caused a reduction in the mean microbial count of S. mutans and C. albicans strains, as observed. Studied biomaterials demonstrated enhanced proliferation of MC3T3 cells, with the exception of the 1:1 nFAp concentration. Conclusions: Both biomaterials enhance the proliferation of fibroblasts and limit the activity of specific oral pathogens in vitro. The research clearly demonstrates the advantage of nFAp over nHAp, with a notable reduction in microbial count of Candida albicans and Streptococcus mutans over time. The lowest microbial count reduction was observed in the case of L. rhamnosus. Further research is required in order to fully understand the specifics of nHAp and nFAp antimicrobial action. However, the results were found to be more favourable for nFAp biomaterial. [ABSTRACT FROM AUTHOR]

Alveolar bone remodeling during the retention phase is essential for successful orthodontic treatment. Pulsed electromagnetic field (PEMF) therapy is an adjunctive therapy for bone-related diseases that induces osteogenesis and prevents bone loss. This study aimed to examine the role of PEMF exposure during the retention phase of orthodontic treatment in alveolar bone remodeling. A total of 36 male Wistar rats were divided into control, PEMF 7, and PEMF 14 groups; a 50 g force nickel–titanium closed-coil spring was inserted to create mesial movement in the first molar for 21 d. Furthermore, the spring was removed, and the interdental space was filled with glass ionomer cement. Concurrently, rats were exposed to a PEMF at 15 Hz with a maximum intensity of 2.0 mT 2 h daily, for 7 and 14 days. Afterwards, the cements were removed and the rats were euthanized on days 1, 3, 7, and 14 to evaluate the expression of Wnt5a mRNA and the levels of RANKL, OPG, ALP, and Runx2 on the tension side. The data were analyzed with ANOVA and post hoc tests, with p < 0.05 declared statistically significant. PEMF exposure significantly upregulated Wnt5a mRNA expression, OPG and ALP levels, and Runx2 expression, and decreased RANKL levels in the PEMF 7 and 14 groups compared to the control group (p < 0.05). This study showed that PEMF exposure promotes alveolar bone remodeling during the orthodontic retention phase on the tension side by increasing alveolar bone formation and inhibiting resorption. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the viability of free gingival grafts (FGG) and assess clinical and radiographic changes in the alveolar ridge following socket seal surgery with or without freeze-dried bone allograft (FDBA). Materials and methods: Twenty-eight anterior and premolar tooth extractions were randomly allocated to 2 groups: socket graft of FDBA sealed with FGG (n = 15) and control with empty sockets sealed solely with FGG (n = 13). Photographs taken at 3, 7, 14, and 30 days post-surgery assessed FGG viability. Alveolar ridge volume was clinically evaluated via intraoral scanners before surgery and at 1 and 3 months post-surgery. CBCT scans taken immediately post-surgery and 3 months later assessed alveolar ridge dimensions. Results: FGG viability in both groups increased from day 3 and reached the maximum score on day 14. Alveolar ridge volume reduction at 3 months in the FDBA group was comparable to the control group. Buccal alveolar bone height reduction was significantly higher in the FDBA group than the control group, while palatal alveolar bone height was comparable. Alveolar bone width reduction was evident but not statistically significant between the groups. The FDBA group exhibited a significant alteration in bone volume compared to the control group. Conclusion: Viability of FGG was not affected by graft filling materials. Sealing the socket with FGG effectively preserved socket integrity and ridge volume in minor socket defects using either graft filling material or not. This study was registered on 4 January 2021 on Thai Clinical Trials Registry (TCTR20210104001). [ABSTRACT FROM AUTHOR]

Background: To avoid cortical compression, several implant systems have included in the protocol dedicated drills aimed at widening the cortical region of osteotomy. However, the manual execution of this operation does not guarantee the necessary precision. Hence, the present study aimed to determine the optimal size of the recipient site at the level of the alveolar crest in relation to the size of the coronal region of the implant to achieve the best healing result. Materials and methods: Blades of different diameters were incorporated into the coronal part of the implant to prepare the cortical region of the mandibular alveolar bone crest in different dimensions in relation to the collar of the implant. The differences in diameter of the blades in relation to the collar of the implant were as follows: one control group, -175 μm, and three test groups, 0 μm, + 50 μm, or + 200 μm. Results: The marginal bone loss (MBL) at the buccal aspect was 0.7 mm, 0.5 mm, 0.2 mm, and 0.7 mm in the − 175 μm, 0.0 μm, + 50 μm, + 200 μm groups, respectively. The differences were statistically significant between group + 50 μm and control group − 175 μm (p = 0.019), and between + 50 μm and + 200 μm (p < 0.01) groups. The level of osseointegration at the buccal aspect was more coronally located in the test groups than in the control group, whereas the bone-to-implant contact percentage was higher in the + 50 μm and + 200 μm groups. However, these differences were not statistically significant. Conclusions: The lowest bone crest resorption and highest levels of osseointegration were observed in the 0.0 μm and + 50 μm groups. The cortical region where the blades had performed their cutting action showed regular healing with perfect hard and soft tissues sealing in all the groups. Cortical blades gathered bone particles, particularly in the + 200 μm group, which were incorporated into the newly formed bone. The results from the present experiment provide support to the use of blades that produce a marginal gap of 50 μm after implant insertion. [ABSTRACT FROM AUTHOR]

This case report demonstrates a rare finding of a pediatric patient with Morning Glory anomaly and Moyamoya Disease with a palatal meningeal hamartoma discovered as a mass within a previously repaired incomplete cleft of the alveolus. Oral meningeal hamartomas are exceedingly rare with only two palatal cases described and none within a cleft palate or alveolus. These findings prompt a review of oral hamartomas with meningeal subclassification. Further discussion describes the relationship of the proposed origins of meningeal hamartomas within the setting of cleft palate development. [ABSTRACT FROM AUTHOR]

Objective : Evaluate periodontal bone support of maxillary central incisors (MCI) in patients with bilateral complete cleft lip and palate (BCCLP). Determine if syndromic diagnosis, age at time of alveolar bone graft (ABG), presence of maxillary lateral incisor (MLI), history of dentofacial orthopedics, maxillary expansion, and pre-maxillary osteotomy are associated with the periodontal bone support of MCI. Design : Retrospective radiographic study. Setting : Tertiary care children's hospital Patients : One hundred seventy-nine patients with BCCLP (22 syndromic) who had post-operative ABG cone beam computed tomography (CBCT) scans taken between 2002-2018. Main Outcome Measures: Crown to root (C/R) ratio of MCI measured on CBCT scans. Results : The C/R ratio in 65% of MCI indicated periodontally compromised teeth. Presence of a MLI improved bone support on adjacent MCI when compared to those missing a MLI (51.4% vs 28.4%, P =.010). There was no significant difference in C/R ratios for syndromic diagnosis, age at ABG, history of dentofacial orthopedics, maxillary expansion, and pre-maxillary osteotomy. Conclusions : The majority of MCI in patients with BCCLP are periodontally compromised but bone support is improved when cleft adjacent lateral incisors are present. [ABSTRACT FROM AUTHOR]

Objectives : This study aimed to analyze the efficacy of stem cell-based tissue engineering for the treatment of alveolar cleft (AC) and cleft palate (CP) defects in animal models. Design : Systematic review and meta-analysis. Setting : Preclinical studies on alveolar cleft repair in maxillofacial practice. Patients, Participants : Electronic search was performed using PubMed, Embase, and Cochrane databases. Pre-clinical studies, where stem cell-based tissue engineering was used in the reconstruction of AC and CP in animal models were included. Quality of the selected articles was evaluated using SYRCLE (SYstematic Review Centre for Laboratory animal Experimentation). Interventions : Review of alveolar cleft bone augmentation interventions in preclinical models. Main Outcome Measures : Outcome parameters registered were new bone formation (NBF) and/or bone mineral density (BMD). Results : Thirteen large and twelve small animal studies on AC (21) and CP (4) reconstructions were included. Studies had an unclear-to-high risk of bias. Bone marrow mesenchymal stem cells were the most widely used cell source. Meta-analyses for AC indicated non-significant benefits in favor of: (1) scaffold + cells over scaffold-only (NBF P =.13); and (2) scaffold + cells over empty control (NBF P =.66; BMD P =.31). Interestingly, dog studies using regenerative grafts showed similar to superior bone formation compared to autografts. Meta analysis for the CP group was not possible. Conclusions : AC and CP reconstructions are enhanced by addition of osteogenic cells to biomaterials. Directions and estimates of treatment effect are useful to predict therapeutic efficacy and guide future clinical trials of bone tissue engineering. [ABSTRACT FROM AUTHOR]

Purpose: To study the effect of BMP-2 on the volumetric and histometric changes in peri-implant defect treatments in animal models. Materials and Methods: An electronic search of four databases and a manual search of peer-reviewed journals for relevant articles were performed. Animal studies with data that compared the volumetric and/or histometric outcomes of peri-implant defect treatment with and without the use of BMP-2 were included. Meta-analyses were performed to analyze the weighted mean difference (WMD) and confidence interval (CI) for the recorded variables. Results: After completing the search process, 21 randomized controlled trials were included. The results of the metaanalyses showed that the WMD of bone-to-implant contact (%BIC) with 4 to 8 weeks and 12 to 24 weeks of follow-up was 15.50% (95% CI = 3.28% to 27.72%, P = .01) and 16.17% (95% CI = 11.17% to 21.16%, P < .00001), respectively, favoring the BMP-2 group. The WMD for the percentage of defect fill with 4 to 8 weeks and 12 to 24 weeks of follow-up was 15.88% (95% CI = 3.90% to 27.86%, P = .009) and 10.48% (95% CI = 0.95% to 20.02%, P = .03), respectively, favoring the BMP-2 group. The WMD for the vertical bone gain with 8 to 16 weeks of follow-up was 1.63 mm (95% CI = 0.58 to 2.67 mm, P = .002), also favoring the BMP-2 group. Conclusion: This review demonstrated that the use of BMP-2 in treating periimplant defects showed better clinical and histometric outcomes than defects not treated with BMP-2 in animal models. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy of split-thickness labial eversion periosteoplasty (EPP) for soft tissue closure in horizontal ridge augmentation of posterior mandibular regions using a bone shell onlay grafting technique. Materials and Methods: Sixteen patients (12 female and 4 male; mean age: 46.2 ± 8.7 years) with 18 horizontal bone defects in posterior mandibular regions were included for lateral onlay bone grafting using the bone shell technique. After lateral bone augmentation, the EPP was used for soft tissue closure and was prospectively followed up for wound healing efficacy using a modified scoring index. The scoring index included dichotomous (yes: 0 / no: 1) evaluation of the following items: (1) bleeding on palpation or spontaneously, (2) tissue color difference, (3) presence of hematoma, (4) presence of granulation tissue, (5) incomplete incision margin closure, (6) dehiscence with visible augmentation material, (7) presence of exudation, and (8) presence of suppuration. In addition, a visual analog scale (VAS) was used to quantify and record the amount of pain and swelling (0 = no pain/swelling and 5 = severe pain/swelling); VAS scores of 0, 1, and 2 were rated as 1 in the dichotomous scoring index, and VAS scores of 3, 4, and 5 were rated as 0. A summarized wound healing score consisting of all 10 items was assessed at days 2, 7, and 14 and at months 1 and 4 postoperatively, including a comparison of the follow-up evaluations. Results: The summarized healing score increased significantly (P < .01) between day 2 (score: 6.6 ± 1.1) and day 7 (score: 8.9 ± 1.0) but showed little difference between day 14 (score: 9.6 ± 0.6) and the 1- and 4-month follow-ups (score: 10.0 ± 0). There was no wound dehiscence and no incomplete incision margin adaptation. For the individual parameters evaluated, bleeding on palpation, hematoma, and exudation were the most frequent side effects at day 2 at 50%, 100%, and 22.2%, respectively, and at day 7 at 16.7%, 55.6%, and 22.2%, respectively. The average pain score and the swelling/edema score were initially 4.0 ± 0 and 3.0 ± 0.77 on day 2, with a significant decrease (P < .001) by day 7 (pain: 2.0 ± 0; edema/swelling: 2.0 ± 0.59) and day 14 (pain: 1.0 ± 0.42; edema/swelling: 2.0 ± 0.79) and complete absence (score: 0) at months 1 and 4. Conclusions: Labial split-thickness EPP facilitates flap advancement and enables tight soft tissue coverage in large horizontal posterior mandibular bone augmentations as a result of offset double-layer wound closure. Although this procedure is shown to be surgically demanding, the postoperative complication rate may be reduced significantly. [ABSTRACT FROM AUTHOR]

This retrospective study investigates the efficacy of the socket shield (SS) in preserving inter-implant papilla and bone in anterior adjacent implant sites. Clinical and radiographic records of 23 patients were evaluated. A total of 31 implants were placed immediately into extraction sockets with SS, resulting in 26 inter-implant sites, and 7 implants were placed without SS. After a mean follow-up of 41.5 months (range: 12 to 124 months), 30/31 (96.8%) implants with SS and 7/7 (100%) implants without SS were clinically successful. The mean changes in inter-implant papilla and bone heights were -0.40 mm and -0.46 mm, respectively. The effects of implant placement timing and the socket shield number, shape, and crestal level on interimplant tissue height changes were found to be insignificant (P > .05). Supracrestal shield level (31.6% vs 16.6% in equicrestal), U-shape shield (41.2% vs 7.1% in C-shape), and shield-to-implant contact (40.0% vs 12.5% in no contact) were associated with increased occurrence of exposures. The application of SS in adjacent anterior implant situations is a viable treatment option for maintaining inter-implant papilla. [ABSTRACT FROM AUTHOR]

BACKGROUND: MiR-338-3p could inhibit osteoclast differentiation, and downregulation of receptor activator of nuclear factor-κB ligand level could promote bone formation. However, it is unclear whether miR-338-3p can affect the proliferation and apoptosis of alveolar bone osteoblasts by regulating the receptor activator of nuclear factor-κB ligand level. OBJECTIVE: To explore the effect and mechanism of miR-338-3p on proliferation and apoptosis of alveolar bone osteoblasts by targeting receptor activator of nuclear factor-κB ligand. METHODS: Human alveolar bone osteoblasts were isolated, transfected and treated with Wnt-C59 (Wnt/β-catenin pathway inhibitor), and divided into transfection control group, miR-338-3p group, miR-338-3p+control group, miR-338-3p+receptor activator of nuclear factor-κB ligand group and miR-338-3p+ Wnt-C59 group. The dual luciferase report experiment was used to verify the regulatory effect of miR-338-3p on receptor activator of nuclear factor-κB ligand. Cell counting kit-8 and 5-Ethynyl-2’-deoxyuridine staining were used to detect cell proliferation levels. Flow cytometry was used to detect cell cycle and apoptosis levels. RT-qPCR was used to detect miR-338-3p, receptor activator of nuclear factor-κB ligand, Wnt-3a, β-Catenin, glycogen synthase kinase-3β mRNA levels. Western blot was used to detect RANKL, proliferating cell nuclear antigen, Ki67, CyclinD1, B-cell lymphoma/leukemia-2, B-cell lymphoma-2 related X protein, Caspase3, Wnt-3a, β-catenin, glycogen synthase kinase-3β protein levels. RESULTS AND CONCLUSION: miR-338-3p could target the regulation of receptor activator of nuclear factor-κB ligand. After overexpression of miR-338-3p, cell survival rate, 5-Ethynyl-2’-deoxyuridine positive cell rate, proportion of S-phase cells were increased, and apoptosis rate was decreased. The mRNA and protein levels of miR-338-3p, proliferating cell nuclear antigen, Ki67, CyclinD1, B-cell lymphoma/leukemia-2, Wnt-3a, and β-catenin were increased, while the mRNA and protein levels of B-cell lymphoma-2 related X protein, Caspase3 protein, receptor activator of nuclear factor-κB ligand, and glycogen synthase kinase-3β were decreased (all P < 0.05). Overexpression of receptor activator of nuclear factor-κB ligand or Wnt-C59 could weaken the effects of overexpression of miR- 338-3p on cell proliferation and apoptosis (all P < 0.05). Overall, miR-338-3p promotes alveolar bone osteoblast proliferation and inhibits apoptosis by targeting receptor activator of nuclear factor-κB ligand, which may act through activation of the Wnt/β-catenin signaling pathway. [ABSTRACT FROM AUTHOR]

Background: Periodontitis is caused by a dysbiosis of oral bacteria resulting in alveolar bone destruction and teeth loss. The role of platelets in pathogenesis of periodontitis is a subject of research. The release of toxins from periodontitis‐associated bacteria may influence platelet function and contribute to the modulation of hemostatic or inflammatory responses. Therefore, we explored platelet function upon exposure to defined toxins: leukotoxin A from Aggregatibacter actinomycetemcomitans (LtxA), a synthetic version of the C14‐Tri‐LAN‐Gly peptide from Fusobacterium nucleatum (C14), and lipopolysaccharides from Porphyromonas gingivalis (LPS). Methods: Light transmission aggregometry was performed after the addition of toxins to platelet‐rich plasma in different doses. Flow cytometry was used to identify inhibitory effects of toxins by measuring phosphorylation of the vaso‐dilator‐stimulated phosphoprotein or to identify activating effects by the detection of CD62P expression. The release of chemokines derived from washed platelets was determined by immunoassays. Results: Collagen‐induced threshold aggregation values were diminished upon incubation with LtxA and C14, accompanied with an increase of vaso‐dilator‐stimulated phosphoprotein (VASP) phosphorylation, indicating platelet inhibition. In contrast, LPS did not affect aggregation but slightly enhanced CD62P expression under co‐stimulation with low‐dose thrombin pointing to slight platelet activation. The three toxins did not relevantly influence the secretion of chemokines. Conclusions: Although weak, the investigated toxins differently influenced human platelet function. LtxA and C14 mediated inhibitory effects, whereas LPS contributed to a slight activation of platelets. Further analysis of specific cellular responses mediated by bacterial toxins may render novel targets and suggestions for the treatment of periodontitis. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) may affect the oral microbial community, exacerbating periodontal inflammation; however, its pathogenic mechanisms remain unclear. As nucleotide‐binding oligomerization domain 2 (NOD2) plays a crucial role in the activation during periodontitis (PD), it is hypothesized that changes in the oral microbial community due to diabetes enhance periodontal inflammation through the activation of NOD2. Methods: We collected subgingival plaque from 180 subjects who were categorized into two groups based on the presence or absence of T2DM. The composition of oral microbiota was detected by 16S rRNA high‐throughput sequencing. In animal models of PD with or without T2DM, we assessed alveolar bone resorption by micro‐computerized tomography and used immunohistochemistry to detect NOD2 expression in alveolar bone. Primary osteoblasts were cultured in osteogenic induction medium with high or normal glucose and treated with inactivated bacteria. After 24 h of inactivated bacteria intervention, the osteogenic differentiation ability was detected by alkaline phosphatase (ALP) staining, and the expressions of NOD2 and interleukin‐12 (IL‐6) were detected by western blot. Results: The relative abundance of Parvimonas and Filifactor in the T2DM group was increased compared to the group without T2DM. In animal models, alveolar bone mass was decreased in PD, particularly in T2DM with PD (DMPD) group, compared to controls. Immunohistochemistry revealed NOD2 in osteoblasts from the alveolar bone in both the PD group and DMPD group, especially in the DMPD group. In vitro, intervention with inactivated Parvimonas significantly reduced ALP secretion of primary osteoblasts in high glucose medium, accompanied by increased expression of NOD2 and IL‐6. Conclusions: The results suggest that T2DM leading to PD may be associated with the activation of NOD2 by Parvimonas. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the alveolar bone morphology of the mandibular second and third molars in skeletal Class III patients from a buccolingual direction. Methods: Sixty skeletal Class III patients were recruited. The alveolar bone width, buccal cortical bone thickness and lingual cortical bone thickness were measured in five planes from mesial to distal and at five depths from gingival to root. The effects of the gender of the patients, the second molar lingual inclination and the third molar on alveolar bone width and cortical bone thickness were evaluated. To explore the effect of third molar extraction on alveolar bone morphology, the measurements before and after third molar extraction were compared. Results: The impacted third molar had significantly greater alveolar bone width and thicker buccal cortical bone at the cervical third of the molar, while the erupted third molar had greater alveolar bone width at the apical third. Three weeks after third molar extraction, these advantages would weaken owing to the reconstruction of the alveolar bone. Patients with lingually inclined molar were observed to own thicker lingual cortical bone. Males tended to have greater alveolar bone width, but no significant differences were shown in this study. Conclusions: The growth of the third molar and the second molar lingual inclination affect the alveolar bone morphology of the mandibular second and third molars significantly, but gender has trivial effects on the morphology. The alveolar bone morphology of the mandibular second and third molars would change 3 weeks after third molar extraction. [ABSTRACT FROM AUTHOR]

Purpose: To compare different socket sealing approaches for alveolar ridge preservation and assess the dimensional changes and histologic characteristics of soft and hard tissues in a 4- to 6-month period. Material and Methods: A total of 22 patients with indicated single-tooth extraction in the maxillary nonmolar region were eligible for this study. After CBCT scanning and minimally traumatic tooth extraction, the alveolar sockets were filled with demineralized bovine bone mineral with collagen (DBBM-C) in patients from all groups except for those in the control group. Patients were divided into groups for socket sealing as follows: unsealed/spontaneous healing (control; n = 6), collagen matrix (n = 5), collagen membrane (n = 5), and autogenous graft (n = 6). A second CBCT scan was taken 4 to 6 months after extraction, and a trephine biopsy of soft and hard tissues was collected during implant placement. Tomographic dimensional changes were compared between groups. Intragroup tomographic evaluation and histological analysis were also performed. Results: Analysis of dimensional changes did not detect differences between the socket sealing groups (P > .05). In an intragroup evaluation, the height of the buccal bone and cross-sectional area of the alveolar ridge were significantly lower 4 to 6 months after extraction for the control group (P = .031). Histological analysis revealed that the socket sealing approach had no impact on hard and soft tissue formation. Conclusion: The data from the present study suggest that socket sealing with a collagen matrix, a collagen membrane exposed to the oral cavity, or an autogenous punch graft had no difference in the effects on volumetric maintenance and tissue formation in a period of 4 to 6 months. [ABSTRACT FROM AUTHOR]

Maintaining facial soft tissue contour and inter-implant papilla are challenging for implants in the esthetic zone. To counteract the inevitable hard and soft tissue changes after tooth extraction, the socket shield technique (SST) has been advocated as means to maintain the facial and/ or interproximal osseous and gingival architecture. Because SST is a technique-sensitive procedure, various complications related to SST have been reported. This article presents a unique complication after a socket shield procedure and a novel management of the complication. [ABSTRACT FROM AUTHOR]

Periodontal regeneration therapy has developed tremendously since its inception, becoming a clinical tool to preserve the periodontally compromised natural dentition. More challenging esthetic defects can often benefit from the combination of bone and soft tissue regeneration, such as the application of connective tissue grafts (CTGs) and techniques that approach the bone defect without interdental papillae incisions. However, periodontal tissue regeneration vertical to the alveolar bone crest in cases of severe periodontitis, with loss of both soft and hard tissues, has not been predictably established. This case report describes a patient with severe periodontitis that was treated with in supra-alveolar periodontal tissue reconstruction. This innovative surgical technique requires both horizontal buccal incisions and several vertical palatal incisions, avoiding the interdental papillae on the periodontal defect. Then, a space is created by suspending and fixating the flap coronally, and CTG and regenerative materials (such as recombinant human fibroblast growth factor-2) and bone graft material are applied. This technique has the potential to gain clinical attachment, achieve supra-/intraperiodontal regeneration, and enhance esthetic outcomes, including a reduced gingival recession and interdental papillae reconstruction. The clinical results of the present case were well maintained over the 2-year follow-up. [ABSTRACT FROM AUTHOR]

This study was designed to assess the use of enamel matrix derivative (EMD; Emdogain, Straumann) and alloplastic bone substitute (BoneCeramic [BC], Straumann) in postextraction alveolar sockets. A total of 45 patients requiring anterior single tooth extractions and subsequent implant placement were recruited and randomly assigned to one of three treatment groups. Postextraction sockets were filled with BC or BC + EMD, or were left to heal spontaneously. Tomographic dimensional changes were measured immediately following tooth extraction and at the 6-month follow-up. Computed tomographic (CT) scans were taken with a radiographic stent within 48 hours of extraction (CT1) and at 6 months (CT2). Paired comparisons related to the mean horizontal reduction of the vestibular crest (VC) showed significant differences between sockets left to heal spontaneously (Group 1) and the two groups filled with BC (Group 2) and BC + EMD (Group 3): 1.7 mm for Group 1 and 0.9 mm for Groups 2 and 3 (P < .05). Thus, the use of alloplastic bone substitute alone or with EMD resulted in better preservation of postextraction socket dimensions. No differences in socket preservation were found between Group 2 (BC) and Group 3 (BC + EMD). [ABSTRACT FROM AUTHOR]

Abstract Background Symmetrical and coordinated dental and alveolar arches are crucial for achieving proper occlusion. This study aimed to explore the association between dental and dentoalveolar arch forms in children with both normal occlusion and malocclusion. Methods 209 normal occlusion subjects (5–13 years, mean 8.48 years) and 199 malocclusion subjects (5–12 years, mean 8.19 years) were included. The dentoalveolar arch form was characterized by the smoothest projected curve representing the layered contour of the buccal alveolar bone, referred to as the LiLo curve. Subsequently, a polynomial function was utilized to assess dental and dentoalveolar arch forms. To facilitate separate analyses of shape (depth/width ratio) and size (depth and width), the widths of dental and dentoalveolar arch forms were normalized. The normalized dental and dentoalveolar arch forms (shapes) were further classified into 6 groups, termed dental/dentoalveolar arch clusters, using the k-means algorithm. Results The association between dental and dentoalveolar arch clusters was found to be one-to-many rather than one-to-one. The mismatch between dental and dentoalveolar arch forms is common in malocclusion, affecting 11.4% of the maxilla and 9.2% of the mandible, respectively. Conclusions There are large individual variations in the association between dental and dentoalveolar arch forms. Early orthodontic treatment may play an active role in coordinating the relationship between the dental and dentoalveolar arch forms.