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The purpose of this review is to search for complications of dental implant superstructures and consider the issues involved. This narrative review was performed by searching through PubMed databases and review articles that were published after 1990. Misfitting of the superstructure can result in loosening of screws, reduced preload, and in some cases, significant stress around the implant. External connection modalities and single implant prostheses have been reported to have more loose or broken abutment screws. In addition, when zirconia abutment was used for platform shifting, the rate of fracture of the abutment was considered to be high. Additionally, it was reported that men were significantly at an increased risk of abutment fracture. As for the retention mechanism of implant overdenture, stud attachment (Locator type) should receive more attention to wear and damage of retention parts than other attachments. The causes of the complications of implant superstructures have not been clarified in some cases, and further verification is required. Verification of complications is considered important to obtain a long-term prognosis for superstructures of implants. It will be necessary to further verify complications of implants in the future.

Various techniques have been applied to the fabrication of duplicate dentures. In this new method, after scanning the cameo and intaglio surfaces of the complete denture using an intraoral scanner, the two images were superimposed on the interocclusal image. The linear gap between cameo and intaglio surfaces was filled using free downloadable CAD software. The superimposed image was subsequently used as data for fabricating the duplicate complete denture with a 3D printer. Using the intraoral scanner, duplication of complete dentures could be performed without needing any complicated processes, laboratory scanners, or advanced CAD software.

Purpose To investigate the difference in improvement of oral health-related quality of life (OHR-QoL) depending on the oral and denture conditions of a complete denture wearer when using a cream or powder type denture adhesive in a 10-center parallel randomized clinical trial.Methods Two hundred edentulous subjects who wore complete dentures were allocated to each of the three groups according to denture adhesive type: cream, powder, and control (saline solution). The materials were applied to the mucosal surface of the dentures for 4 days, and baseline data and data after the intervention were collected. OHR-QoL was assessed using the Japanese version of the modified Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT-J) scale for outcome. Multivariate analysis was used to investigate improvements in OHR-QoL according to participant characteristics among complete denture wearers using these materials.Results OHIP-EDENT-J scores were significantly decreased in all groups after the intervention (p < 0.05); however, there were no statistically significant differences among the groups. Multiple logistic regression analysis revealed a significant association between the vertical height of the maxillary and mandibular alveolar ridge and OHIP-EDENT-J scores in the cream-type denture adhesive group. In contrast, there were no significant association between participant characteristics and OHIP-EDENT-J scores in the powder-type adhesive and control groups.Conclusions The use of denture adhesives could improve OHR-QoL for complete denture wearers. The cream-type denture adhesives may be expected to improve OHR-QoL in patients with poor residual ridge conditions compared with patients with good residual ridge conditions.

Abstract A DNA hybridization-based differential peptide display (DPD) was developed for the screening of phage peptide library to find osteogenic peptides intended to bind to epigenetically induced osteogenic receptors on NIH/3T3 (3T3) cell surface. In the presence of DNA methylation inhibitor of 5-azacytidine (5AZC), an osteoblastic receptor of bone morphogenetic protein (BMP) receptor 1A (BMPR1A) was induced on the cell surface of NIH/3T3 fibroblasts. Cyclic heptamer-displaying phage library was screened against vehicle and 5AZC treated (Tx) 3T3 cells. Antisense oligo against library against library peptide coding DNA of control 3T3 cell bound phages were synthesized to subtract common binders from that of 5AZC-Tx 3T3 cell-bound phages that included 5AZC-induced receptor binders. The library peptide coding regions of conformational receptor binder-subtracted DPD were PCR-amplified and cloned into a plasmid vector specifically designed for short peptide expression. No unique binder was identified when 96 clones were randomly picked from the third round of panning against 5AZC-treated 3T3 cells, suggesting miscellaneous bindings to cell surface proteins. Unique binders showing homology to known function proteins were successfully identified when constitutive receptor binders were subtracted from 5AZC-induced protein binders. Some of identified peptides significantly increased alkaline phosphatase activity in 5AZC-Tx 3T3 cells. DPD can be a useful tool to screen functional peptide bindings to cell surface receptors. Graphic Abstract

The purpose of this study was to investigate the effect of denture adhesives on oral moisture in a 10-center parallel randomized clinical trial.Two hundred edentulous subjects wearing complete dentures were allocated into three groups: cream-type adhesive, powder-type adhesive and control groups. The adhesives (and saline solution in the control group) were applied to the mucosal surface of the dentures for 4 days, and baseline data and data after the intervention for eight meals over 4 days were obtained. For the main outcome, oral moisture was measured with a moisture checking device. Secondary outcomes were denture satisfaction, masticatory performance, denture retention, and occlusal force. In addition to between-group and within-group comparisons of oral moisture, investigations for secondary outcomes were undertaken in subgroups classified according to the degree of oral moisture at baseline (normal subgroup and dry mouth subgroup). Intention-to-treat analysis was also performed.Between-group and within-group comparisons of oral moisture showed no significant differences. The cream-type and powder-type denture adhesives were significantly effective in the dry mouth group for denture satisfaction ratings of ability to masticate, stability, retention, and comfort of mandibular dentures (p0.05). The masticatory performance and retentive force of the dry mouth denture adhesive using groups were significantly improved after intervention (p0.05).The oral moisture of complete denture wearers was not influenced by the use of denture adhesives. Our findings showed that denture adhesives improved subjective denture satisfaction, masticatory performance, and retention for complete denture patients with oral dryness.

The purpose of this retrospective study was to evaluate computer-assisted virtual surgery and the outcomes of mandibular reconstruction using an autogenous particulate cancellous bone and marrow (PCBM) graft combined with a custom-made titanium mesh (TiMesh) using a three-dimensional (3D) printing model. Eighteen consecutive patients were included, and preoperative virtual simulation surgery was performed using digital data. Segmental bone defects showed deviation of the mandible due to displacement of the condyle and segments, unnatural length of the mandibular body, or poorer intermaxillary relationship compared to the marginal bone defect caused by previous operations. These mandibular disharmonies could be simulated, and virtual surgery was performed on a computer with adjustment of displaced mandibular segments, length of the mandibular body, and dental arch with digital bone augmentation. TiMesh was manually pre-bent using a 3D printing model, and PCBM from the iliac crest was grafted with TiMesh. The short-term clinical results were good; reconstruction of the alveolar crest was prosthetically desirable; and minor complications were observed. In conclusion, virtual reconstruction is crucial for treating complex deviated mandibles. Accurate condylar and dental arch positions with an optimum mandibular length are important for prosthetically satisfactory mandibular reconstruction.

Collagenous biomaterials that are clinically applied in dentistry have dermis-type and membrane-type, both of which are materials for promoting bone and soft tissue formation. The properties of materials supplied with different types could affect their biodegradation periods. The purpose of this study was to characterize five of these products by four different methods: scanning electron microscopy (SEM) observation, thermogravimetry-differential thermal analysis (TG-DTA), 0.01 wt% collagenase dissolution test, and subcutaneous implantation test in vivo. SEM micrographs revealed that both dermis and membranous materials were fibrous and porous. The membranous materials had higher specific derivative thermal gravimetry (DTG) peak temperatures in TG-DTA at around 320 °C, longer collagenase dissolution time ranging from about 300 to 500 min, and more longevity in mice exceeding 9 weeks than the dermis materials. There existed a correlation between the peak temperature in TG-DTA and the collagenase dissolution time. It was considered that higher cross-link degree among collagen fibrils of the membrane-type collagenous materials might account for these phenomena. The experimental protocol and numerical results obtained could be helpful for selection and future development of fibrous collagenous biomaterials in clinical use.

Background The purpose of this study was to evaluate the accuracy of intraoral scanners by comparing the trueness and precision of several types of scanners in measuring the distance between the ball abutments on pairs of multiple implants. Methods Seven implants were placed on a fully edentulous upper jaw model. After ball abutments were attached to the implants on the master model, the three-dimensional (3D) shape of the model was evaluated using a computer numerical control 3D coordinate-measuring machine. Subsequently, the 3D shape-related data of the model were obtained using two types of intraoral scanners (3M True Definition Scanner [TDS] and 3Shape Trios3 [TR3]) and two types of laboratory scanners (KaVo ARCTICA Auto Scan [KA] and Identica Hybrid [IH]). Using the obtained 3D shape-related data, the trueness and precision in measuring the distance between the balls within seven pairs of ball abutments were compared among the scanners using 3D analysis software. Results Intraoral scanners produced significantly greater errors in trueness and precision than laboratory scanners in measuring the distances between the ball abutments in all the dental regions. Between the intraoral scanners, powder-requiring TDS produced significantly lower errors at inflection points than powder-free TR3. Conclusions These results indicate that an optical impression technique using an intraoral scanner is suitable for dental implant treatment in patients with a few missing teeth.

Background This study aimed to collect data regarding patient perception and knowledge of dental implants. It was conducted with the hope that the data would provide dental professionals and policymakers with a better understanding of ways to promote implant therapy. Methods An anonymous online survey with 10 questions was distributed through 12 dental offices in Tokyo and provincial cities in Japan to assess patient perception and knowledge of dental implants. Harvard Medical School’s IRB approved this study. Results We collected data from 1172 patients (59% female, 41% male). The most common perceptions of implant therapy were that it was “expensive,” “advanced,” and “scary”. Patients’ implant knowledge came primarily from magazines or books, while professional dental societies/associations were the least sought out source of information. Patients believed that the purpose of dental implants was to avoid dentures and improve chewing function. Their primary concerns about dental implants were the cost and longevity. Approximately 12% of patients with dental implants and 61% of patients without implants did not know that bone grafts may be required and that sedation during surgery was an option. For patients who experienced sedation during the procedure, 60% of them want it for future surgeries. Patients also had limited knowledge of bone-graft materials and the effects of CBCT radiation; 75% of the patients expressed concerns over the safety of graft materials and radiation exposure. For patients with a history of dental implant therapy, 80% of them would recommend dental implants to their family and friends. Conclusions Overall, patients’ experiences with dental implant therapy were positive, but there was a lack of patient education regarding dental implants and their associated procedures. Dental professionals need to take the initiative to improve patient education.

Titanium is often used in the medical field and in dental implants due to its biocompatibility, but it has a high rate of leading to peri-implantitis, which progresses faster than periodontitis. Therefore, in the present study, the expression of cytokines from gingival epithelial cells by nanotitania was investigated, which is derived from titanium in the oral cavity, and the additional effect of Porphyromonasgingivalis (periodontopathic bacteria) lipopolysaccharide (PgLPS) was investigated. Ca9-22 cells were used as a gingival epithelial cell model and were cultured with nanotitania alone or with PgLPS. Cytokine expression was examined by reverse transcription-quantitative polymerase chain reaction and enzyme-linked immunosorbent assay. In addition, cellular uptake of nanotitania was observed in scanning electron microscopy images. The expression of interleukin (IL)-6 and IL-8 significantly increased in Ca9-22 cells by nanotitania treatment alone, and the expression was further increased by the presence of PgLPS. Nanotitania was observed to phagocytose Ca9-22 cells in a dose- and time-dependent manner. Furthermore, when the expression of IL-11, related to bone resorption, was investigated, a significant increase was confirmed by stimulation with nanotitania alone. Therefore, nanotitania could be associated with the onset and exacerbation of peri-implantitis, and the presence of periodontal pathogens may worsen the condition. Further clinical reports are needed to confirm these preliminary results.

When the sinus is enlarged, it may be necessary to elevate the floor of the maxillary sinus using the crestal or lateral approach. This report presents a case where sinus floor elevation was performed using tricalcium phosphate (TCP) plates supported by implant bodies, and only the blood clot was present around the implant bodies. Cone-beam computed tomography images, taken one year after the lateral approach, revealed the presence of a TCP-like radio-opacity, which almost disappeared after two years. About seven years after the surgery, the patient's superstructure and occlusion were stable. Furthermore, the grafted TCP was completely absorbed, and the implant body appeared to be in good condition, with no signs of bone resorption around the implant.

Purpose To reveal effects of improvement of masseter muscle activity on brain function in elderly people wearing complete dentures.Methods Subjects were 14 edentulous patients with a chief complaint of the inconvenience of their complete dentures. The surface electromyographic (EMG) activity of the masseter muscles was measured. Brain activities were analyzed with functional magnetic resonance imaging (fMRI), employing chewing gum as the task program. Cognitive functions were evaluated with Trail Making Test Part A (TMT-A), Rey Auditory Verbal Learning Test (RAVLT) and Rey-Osterrieth Complex Figure Test (R-OCFT). Those evaluations were performed in which subjects wore their old dentures (OD) or newly fabricated dentures (ND).Results We compared ND condition with OD condition. The masseter muscle activity significantly increased in ND condition (p0.05, Wilcoxon signed rank test). The brain activity increased significantly in the superior frontal gyrus, precentral gyrus, putamen, inferior parietal lobule, cerebellum, inferior frontal lobe, and middle frontal gyrus under the ND condition than under the OD condition (p0.01, uncorrected, cluster size10 voxels). Results of TMT-A, RAVLT, and R-OCFT were also significantly improved (p0.05, Wilcoxon signed rank test).Conclusions In the edentulous elderly, the brain activity was increased following the improvement of the masseter muscle activity. Consequently, it is possible that the improvement of the masseter muscle activity might influence on the attention, verbal skills, and visual memory.

This narrative review aims to provide an overview of recent studies and case reports on three-dimensional (3D) printing, and to verify the applicability of 3D printers in the field of dental prostheses. This review was performed by conducting a search of PubMed. The clinical application of fabricating a prosthesis made with cobalt-chromium is considered possible depending on the material and hardware of the 3D printer. However, it is currently difficult to assess the clinical use of 3D-printed zirconia crowns. Further research is required, such as verification of materials used, margin morphology, and hardware. Clinically acceptable results have been reported for patterns using 3D printers. Interim restorations made using a 3D printer have been reported with good results that are considered clinically usable. Dentures made with 3D printers need further verification in terms of strength and deformation. Custom trays made with 3D printers are clinically useful, however, issues remain with design time and effort. Although several studies have reported the usefulness of 3D printers, further verification is required since 3D printers are still considered new technology.

Purpose To determine the effects of titanium nanoparticles, that may have been scattered after dental implant placement, on gene and promoter expression, and gingival tissue. Methods Ca9-22 cell lines were used as gingival epithelial cells to assess the effects of titanium dioxide nanomaterials as titanium nanoparticles. Cells were cocultured with or without titanium dioxide nanomaterials prior to gene and promoter expression analysis. Expression of interleukin-13α2 receptor was investigated using real-time quantitative reverse-transcription polymerase chain reaction and immunofluorescence staining. Additionally, the enhanced messenger ribonucleic acid (mRNA) expression of transforming growth factor β1 was analyzed using the same method. Results Titanium dioxide nanomaterials affected gene and promoter expression in Ca9-22 cells: among the 160 upregulated genes, the upregulation of IL13RA2, which encodes interleukin-13α2 receptor, was the highest (8.625 log2 fold change). Immunofluorescence staining confirmed the increased expression of interleukin-13α2 receptor, which enhanced transforming growth factor β1 expression by stimulation with interleukin-13. Conclusion Titanium dioxide nanomaterials applied on the gingival epithelium around the dental implant may increase interleukin-13α2 receptor expression. In turn, this can enhance the secretion of transforming growth factor β1, which is known to promote the differentiation of osteoclasts involved in bone resorption, and potentially affect gingival tissue.

PURPOSE The purpose of this study was to examine morphological changes in the superstructure of implants in relation to the degree of attrition of the implant superstructure and its antagonists. METHODS Thirty-three patients participated. The implant superstructures of the first molar and its antagonists were scanned with an intraoral scanner every 3 months. The amount of attrition was calculated in relation to the various materials used for the superstructure, and differences were analyzed statistically (P < 0.05). RESULTS Attrition of the implant superstructure was 110 ± 30 µm for monolithic zirconia and 105 ± 27 µm for resin-veneered metal after 12 months. No statistically significant difference was found between the two groups. In contrast, attrition of the antagonists was 75 ± 25 µm for zirconia and 105 ± 20 µm for resin-veneered metal after 12 months. A statistically significant difference in the attrition levels between the two groups was observed after 9 and 12 months. CONCLUSION During the 12-month observation period, there was no difference in superstructure attrition between zirconia and resin-veneered metal. Attrition of the antagonists was higher for hybrid composite resin-veneered metal than for zirconia, suggesting that surface roughness affected the degree of attrition.

Adequate oral status and functional assessments are important for dysphagia rehabilitation in acute care inpatient settings, especially to establish individualised oral intake. However, the association between food intake levels and oral function has not been elucidated in acute care inpatients. This cross-sectional study clarified the association between oral intake levels and the oral status/function of patients with dysphagia admitted to acute care settings. Admitted patients aged ≥40 years (n = 459; men: 288; mean age: 70.8 ± 12.0) examined at the Department of Dysphagia Rehabilitation at the Iwate Medical University Hospital from April 2007 to March 2014 were included. The oral health status was evaluated by the tongue coating, oral dryness severity, plaque control, posterior occlusal support and a repetitive saliva swallowing test (RSST). Dysphagia severity was determined from the Dysphagia Severity Scale. Oral intake levels were evaluated using the Functional Oral Intake Scale (FOIS) at the time of the initial dental examination (FOIS-I), and they were re-evaluated after the revision of levels according to the participants' general condition and oral health status (FOIS-R). Divergence between FOIS-I and FOIS-R was noted in >40% patients. Multiple regression analysis showed significant associations between FOIS-R and consciousness level, activities of daily living, tongue coating, RSST and posterior occlusal support. Patients with dysphagia in acute care settings require detailed assessments of their oral status and function, including swallowing, to determine the most suitable feeding methods and dental interventions to improve oral intake levels.

There exists a close connection between changes occurring in the teeth and those occurring in the jaw during the evolutionary process. In mammals, the roots of teeth are supported, along with periodontal ligaments and alveolar bones by a unique structure termed the gomphosis. In the present study, we performed combined in silico analysis using the information obtained from various DNA microarrays and identified 19 putative tooth root formation-related genes. Furthermore, quantitative PCR was performed on the candidate genes, Chd3 was confirmed as having sufficient expression levels in the early stage of tooth root formation and increased gene expression toward the middle stage. A high degree of Chd3 gene expression was observed in secretory ameloblasts and Hertwig's epithelial root sheath (HERS), but low expression was observed in developing odontoblasts and stellate reticulum. The CHD3 foci were observed in the nucleus of the HERS01a cells. In addition, knockdown experiments using SiChd3 suggested the involvement of Chd3 in the suppression of DNA synthesis. These results suggested that Chd3 plays a role in DNA synthesis in HERS cells for promoting tooth root development.

Purpose One of the most prominent issues in a super-aging society is the rapid increase in dementia patients. Cross-sectional studies in dentistry have indicated that patients with dementia have worse oral health compared to healthy people. The purpose of this study was to clarify the influence of tooth loss on brain structure by comparing the volumes of gray matter (GM) and white matter (WM) between edentulous and dentulous subjects. Methods Subjects were recruited from the Denture Clinic at Iwate Medical University Hospital Dental Center. Experiments were performed on edentulous (5 males, 8 females, 81.8±1.24years) and dentulous subjects (4 males, 7 females, 77.1±4.25years). Patients with dementia were excluded from this study. Brain volumes of GM and WM in edentulous and dentulous subjects were compared using intracranial volume, age, gender and history of hypertension as covariates. Analyzed brain areas were identified by transforming the Montreal Neurological Institute coordinate into the anatomical coordinate in edentulous subjects. Results The analysis of WM structural images found no morphological differences between dentulous and edentulous subjects. However, significant atrophy of GM was observed in the hippocampus, caudate nucleus and temporal pole of the right hemisphere in edentulous subjects. Conclusions The results of this study suggest that tooth loss was a causal factor for volume reduction in brain areas related to memory, learning and cognition.

Purpose The digitization of the dental field has been vigorously promoted in recent years. An impression using an intraoral scanner is considered to significantly change future dental treatment. The purpose of this review is to evaluate accuracy and practicality of various intraoral scanners and verification method of intraoral scanners. Study selection This review was based on articles searched through the MEDLINE and PubMed databases. The main keywords that were employed during the search were “Oral Scanner, Intraoral Scanners, Desktop Scanner, and Digital Impression”. Result It was reported that illuminance and color temperature affected trueness and precision of intraoral scanners. The repeatability of intraoral scanners indicated the possibility of producing fixed prostheses within the range of being partially edentulous. It is considered difficult to use intraoral scanners in fabricating cross-arch fixed prostheses. However, with intraoral scanners, it may be considered possible to fabricate mouth guards and dentures equivalent to those of desktop scanners. Current intraoral scanner scans are considered more comfortable than traditional impressions that use irreversible hydrocolloid and elastomeric impression materials. Conclusion Since the intraoral scanner is an evolving device, further improvement in accuracy is expected in the future. In addition, verification of the accuracy of intraoral scanners must be conducted accordingly.

Natural teeth are supported by connective tissue collagen fibers that insert perpendicularly in the tooth cementum. Perpendicular insertion plays an important role in the maintenance of the junction between the oral epithelium and the periodontal connective tissue. Most titanium dental implant surfaces have no micro or macro structure to support perpendicularly oriented collagen attachment. Without this tight biologic seal to resist bacterial invasion and epithelial downgrowth, progressive bone loss in peri-implantitis is seen around dental implants. The purpose of this study was to establish the perpendicularly oriented collagen attachment to titanium oxide nanotube (TNT), and to assess its binding stability. TNT was prepared on the titanium-surface by anodization. Scanning electron microscopy (SEM) showed a regularly aligned TNT with an average 67 nm-diameter when anodized at 30 V for 3 h. Subsequently, collagen type I (CoI) was electrophoretically fused to anodic TNT in native polyacrylamide gel system where negatively charged CoI-C term was perpendicularly navigated to TNT. SEM and atomic force microscopy (AFM) were used to analyze CoI on the TiO2 and TNT surface. Several tens of nanometers of CoI protrusion were recorded by AFM. These protrusions may be long enough to be priming sites for cell-secreted CoI. CoI laid parallel to the titanium surface when fused by a chemical linker. Binding resistance of CoI against drastic ultrasonication was measured by Fourier-transform infrared spectroscopy attenuated total reflection (FTIR-ATR). The electrophoretically fused CoI in the titanium nanotube (TNT–CoIEPF) showed the significantly greatest binding resistance than the other groups (P

Purpose To determine the appropriate attachment and design of a denture base for mandibular implant overdenture (IOD), the oral mucosa pressure caused by mandibular implant overdentures was measured using edentulous jaw models with various attachments. Methods An experimental edentulous mandibular model with a 1.5-mm thick artificial oral mucosa was used. Two implants were placed at the area equivalent to the bilateral canines of an experimental jaw model. Locator attachments (LA), ball attachments (BA), magnetic attachments (MA), and round-bar attachments (R-BA) were fabricated. Six miniature pressure sensors were placed at the bilateral buccal premolar regions, bilateral buccal shelves, and bilateral lingual molar regions. A precision universal testing machine was used to apply dynamic repetitive loads of 50 N. The load points were the center of the model, which should represent bilateral mastication on both sides (bilateral load), and were equivalent to the left first molar, which should represent unilateral mastication (unilateral load). Statistical analysis was performed using one-way analysis of variance. Multiple comparisons were then performed using the Bonferroni post hoc test. P Results Under the bilateral load condition, the lower oral mucosa pressure value with BA was measured, compared to other attachments at all measurement sites. Under the unilateral load condition, the oral mucosa pressure value of BA was smaller than the other attachments at the measurement site on the loading side. Conclusions BA has exerted the greatest effects on support and bracing, suggesting that, BA is suitable for reducing oral mucosa pressure during mastication.

Purpose We investigated the effects of denture adhesives (cream (Cr), powder (Po), and cushion (Cu)) on growth and adhesive-related morphological transformation of Candida albicans. For this purpose, the numbers of adherent C. albicans, hyphae-specific gene expressions, and the SEM images were examined. Methods Acrylic resin blocks were prepared as controls (Co). Cr, Po, and Cu were thinly spread on the surface of the resin block.C. albicans suspension was seeded on the specimens and incubated at 4 °C for 2 h. The numbers of C. albicans adhering to each specimen at each incubation time period (1, 2, 3, 6, 12, and 24 h) were quantified using real-time RT-PCR. The hyphae-specific genes expressions were examined. The surface of each specimen was observed under the SEM to detect the transformation to the hyphal form. Results The initial adhesion rates in all groups were not statistically significant. The numbers of C. albicans adhering increased with time in all groups, and those adhering to the Cr, Po, and Cu were significantly greater than that adhering to the Co. In the Cr and Po, the hyphal-specific genes expressions were higher after incubation for 6 h. The transformation to the hyphal form was identified in the Cr and Po after incubation for 6 and 12 h. Conclusions The denture adhesives used in this study accelerated the growth of C. albicans. Moreover, the early transformation to the hyphal form on the Cr- and Po-type adhesives was observed, suggesting that we should carefully use Cr- and Po-type adhesives.

The direction of mesenchymal stem cell (MSC) differentiation is regulated by stimulation with various growth factors and cytokines. We recently established MSC lines, [transforming growth factor-β (TGF-β)-responsive SG‑2 cells, bone morphogenetic protein (BMP)-responsive SG‑3 cells, and TGF-β/BMP-non-responsive SG‑5 cells], derived from the bone marrow of green fluorescent protein-transgenic mice. In this study, to compare gene expression profiles in these MSC lines, we used DNA microarray analysis to characterize the specific gene expression profiles observed in the TGF-β-responsive SG‑2 cells. Among the genes that were highly expressed in the SG‑2 cells, we focused on vascular endothelial growth factor (VEGF) receptor 3 (VEGFR3), the gene product of FMS-like tyrosine kinase 4 (Flt4). We found that VEGF-C, a specific ligand of VEGFR3, significantly induced the cell proliferative activity, migratory ability (as shown by Transwell migration assay), as well as the phosphorylation of extracellular signal-regulated kinase (ERK)1/2 in the SG‑2 cells. Additionally, VEGF-C significantly increased the expression of prospero homeobox 1 (Prox1) and lymphatic vessel endothelial hyaluronan receptor 1 (Lyve1), which are lymphatic endothelial cell markers, and decreased the expression of osteogenic differentiation marker genes in these cells. By contrast, TGF-β significantly increased the expression of early-phase osteogenic differentiation marker genes in the SG‑2 cells and markedly decreased the expression of lymphatic endothelial cell markers. The findings of our study strongly suggest the following: i) that VEGF-C promotes the proliferative activity and migratory ability of MSCs; and ii) VEGF-C and TGF-β reciprocally regulate MSC commitment to differentiation into lymphatic endothelial or osteoblastic phenotypes, respectively. Our findings provide new insight into the molecular mechanisms underlying the regenerative ability of MSCs.