Search

Purpose: To measure the surface temperature distribution after using a CO2 laser to heat titanium dental implants via different power settings, application intervals, and irradiation times. Materials and Methods: A total of 10 tissue-level titanium implants (Screw-Line Promote Plus, Camlog; 4.3 × 11 mm) were placed (EpoFix, Struers) and irradiated with a CO2 laser (Denta 2, Lutronic) with a wavelength of 10.6 µm at power levels of 4 watts (Group 1), 6 watts (Group 2), 8 watts (Group 3), and 10 watts (Group 4). A continuous beam mode (setting I) and noncontinuous beam modes with 5-second (setting II) and 10-second (setting III) pause intervals were used. For each setting, a total irradiation time of 50 seconds was used and repeated 10 times. The temperature was measured using external thermocouple (Testo) in contact with the implant surface at the implant shoulder, middle, and apex. A linear regression model was used to analyze the data (P = .05). Results: Setting I demonstrated the most rapid increase in implant surface temperature in all three test sites as well as the greatest total temperature at 50 seconds of irradiation time. The greater the pause interval (settings II and III) during the 50 seconds of irradiation, the lower the rate of temperature increase as well as the total temperature in all three test sites and with all power levels. The average temperature difference between the apex and shoulder site was significant for setting III for all groups, but not for any groups in settings I and II. Conclusions: Heating the internal aspect of an implant with a CO2 laser produces different temperature distribution profiles depending on the laser power level and the application interval. Laser-beam irradiation leads to a temperature gradient, which is greatest at the implant apex and smallest at the implant shoulder. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the correspondence between output from a new artificial intelligence tool (AIT) and clinician evaluation regarding the immediate loading suitability of dental implants based on insertion torque curves recorded during implant placement in an in vitro test. The secondary aim was to analyze peak insertion torque (PIT) and variable torque work (VTW) values of the implants. Materials and Methods: The study was performed with four different densities of artificial bone blocks of solid rigid polyurethane without a cortical layer. Five types of implants with different macrogeometries were used. A total of 140 implants (7 implants of each type in the four polyurethane blocks) were inserted. Immediately after implant placement, the insertion torque curves were classified by the operator as suitable (S) or nonsuitable (NS) for immediate loading. The same curves were then analyzed by the new AIT, which classified them as belonging to the "YES" or "NO" class. For each implant, PIT and VTW values were also recorded. Results: The correspondence between clinician and AIT evaluation was 99.3%, with only one false negative reported by the algorithm analysis. The AIT was found to have a sensitivity of 98.95%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 97.8%. Mean PIT of the whole sample was 34.19 ± 19.43 Ncm, while mean VTW was 2,266.89 ± 1,993.73 Ncm. Statistically significant differences were found between implant systems in the whole sample and according to density of the polyurethane block. Conclusions: The AIT showed a high level of accuracy in the prediction of immediate loading suitability of dental implants based on the provided insertion torque curves. All the implants used in the in vitro test achieved good levels of primary stability, except when inserted in the least-dense polyurethane block. Clinical studies conducted with larger samples and more clinicians are necessary to confirm these results. [ABSTRACT FROM AUTHOR]

Purpose: To examine the behavior and function of human gingival fibroblasts growing on healing abutments with or without laser-textured topography. Materials and Methods: Human primary gingival connective tissue fibroblasts were cultured on healing abutments with machined or laser-textured (Laser-Lok, BioHorizons) surfaces. Cellular and molecular responses were evaluated by a variety of tests, including cell density assay (WST-1), fluorescence microscopy, real-time quantitative reverse-transcription polymerase chain reaction (qRT-PCR), and detachment tests. Results: The machined surface showed monodirectional traces and scratches from milling, whereas the laser-textured surface showed a distinct morphology consisting of monodirectional mesoscale channels (15-µm pitch) and woven oblique microridges formed within the channels. There were no differences in initial fibroblast attachment, subsequent fibroblast proliferation, or collagen production between the machined and laser-textured surfaces. Fibroblasts growing on a laser-textured surface were found to spread in one direction along the mesochannels, while cells growing on machined surfaces tended to spread randomly. Fibroblasts on laser-textured surfaces were 1.8 times more resistant to detachment than those on machined surfaces. An adhesive glycoprotein (fibronectin) and transmembrane adhesion linker gene (integrin ß-1) were upregulated on laser-textured surfaces. Conclusions: The increased fibroblast retention, uniform growth, and increased transcription of cell adhesion proteins compellingly explain the enhanced tissue-level response to laser-created and hybrid-textured titanium surfaces. These results provide a cellular and molecular rationale for the tissue reaction to this unique surface; in addition, they support its extended use, from implants and healing abutments to diverse prosthetic components where enhanced soft tissue responses would be desirable. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate four decontamination strategies utilizing enzymatic agents available in most clinical settings to determine (1) the amount of biomaterial that can be removed in a group of previously used healing abutments (uHAs) and (2) the degree to which the decontaminated HAs are capable of inducing an inflammatory response in vitro compared to new HAs. Materials and Methods: In total, 50 HAs were collected following 2 to 4 weeks of intraoral use and distributed randomly into five test groups (groups A-E; n = 10 per group). Group A used enzymatic cleaner foam and an autoclave. Group B used an ultrasonic bath with enzymatic cleaner and an autoclave. Group C used a prophy jet, enzymatic cleaner foam, and an autoclave. Group D used a prophy jet, an ultrasonic bath with enzymatic cleaner, and an autoclave. Lastly, group E used a prophy jet and an autoclave. The control group consisted of 10 new and sterile HAs. Residual protein concentration was determined by a Micro BCA protein assay (Thermo Fisher Scientific), while HAs from each group were stained with Phloxine B and macroscopically examined for the presence of debris. To examine the inflammatory potential, human primary macrophages were exposed to HAs, and supernatant levels of nine cytokine and chemokine profiles were analyzed using a multiplex bead assay. Results: All test groups showed differences in the degree of visual decontamination compared to controls. Groups D and E displayed the most effective surface debris removal and reduced protein concentration, while group A was the least effective. However, compared to controls, all test groups showed high levels of inflammatory cytokine secretion via multiplex assay for up to 5 days. Conclusions: Our study found that decontamination of uHAs utilizing enzymatic cleaners failed to reestablish inert HA surfaces and prevent an inflammatory immune response in vitro. Clinicians should not reuse HAs even after attempts to decontaminate and sterilize HA surfaces. [ABSTRACT FROM AUTHOR]

Purpose: To determine the relationship between bone loss that occurs during the peri-implantitis process and variations in implant stability using resonance frequency analysis (RFA) measurement methods. Materials and Methods: Forty selftapping implants were placed in cow ribs, and study scenarios were established according to the affected implant side and bone loss depth (n = 10 implants per group): Case 1 = bone loss on one side (vestibular); Case 2 = bone loss on two opposite sides (buccal and lingual); Case 3 = bone loss on two adjacent sides (buccal and mesial); and Case 4 = foursided bone loss (circumferential). For each group of 10 implants, first a bone loss of 0 mm was evaluated, then 4-mm defects (simulating 1/3 of bone loss) were created and evaluated, and finally 8-mm defects (simulating 2/3 of bone loss) were created and evaluated. Osteotomy measurements were made with a periodontal probe. For each implant, RFA was measured by the same operator using the Beacon system (Osstell). Results: The initial implant stability quotient (ISQ) values of the 40 implants exceeded 70, reflecting an average of 73 in the buccolingual (VL) and 74.8 in the mesiodistal (MD) directions. ISQ measurements in the 10 implants in which bone dehiscence was performed on the vestibular aspect reflected a decrease in ISQ values as bone loss increased. When generating bone loss in two opposite sides (buccal and lingual), a greater decrease in ISQ values was observed when 2/3 of the implant were affected. The average VL ISQ measurement was less than 70 when at sites with 2/3 of bone loss. Conclusions: When bone loss occurs on only one side of the implant, the ISQ values decrease, but the implant maintains good stability. The same occurs when two opposite sides of the implant are affected, as the unaffected side has the least decrease in ISQ value. [ABSTRACT FROM AUTHOR]

Purpose: To assess whether a recently introduced implant placement micromotor that provides site-specific, operatorindependent cancellous bone density measurements can detect the presence of a cortical bone layer and measure its thickness and density. Materials and Methods: An in vitro experiment was performed on six double-layer polyurethane foam blocks mimicking the jawbone with different cortical thickness/cancellous density combinations. The densities were measured using the micromotor after either removing the cortical layer or leaving it intact, both with and without irrigation. Results: The results were compared by means of nonparametric statistical tests. Independent of irrigation, the micromotor detected the cortical layer when it was left intact and accurately estimated its thickness. The micromotor did not discriminate between blocks when they were considered separately, but it did when they were grouped into four or three classes. Conclusions: The present study suggests that the micromotor may represent a valid device to quantitatively assess bone quality and density. If the micromotor can quantitatively distinguish different cortical/cancellous bone combinations in humans, it may be a helpful tool for performing finely tuned, patient-tailored preparations of the implant seat, making tooth rehabilitation in challenging clinical conditions more predictable. [ABSTRACT FROM AUTHOR]

Objectives: White spot lesions are more susceptible to staining agents due to their porous structure. This study examines the impact of white spot lesion treatments on discoloration caused by pediatric supplements. Method and materials: Three treatments (fluoride, casein phosphopeptide-amorphous calcium phosphate [CPP-ACP], resin infiltration), a control, and their respective syrup-based subgroups (iron and black elderberry syrups) were established, each with eight teeth. Artificial white spot lesions were induced, and weekly applications of fluoride varnish, daily applications of CPP-ACP paste, or a single resin infiltration procedure were performed on the white spot lesions within the treatment groups over 4 weeks. Simultaneously, samples were exposed daily to iron or black elderberry syrups. Spectrophotometer measurements were taken at baseline, after demineralization (T0), and after 1 (T1), 2 (T2), and 4 weeks (T4). ΔE00 values were calculated. Statistical analysis was conducted using a three-way mixed-design ANOVA, with the significance level set at P = .05. Results: At T4, ΔE00 values from all groups exceeded the clinical acceptability limit of 1.8. At T2 and T4, the ΔE00 values obtained from the black elderberry syrup subgroups were significantly higher (P < .001). At T4, the highest ΔE00 values were seen in the CPP-ACP groups (P < .001). The lowest ΔE00 values at T2 and T4 were observed in the resin infiltration groups (P < .05). Conclusions: Supplements containing ferrous sulfate and black elderberry extract caused color changes in white spot lesions that exceeded the clinical acceptability limit. Resin infiltration of white spot lesions provides advantages over remineralization treatments, particularly in minimizing discoloration induced by pediatric supplements. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the influence of immediate dentin sealing (IDS) vs delayed dentin sealing (DDS) on the marginal gaps of machinable monolithic zirconia vs pressable lithium disilicate laminate veneers.Materials and Methods: A total of 40 maxillary lateral incisors were used and received butt-joint laminate veneer preparation. The samples were divided into two groups (n = 20 each) according to ceramic material: pressable lithium disilicate ceramic (PLD) was used in the first group, and machinable monolithic zirconia (MMZ) was used in the second. Each group was then divided into two subgroups according to the bonding protocol: IDS was employed in one, and DDS in the other (n = 10 each). The marginal gap widths were measured using digital microscopy and statistically analyzed.Results: The smallest marginal gaps were observed in MMZ-DDS (57.2 ± 8.4 μm), followed by PLD-DDS (62.4 ± 2.7 μm) and MMZ-IDS (63.5 ± 1.9 μm). The largest marginal gaps were observed in PLD-IDS (81.5 ± 6.3 μm). Two-way ANOVA revealed that the bonding technique (P < .001) and ceramic material (P < .001) both showed significant differences.Conclusions: MMZ produced better marginal accuracy than PLD. IDS seems to have a predisposition to significantly wider marginal gaps than DDS, but these gaps are within the clinically acceptable range. The marginal accuracy of ceramic veneers appears to be related to the bonding technique as well as the material of construction. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the precision and efficiency of a novel guide system for single implant placement in the mandibular symphyses and to evaluate whether the outcome is affected by the level of operator experience. Materials and Methods: A total of 90 implants were placed in three different mandibular cast types (Cawood and Howell class III, IV, and V). For each model, a complete denture was 3D printed. A polyether ether ketone rail with a guide sleeve was embedded in the middle of the denture. To determine the ideal implant position, the sleeve could be moved in a buccolingual direction. Adjustment of implant angulation was possible, and an angle correction of 0, 12, or 24 degrees was available. A total of 30 clinicians were divided into three groups: group 1 (experienced, n = 10), group 2 (beginner, n = 10), and group 3 (inexperienced, n = 10). Each clinician was asked to plan and perform a guided flapless implant placement in the mandibular symphysis. Two preoperative CBCT scans were taken; the first was to verify the planning, and the second was to adjust the planning if needed. Finally, a postoperative CBCT scan was taken to compare the planning to the final implant position. Results: Based on the first CBCT, the clinicians adjusted their planning by an average of 1.66 ± 1.65 mm coronally, 2.41 ± 2.44 mm apically, and by a mean angular correction of 6.08 ± 0.77 degrees. After implant placement, the mean deviation from the planned implant position was 0.87 ± 0.58 mm at the coronal aspect and 0.98 ± 0.64 mm at the apical aspect. The mean angular deviation was 6.05 ± 0.71 degrees. Overall, there were no significant differences in coronal and apical deviation (P > .05) based on the level of experience. In terms of angulation, a significant difference was found in both planning (P = .049) and placement (P = .038) between beginners and experienced clinicians. Conclusions: Guided implant placement of a single implant in the mandibular symphysis using a removable denture with guide sleeve had an acceptable level of accuracy. Clinicians with limited experience spent more time on the procedure, resulting in less angular deviation during implant planning and placement compared to experienced clinicians. [ABSTRACT FROM AUTHOR]

Purpose: This in vitro study investigated the effect of implant geometry and diameter on the rotational load fatigue performance of an implant system with an internal conical connection with microthreads. Materials and Methods: Regular (4.2 mm) and wide-diameter (4.8 mm) Astra Tech EV implants with straight (S) and conical (C) geometries were tested with their corresponding titanium abutments, comprising four test groups: 4.2-mm S (Group 1), 4.2-mm C (Group 2), 4.8-mm S (Group 3), and 4.8-mm C (Group 4). Five samples were included in each group. Customized brass implant holders and abutment holders were machined. A rotational load fatigue machine was used to apply a sinusoidally varying load to the implant-abutment interface at an angle of 45 degrees to produce an effective bending moment of 35 Ncm at a frequency of 14 Hz (air temperature: 20°C). The number of cycles to failure was recorded, with the upper limit set at 5 × 106 cycles. Results were analyzed using ANOVA. Failed samples were examined with a scanning electron microscope to evaluate the mode of failure. Results: Of the 20 total samples, 2 failed, with Groups 1 and 2 each reporting one failure. Abutment and abutment screw fracture were observed in the failed sample in Group 1, while implant and abutment screw fracture occurred in the failed sample in Group 2. All wide-diameter implants ran beyond the cut-off without failure, but abutment screw loosening was noted in one sample in Group 3. No significant difference was found between implant groups of different geometries and diameters. Damage to the abutments and the implant internal surface were noted in all failed samples. Conclusions: While no significant differences were found between the test groups, failures were observed only in the regular-diameter group. The abutment and abutment screw fractured deep within the implant, and the implant fractured below the simulated bone level. These modes of failure may pose a significant clinical challenge during retrieval of these components. [ABSTRACT FROM AUTHOR]

This study investigated the effect of erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser conditioning on dentin bond strength and nanoleakage of different universal and self-etch adhesives. A total of 84 intact human third molar teeth were cut at the dentin level, and half of them were laser conditioned. The specimens were divided into three groups; two different universal resins and one self-etch adhesive resin were applied and composite resin restorations were created. For the microtensile bond strength (pTBS) test, 20 microspecimens were prepared from the laser and control group of each adhesive (n = 20) and tested with a universal device. For nanoleakage observation, 10 specimens were prepared from each group (n = 10) and stored in silver nitrate solution, and then the amount of nanoleakage was analyzed by field emission scanning electron microscopy (FESEM). Data were analyzed with two-way ANOVA, Tukey's honestly significant difference, and chi-square tests. The mean dentin bond strength of all adhesives in the laser groups was found to be statistically significantly lower than those of the control groups (P < .05). No difference was found between the mean bond strength of the adhesives in the laser and control groups (P > .05). Higher nanoleakage was observed in all adhesives in the laser groups compared to the control groups (P < .05). Irradiation of the dentin surface with Er,Cr:YSGG could adversely affect the piTBS and nanoleakage, likely by affecting the structure of the hybrid layer. [ABSTRACT FROM AUTHOR]

This article evaluated tooth discoloration after the use of calcium silicate-based materials to examine the effect of internal bleaching on tooth discoloration. The specimens were randomly divided into two experimental groups (n = 45) and a control group (n = 6). Cavities were filled with ProRoot MTA (Dentsply Sirona) in Group 1 and Biodentine (Septodont) in Group 2. Color measurements were taken with a spectrophotometer before and after the application of materials at 1 week, 13 weeks, and 6 months. After 6 months, Groups 1 and 2 were divided into three subgroups according to internal bleaching techniques. All color change ratios and lightness differences were calculated using the CIE L*a*b* system. Data were analyzed using repeated ANOVA and Kruskal-Wallis test (P = .05). There were statistically significant differences between Groups 1 and 2 at all time intervals (P < .05). Group 1 showed more discoloration than Group 2 (P < .05). There were no significant differences between the bleaching agents (P > .05). Additionally, specimens in both groups became lighter than their initial color (P < .05). Teeth treated with ProRoot MTA exhibited darkening at 1 week that increased over time, whereas those treated with Biodentine maintained the lightness for 6 months. [ABSTRACT FROM AUTHOR]

Purpose: To compare the fit of 3D-printed titanium (Ti) and cobalt-chromium (Co-Cr) abutments with implants to computer numerical control (CNC)-milled, ready-made abutment-implant assemblies. Their clinical applicability was also evaluated by measuring removal torque values (RTVs) and percentage torque loss of abutment screws. Materials and Methods: A total of 138 abutments were included in the study: 92 abutments were fabricated with Ti and Co-Cr alloys using computerassisted design (CAD) through selective laser melting, and 46 ready-made abutments were prepared. The fit of interfaces between 90 abutments from the three groups (30 ready-made, 30 3D-printed Ti, and 30 3D-printed Co-Cr abutments) and implant assemblies was demonstrated by scanning electron microscopy (SEM) and confocal scanning laser microscopy (CSLM). After 30-Ncm torque tightening of Ti abutment screws twice within 10 minutes, the RTVs and percentage torque loss of screws of 48 abutments (16 ready-made, 16 3D-printed Ti, and 16 3D-printed Co-Cr) were evaluated after 10 minutes of thermocycling and cyclic loading. Results: The fits of 3D-printed Co-Cr abutments were not statistically different from those of ready-made abutments (P = .383), while the fit of 3D-printed Ti abutments was inadequate (P < .001). The RTVs of 3D-printed abutments after cyclic loading were significantly decreased compared with those of CNC-milled abutments (P < .001). Conclusion: The fit of interfaces between 3D-printed Co-Cr abutments and implants was adequate. The RTVs of 3D-printed Co-Cr abutments were not significantly different from those of CNC-milled abutments after 10 minutes of 30-Ncm torque tightening and thermocycling. [ABSTRACT FROM AUTHOR]

Purpose: To compare the linear and angular deviations of sites prepared for implants with the proposed 3D-printed sliding guide vs a 3D-printed conventional sleeveless static guide. Materials and Methods: This study consisted of two groups: a control group of 14 3D-printed conventional sleeveless static guides, and a test group of 37 3D-printed sliding guides. The guides were designed to drill 37 implant sites in each group. Linear and angular deviations were determined after scanning the drilled casts. Linear deviations were measured at the coronal and apical aspects of the drilled implant sites at 5-, 10-, 15-, and 20-mm distances. Results: There were no significant differences between the control and study groups regarding the coronal and 5-mm apical linear deviations. The angular and 10-, 15-, and 20-mm linear deviations of the 3D-printed sliding guide were significantly smaller than the control group. Conclusions: The proposed 3D-printed sliding guide could reduce the angular deviation of drilled implant sites from the planned positions, which is reflected in reducing the linear apical deviation of prepared implant sites longer than 5 mm. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate differences in the temperature rise at the cervical area of one-piece vs two-piece implants during the setting of relined provisional crowns. Materials and Methods: A K-type thermocouple was fixed to the coronal thread of 15 one-piece implants and 15 two-piece implants that were mounted on a plexiglass apparatus. Baseline temperature (Bl Temp) was recorded before starting the curing process. The maximum temperature (Max Temp) reached during the process in both implant groups was also recorded. Total heat flux (THF) was calculated as well as the thermal amplitude (Temp-Amp) at the implant surface. Finally, the differences between the implant types were compared using unpaired t test. Results: The increase in temperature from baseline was statistically significantly greater in the one-piece implants than in the two-piece implants (P < .01). Similarly, the THF and Temp-Amp were significantly greater in the one-piece implants compared to two-piece implants (P < .01). Conclusions: The polymerization of PMMA-based resin temporary crowns produces a significant temperature rise in both one-piece and two-piece implants. It is advisable to use two-piece implants to restore immediately loaded implants to reduce the risk to implant surroundings that may occur due to the temperature rise at the implant neck. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the incorporation of liquid platelet-rich fibrin in different collagen matrices in vitro. Materials and Methods: Collagen matrices with liquid platelet-rich fibrin were used and divided into the following test groups (n = 5): Mucoderm (MD), Mucograft (MG), and Fibro-Gide (FG). After incubating the collagen matrices in liquid plateletrich fibrin, histologicl and fluid absorption capacity analysis were performed. Intergroup comparisons of cell count, blood plasma penetration area, and fluid absorption capacity were performed using one-way ANOVA and Tukey tests. Intragroup comparisons of fluid absorption capacity were made using the independent t test with a 5% significance level. Results: Descriptive qualitative analysis showed total incorporation of liquid platelet-rich fibrin in the FG group, while the MG and MD groups showed only partial and shallow incorporation, respectively. There was a statistically significant difference among the three groups regarding inflammatory cell infiltration (P = .000), with the FG group presenting the highest number of cells in the matrices (577.15 ± 54.88). The FG group showed an area of total blood plasma penetration into the matrix, followed by the MG group with partial penetration, and the MD group with minor penetration area (P = .000). Considering the fluid absorption capacity analysis, only groups FG and MG were statistically different when comparing the liquid platelet-rich fibrin absorption coefficient (P = .017), with higher absorption in group FG (14.30 ± 3.35). Conclusions: The FG collagen matrix showed a good capacity for liquid platelet-rich fibrin incorporation in vitro. [ABSTRACT FROM AUTHOR]

Purpose: To determine which clinical factors might affect the postimplantoplasty presence of residual threads, platform alterations, and level of surface roughness. Materials and Methods: A total of 60 implants were placed in 20 resin models (10 edentulous maxillary models and 10 partially dentate mandibular models), and 5-mm peri-implant bone defects were created. These models were then placed in simulation mannequins. A single researcher performed the implantoplasties, which were divided into the following groups: favorable situation (FS; maxillary incisors without adjacent teeth), unfavorable situation (US; mandibular molars with adjacent teeth), crown (C; mandibular premolars with a prosthetic crown and adjacent teeth), and noncrown (NC; mandibular premolars with adjacent teeth and without a prosthetic crown). The presence of residual threads, gaps in the implant-abutment interface, and silicone debris was assessed using a scanning electron microscope (SEM), and the surface roughness (Sa and Sz) was analyzed with a confocal optical microscope. A descriptive and bivariate analysis was conducted. Results: The postimplantoplasty surfaces were significantly smoother than the original implant surfaces. The surface roughness was significantly higher in the US group than in the FS group. Gaps in the implant-abutment interface were infrequent (6.67%; 95% CI = 2.62 to 15.93) and only appeared in the posterior zone. The odds ratio for the presence of residual threads and silicone debris (US group vs FS group) was 7.1 (95% CI = 4.15 to 12.14; P < .001) and 5.53 (95% CI = 3.21 to 9.53; P < .001), respectively. When a prosthetic crown was present, residual threads were 7 times more likely to be found (OR = 7.0; 95% CI = 3.5 to 13.99; P < .001). Conclusions: Implantoplasty leads to a significant reduction in the surface roughness of implants but is affected by several variables. Performing implantoplasty on posterior mandibular implants with adjacent teeth seems to be more challenging compared to implants placed in the anterior region of a fully edentulous maxilla. The presence of a prosthetic crown should also be considered as a relevant factor. Furthermore, implantoplasty can sometimes cause gaps in the implant-abutment interface and an accumulation of silicone debris, especially in areas with limited access. [ABSTRACT FROM AUTHOR]

Hyperpolarized13 C magnetic resonance spectroscopy can provide unique insights into metabolic activity in vivo. Despite the advantages of this technology, certain metabolic pathways such as the tricarboxylic acid (TCA) cycle are more challenging to examine due to the limitations associated with currently available hyperpolarized13 C probes. In this report, we systematically employ computational analyses, synthetic techniques, and in vitro studies to facilitate the design of new chemical probes for the TCA cycle. This platform allows for the rapid identification of probe scaffolds that are amenable to hyperpolarized13 C experimentation. Using these results, we have developed two13 C-labeled chemical probes, [1,4-13 C2 ]-dipropyl succinate and [1,4-13 C2 ]-diallyl succinate, which are employed in hyperpolarized13 C metabolic studies. [ABSTRACT FROM AUTHOR]

In this paper, we present the synthesis of four new complexes: the dimeric precursor [Ir(dmppz)2(μ-Cl)]2 (1) (Hdmppz -- 3,5-dimethyl-1-phenyl-1H-pyrazole) and heteroleptic bis-cyclometalated complexes: [Ir(dmppz)2(Py2CO)]PF6•½CH2Cl2 (2), [Ir(dmppz)2(H2biim)]PF6•H2O (3), and [Ir(dmppz)2(PyBIm)]PF6 (4), with auxiliary N,N-donor ligands: 2-di(pyridyl)ketone (Py2CO), 2,2'-biimidazole (H2biim) and 2-(2'-pyridyl)benzimidazole (PyBIm). In the obtained complexes, SC-X-ray analysis revealed that Ir(III) has an octahedral coordination sphere with chromophores of the type {IrN2C2Cl2} (1) or {IrN4C2} (2-4). The complexes obtained, which have been fully characterised by physicochemical methods (CHN, TG, FTIR, UV-Vis, PL and ¹H, 13C, 15N NMR), were used to continue our studies on the factors influencing the cytotoxic properties of potential chemotherapeutic agents (in vitro). To this end, the following studies are presented: (i) comparative analysis of the effects on the biological properties of N,N-donor ligands and C,N-donor ligands in the studied complexes, (ii) studies of the interactions of the compounds with the selected molecular target: DNA and BSA (UV-Vis, CD and PL methods), (iii) and the reactivity towards redox molecules: GSH, NADH (UV-Vis and/or ESI-MS methods), (iv) cytotoxic activity (IC50) of potential chemotherapeutics against MCF-7, K-562 and CCRF-CEM cell lines. [ABSTRACT FROM AUTHOR]

Background: Dermatophytosis, a prevalent fungal infection, often exhibits treatment failure. It poses ongoing public health concerns, urging exploration of alternative treatment strategies. This study examines eucalyptol's in vitro activity and its interaction with antifungal agents against dermatophyte isolates. Methods: Overall, 489 patients clinically suspected of dermatophytosis were investigated, and the causative agents were molecularly identified. The antifungal activity of eucalyptol, itraconazole, terbinafine, and griseofulvin was assessed according to the guideline of the Clinical and Laboratory Standards Institute (CLSI M38 ed3). The interaction between eucalyptol and the aforementioned antifungals was determined using a checkerboard method. Results: Dermatophytosis was confirmed in 30 out of 489 (6.13%) patients, with a female-to-male ratio of 3:2 and an age range of 8–67 years. The most commonly observed clinical manifestation was tinea corporis (34.21%), and Trichophyton indotineae (n = 14, 46%) was the most common causative agent. Antifungal susceptibility testing revealed that eucalyptol exhibited antidermatophyte properties with minimum inhibitory concentrations (MIC) ranging from 0.78 to 25 mg/mL. Itraconazole demonstrated the lowest geometric mean (GM) value (MIC range: 0.0019–0.25 µg/mL, GM: 0.015 µg/mL), while griseofulvin exhibited the highest GM value (MIC range: 0.125–8 µg/mL, GM: 2.37 µg/mL). The in vitro interaction of eucalyptol with antifungal drugs, except for its combination with terbinafine against two Trichophyton tonsurans isolates resulting in synergistic effects, showed indifference (n = 70, 77.77%) and antagonistic types (n = 18, 20%). Conclusion: Among the evaluated antifungals, itraconazole demonstrated the highest effectiveness against clinical isolates, while eucalyptol alone exhibited a more pronounced effect than when combined with antifungal agents. [ABSTRACT FROM AUTHOR]

Background: Bone loss caused by microgravity exposure presents a serious threat to the health of astronauts, but existing treatment strategies have specific restrictions. This research aimed to investigate whether salidroside (SAL) can mitigate microgravity-induced bone loss and its underlying mechanism. Methods: In this research, we used hindlimb unloading (HLU) and the Rotary Cell Culture System (RCCS) to imitate microgravity in vivo and in vitro. Results: The results showed that salidroside primarily enhances bone density, microstructure, and biomechanical properties by stimulating bone formation and suppressing bone resorption, thereby preserving bone mass in HLU rats. In MC3T3-E1 cells cultured under simulated microgravity in rotary wall vessel bioreactors, the expression of osteogenic genes significantly increased after salidroside administration, indicating that salidroside can promote osteoblast differentiation under microgravity conditions. Furthermore, the Nrf2 inhibitor ML385 diminished the therapeutic impact of salidroside on microgravity-induced bone loss. Overall, this research provides the first evidence that salidroside can mitigate bone loss induced by microgravity exposure through stimulating the Nrf2/HO-1 pathway. Conclusion: These findings indicate that salidroside has great potential for treating space-related bone loss in astronauts and suggest that Nrf2/HO-1 is a viable target for counteracting microgravity-induced bone damage. [ABSTRACT FROM AUTHOR]

Background: Beneficial effects from practising a Paleolithic diet as compared to a diabetes diet on weight, waist circumference, satiety, leptin, HbA1c and glucose control in randomised controlled trial participants with type 2 diabetes could be due to lower leptin resistance. Support for this hypothesis comes from an in vitro experiment that showed that digested wheat gluten, which is excluded from a Paleolithic diet, inhibits leptin from binding to its receptor, thus indicating a possible dietary cause of leptin resistance. However, the clinical relevance of the latter finding is unclear since removal of enzyme activity from the gluten digest by heat treatment also abolished leptin binding inhibition. Assessment of leptin binding inhibition in vivo is possible by comparison of total leptin levels with those of 'biologically active' leptin bound to its receptor (bioLep). Objectives: To assess the effects of a Paleolithic diet compared to a diabetes diet on leptin binding inhibition and to replicate our in vitro study. Methods: BioLep and total leptin levels were measured in secondary analysis of fasting plasma samples from our open label random order three plus three-month long cross-over trial performed in 2005–2007, that compared a Paleolithic diet with a diabetes diet in participants with type 2 diabetes without insulin treatment (per protocol). BioLep was also measured in vitro for known recombinant leptin concentrations incubated with a series of concentrations of 10 kDa spin-filtered digested wheat gluten, with or without prior heat treatment, at 100ºC for 30 min and centrifugation. Results: There was no difference between diets when comparing differences between bioLep and total leptin levels and their ratio in the 13 participants, three women and 10 men, aged 52–74 years with a mean BMI of 30 kg/m2 and a mean diabetes duration of eight years. We found no carry-over or period effect for bioLep and total leptin. In vitro, wheat gluten digest inhibited leptin binding in a dose-dependent manner but not after heat treatment. Conclusions: We found no leptin binding inhibition after the Paleolithic or diabetes diet, possibly due to its abolishment from cooking-related heat treatment of wheat gluten. Trial registration: Registered on 14/02/2007 at ClinicalTrials.gov Identifier: NCT00435240. [ABSTRACT FROM AUTHOR]

Transient melting of the duplex‐DNA (B‐DNA) during DNA transactions allows repeated sequences to fold into non‐B‐DNA structures, including DNA junctions and G‐quadruplexes. These noncanonical structures can act as impediments to DNA polymerase progression along the duplex, thereby triggering DNA damage and ultimately jeopardizing genomic stability. Their stabilization by ad hoc ligands is currently being explored as a putative anticancer strategy since it might represent an efficient way to inflict toxic DNA damage specifically to rapidly dividing cancer cells. The relevance of this strategy is only emerging for three‐way DNA junctions (TWJs) and, to date, no molecule has been recognized as a reference TWJ ligand, featuring both high affinity and selectivity. Herein, we characterize such reference ligands through a combination of in vitro techniques comprising affinity and selectivity assays (competitive FRET‐melting and TWJ Screen assays), functional tests (qPCR and Taq stop assays) and structural analyses (molecular dynamics and NMR investigations). We identify novel azacryptands TrisNP‐amphi and TrisNP‐ana as the most promising ligands, interacting with TWJs with high affinity and selectivity. These ligands represent new molecular tools to investigate the cellular roles of TWJs and explore how they can be exploited in innovative anticancer therapies. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Material and Methods Result Conclusion Clinical Implication New shade‐matching devices are available for clinical use, but their accuracy and reliability have not been investigated. This in vitro study compared the accuracy and reliability of a shade‐matching colorimeter (Optishade), a spectrophotometer (VITA Easyshade V), and visual shade matching in simulated clinical conditions.Shade matching was conducted with two digital devices; (Optishade and Vita Easyshade) and the visual shade selection method, with a new 16‐tab Vita Classical shade guide. Shade tabs were placed within a gingival matrix and measurements were taken from the central area of each shade tab enclosed in a black box to simulate the oral cavity. Visual assessments were conducted independently by two examiners. For the reliability assessment, each shade tab was measured 20 times by each examiner. Accuracy was calculated as a percentage of the matching readings with the actual shade per each tab. Data were analyzed with the one‐way ANOVA test (α = 0.05) and Pairwise Comparison (Bonferroni Post hoc Test) to assess accuracy. The reliability evaluation was conducted by comparison between both examiners using mean and standard deviation; by a two‐tailed t‐test for the independent samples for all the three groups included in the study.The shade matching accuracy of Optishade was 97.50%, Vita Easyshade 89.38%, and visual method 62.19%. Statistically, high significant difference in accuracy (p < 0.001) was found when comparing both Optishade and VITA Easyshade with the visual method. Additionally, there was statistically significant difference in accuracy (p < 0.05) when Optishade was compared to Vita Easyshade. The reliability of the Optishade was 99.6% and Vita Easy shade was 99.38%. Statistically, showed no statistically significant difference in the reliability of shade match obtained within the same group when comparing the readings of Examiner 1 and Examiner 2 (p > 0.05).The colorimeter demonstrated the highest accuracy, followed by the spectrophotometer, and the visual shade selection method. Both digital methods investigated in this study showed comparable reliability.The results of this study emphasize the clinical advantage of digital shade‐matching devices over visual shade‐matching. The colorimeter offers high accuracy for shade matching and should be considered to use for shade matching especially with restorations in the esthetic zone. [ABSTRACT FROM AUTHOR]

Background: The accuracy of intraoral scanning is critical for computer-aided design/computer-aided manufacturing workflows in dentistry. However, data regarding the scanning accuracy of various adjacent restorative materials and intraoral scanners are lacking. This in vitro study aimed to evaluate the effect of adjacent restorative material type and CEREC's intraoral scanners on the accuracy of intraoral digital impressions for inlay cavities. Methods: The artificial tooth was prepared with an occlusal cavity depth of 2 mm, a proximal box width at the gingival floor of 1.5 mm, and an equi-gingival margin extended disto-occlusally at the transition line angle on both the lingual and buccal sides for an inlay restoration. The adjacent teeth were veneered with crowns made of gold and zirconia, and an artificial tooth (resin) was utilized as the control group. The inlay cavity and adjacent teeth (Gold, Zirconia, and resin) were scanned 10 times using Chairside Economical Restoration of Esthetic Ceramics (CEREC) Primescan (PS), Omnicam (OC), and Bluecam (BC). A reference scan was obtained using a laboratory scanner (3-shape E3). Scanning was performed according to the manufacturer's instructions, including powder application for the BC group. Standard tesselation language files were analyzed using a three-dimensional analysis software program. Experimental data were analyzed using a two-way analysis of variance and the Tukey's post-hoc comparison test. Results: The restorative materials of the adjacent teeth significantly affected the accuracy of the intraoral digital impressions (p <.05). The zirconia group exhibited the highest trueness deviation, followed by the resin and gold groups, with each demonstrating a statistically significant difference (p <.05). The resin group demonstrated the highest maximum positive deviation and deviation in precision. Gold exhibited the lowest average deviation value for trueness compared with those of the other adjacent restorative materials. Intraoral scanner type significantly influenced the trueness and precision of the scan data (p <.05). The average deviation of trueness according to the intraoral scanner type increased in the following order: BC > PS > OC. The average deviation in precision increased in the following order: PS>OC>BC (p <.05). Conclusion: The restorative materials of the adjacent tooth and the type of intraoral scanner affect the accuracy of the intraoral digital impression. The trueness of the digital images of the BC group, obtained by spraying the powder, was comparable to that of the PS group. Among the adjacent restorative materials, zirconia exhibited the lowest trueness. In contrast, PS demonstrated the highest precision among the intraoral scanners, while resin displayed the lowest precision among the adjacent restorative materials. [ABSTRACT FROM AUTHOR]

Purpose: The original aim of the study was to determine, in a double-blind 3-arm crossover human trial (n = 7), the effect of supplemental levels of iron (25 mg) and zinc (30 mg) on β-carotene (synthetic) bioavailability (10 h postprandial). However, despite the high dose of supplemental β-carotene (15 mg) consumed with the high fat (18 g), dairy-based breakfast test meal, there was a negligible postprandial response in plasma and triglyceride rich fraction β-carotene concentrations. We then systematically investigated the possible reasons for this low bioavailability of β-carotene. Methods: We determined (1) if the supplemental β-carotene could be micellised and absorbed by epithelial cells, using a Caco-2 cell model, (2) if the fat from the test meal was sufficiently bioavailable to facilitate β-carotene bioavailability, (3) the extent to which the β-carotene could have been metabolised and converted to retinoic acid/retinol and (4) the effect of the test meal matrix on the β-carotene bioaccessibility (in vitro digestion) and Caco-2 cellular uptake. Results: We found that (1) The supplemental β-carotene could be micellised and absorbed by epithelial cells, (2) the postprandial plasma triacylglycerol response was substantial (approximately 75–100 mg dL−1 over 10 h), indicating sufficient lipid bioavailability to ensure β-carotene absorption, (3) the high fat content of the meal (approximately 18 g) could have resulted in increased β-carotene metabolism, (4) β-carotene bioaccessibility from the dairy-based test meal was sixfold lower (p < 0.05) than when digested with olive oil. Conclusion: The low β-carotene bioavailability is probably due to a combination of the metabolism of β-carotene to retinol by BCMO1 and interactions of β-carotene with the food matrix, decreasing the bioaccessibility. Trail registration: The human trail was retrospectively registered (ClinicalTrail.gov ID: NCT05840848). [ABSTRACT FROM AUTHOR]

Purpose: Recent advances have led to greater recognition of the role of mitochondrial dysfunction in the pathogenesis of chronic kidney disease (CKD). There has been evidence that CKD is also associated with dysbiosis. Here, we aimed to evaluate whether probiotic supplements can have protective effects against kidney injury via improving mitochondrial function. Methods: An animal model of CKD was induced by feeding C57BL/6 mice a diet containing 0.2% adenine. KBL409, a strain of Lactobacillus acidophilus, was administered via oral gavage at a dose of 1 × 109 CFU daily. To clarify the underlying mechanisms by which probiotics exert protective effects on mitochondria in CKD, primary mouse tubular epithelial cells stimulated with TGF-β and p-cresyl sulfate were administered with butyrate. Results: In CKD mice, PGC-1α and AMPK, key mitochondrial energy metabolism regulators, were down-regulated. In addition, mitochondrial dynamics shifted toward fission, the number of fragmented cristae increased, and mitochondrial mass decreased. These alterations were restored by KBL409 administration. KBL409 supplementation also improved defects in fatty acid oxidation and glycolysis and restored the suppressed enzyme levels involved in TCA cycle. Accordingly, there was a concomitant improvement in mitochondrial respiration and ATP production assessed by mitochondrial function assay. These favorable effects of KBL409 on mitochondria ultimately decreased kidney fibrosis in CKD mice. In vitro analyses with butyrate recapitulated the findings of animal study. Conclusions: This study demonstrates that administration of the probiotic Lactobacillus acidophilus KBL409 protects against kidney injury via improving mitochondrial function. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the effect of plasma‐activated Ringer's lactate solution (PAL) on oral squamous cell carcinoma (OSCC) cells and carcinogenic processes with a particular focus on iron and collagenous matrix formation. Materials and Methods: We used three OSCC cell lines, one keratinocyte cell line, and two fibroblast lines, and cell viability assays, immunoblotting, flow cytometry, and transmission electron microscopy were performed to evaluate the effect and type of cell death. The effect of PAL treatment on lysyl oxidase (LOX) expression was investigated in vitro and in vivo. Tamoxifen‐inducible Mob1a/b double‐knockout mice were used for the in vivo experiment. Results: PAL killed OSCC cells more effectively than the control nontumorous cells and suppressed cell migration and invasion. Ferroptosis occurred and the protein level of LOX was downregulated in cancer cells in vitro and in vivo. Additionally, PAL improved the survival rate of mice and suppressed collagenous matrix formation. Conclusions: We demonstrated that PAL specifically kills OSCC cells and that ferroptosis occurs in vitro and in vivo. Furthermore, PAL can prevent carcinogenesis and improve the survival rate of oral cancer, especially tongue cancer, by changing collagenous matrix formation via LOX suppression. [ABSTRACT FROM AUTHOR]

Objective: Glucocorticoid‐induced tumor necrosis factor receptor superfamily–related protein (GITR), with its ligand (GITRL), plays an important role in CD4+ T cell–mediated autoimmunity. This study aimed to investigate the underlying mechanisms of GITRL in primary Sjögren syndrome (pSS). Methods: Patients with pSS and healthy controls were recruited. Serum GITRL and Th17‐related cytokines were determined. RNA sequencing was performed to decipher key signal pathways. Nonobese diabetes (NOD) mice were adopted as experimental Sjögren models and recombinant adeno‐associated virus (rAAV) transduction was conducted to verify the therapeutic potentials of targeting GITRL in vivo. Results: Serum GITRL was significantly higher in patients with pSS and showed a positive correlation with leukopenia, thrombocytopenia, autoantibodies, lung involvement, and disease activity. Serum GITRL was correlated with Th17‐related cytokines. GITRL promoted the expansion of Th17 and Th17.1 cells. Expansion of granulocyte‐macrophage colony‐stimulating factor positive (GM‐CSF+) CD4+ T cells induced by GITRL could be inhibited by blockade of GITRL. Moreover, GM‐CSF could stimulate GITRL expression on monocytes. RNA sequencing revealed mammalian target of rapamycin complexes 1 (mTORC1) might be the key modulator. The increased phosphorylation of S6 and STAT3 and the expansion of Th17 and Th17.1 cells induced by GITRL were effectively inhibited by rapamycin, suggesting a GITRL–mTORC1–GM‐CSF positive loop in pathogenic Th17 response in pSS. Administration of an rAAV vector expressing short hairpin RNA targeting GITRL alleviated disease progression in NOD mice. Conclusion: Our results identified the pathogenic role of GITRL in exacerbating disease activity and promoting pathogenic Th17 response in pSS through a GITRL–mTORC1–GM‐CSF loop. These findings suggest GITRL might be a promising therapeutic target in the treatment of pSS. [ABSTRACT FROM AUTHOR]

• Paphiopedilum spp. is known as lady slipper orchid. • Embryogenesis in Paphiopedilum spp. can be induced with plant growth regulator. • Development of somatic embryos in Paphiopedilum spp. is the same as zygotic embryos. • The homologous embryo gene RKD4 is present and functional in Paphiopedilum spp. Paphiopedilum spp. is one of the terrestrial orchids that is interesting as an ornamental plant. This orchid flower has a distinctive characteristic, namely its labellum resembles a sac, so it is sought after by ornamental flower collectors because of its uniqueness. This orchid is included in the Appendix I group according to CITES, namely a critical species that is threatened with extinction, so it needs to be conserved both in situ and ex situ. Ex situ conservation can be done by propagating orchids using in vitro culture techniques. The objective of this research is to carry out mass propagation of 3 species of Paphiopedilum spp orchids: P. supardii, P. primulinum, P. glaucophyllum through somatic embryogenesis and to characterize the existence of embryo gene RKD4 homolog in Paphiopedilum orchids. The method is to culture the nodes slices in dark conditions for 2 weeks, and then changed to photoperiod mode 16:8 hours (dark:light) on ½ MS media plus a combination of 2,4-D or NAA with TDZ. The somatic embryo were analyzed anatomically. This method is an improvement over previously reported methods for Paphiopedilum spp. due to its efficiency and reproducibility for conservation. We concluded that ½ MS media with a combination of NAA or 2,4D with TDZ were able to induce somatic embryogenesis. The result show that 3 mg L−1 NAA was the best PGRs for PLBs induction in P. supardii (50 %), 1 mg L−1 2,4-D + 0.5 mg L−1 TDZ was the best PGRs for callus embryogenic induction in P. primulinum (20 %), and 1 mg L−1 NAA was the best PGRs for PLBs induction in P. glaucophyllum (33 %). [ABSTRACT FROM AUTHOR]

Objective: This systematic review aimed to analyze the clinical (survival rate, failure risk, or fracture) and laboratory performance (fracture mode or failure) of rehabilitations of endodontically treated teeth, with and without posts. Materials and Methods: A systematic search was conducted in the Pubmed, Scopus, Web of Science, Embase, Cochrane Library, and OpenGrey databases up to March 2023, according to PRISMA guidelines. In vitro and clinical studies that compared the clinical and laboratory performance of endodontically treated teeth with and without intraradicular posts were included. Studies selection, data extraction, and risk of bias analysis were performed. Results: Thirty‐one in vitro and 7 clinical studies were included. For in vitro studies, fiberglass post (n = 24) was the most mentioned. The follow‐up time of the clinical studies ranged from 1 to 17 years, with the fiber‐reinforced composite post (n = 3) being the most evaluated, and only failure risk proved to be more favorable for using intraradicular posts. Conclusion: Rehabilitations of endodontically treated teeth with and without intraradicular retainers showed no difference in fracture resistance and failure mode, evaluated by in vitro studies. Clinical studies showed no difference in survival rate, but failure risk proved to be more favorable for the use of posts. Clinical Significance: This analysis revealed significant variability between results, however, most laboratory and clinical studies revealed no difference with using the post. Furthermore, it is important to emphasize the need to evaluate the coronary remnant and the general characteristics of the tooth in each situation. [ABSTRACT FROM AUTHOR]

Workers in the iron casting industries are exposed to various chemicals, especially graphite in furnace process. This study aims to investigate the toxic effects of graphite particles on human lung cells. Particle characteristics were confirmed by electron microscope and light scattering. Cell viability and oxidative stress markers were measured. The expression of oxidative repair genes, namely OGG1, MTH1, and ITPA, was evaluated. The average particle size was determined to be 172.1 ± 11.96 nm. The median inhibition concentration (IC50) of graphite particles was 46.75 µg/mL. Notably, 25 and 50 µg/mL concentrations resulted in significant GSH depletion and MDA production. The high concentration of graphite particles (200 µg/mL) led to OGG1 suppression and increased MTH1 expression. Based on these findings, graphite exposure may induce toxicity in human lung cells by increasing oxidative stress. Further research is necessary to fully understand the mechanisms underlying graphite toxicity. [ABSTRACT FROM AUTHOR]

Cognitive impairment is a severe complication of acute respiratory distress syndrome (ARDS). Emerging studies have revealed the effects of pyrrolidine dithiocarbamate (PDTC) on improving surgery-induced cognitive impairment. The major aim of the study was to investigate whether PDTC protected against ARDS-induced cognitive dysfunction and to identify the underlying mechanisms involved. The rat model of ARDS was established by intratracheal instillation of lipopolysaccharide (LPS), followed by treatment with PDTC. The cognitive function of rats was analyzed by the Morris Water Maze, and pro-inflammatory cytokines were assessed by quantitative real-time PCR, enzyme-linked immunosorbent assay, and western blot assays. A dual-luciferase reporter gene assay was performed to identify the relationship between miR-181c and its target gene, TAK1 binding protein 2 (TAB2). The results showed that PDTC improved cognitive impairment and alleviated neuroinflammation in the hippocampus in LPS-induced ARDS model. Furthermore, we demonstrated that miR-181c expression was downregulated in the hippocampus of the ARDS rats, which was restored by PDTC treatment. In vitro studies showed that miR-181c alleviated LPS-induced pro-inflammatory response by inhibiting TAB2, a critical molecule in the nuclear factor (NF)-κB signaling pathway. PDTC improves cognitive impairment in LPS-induced ARDS by regulating miR-181c/NF-κB axis-mediated neuroinflammation, providing a potential opportunity for the treatment of this disease. [ABSTRACT FROM AUTHOR]

Urinary tract infection (UTI) prevention benefits of cranberry intake are clinically validated, especially for women and children. To ensure the benefits of cranberry dietary supplement products, the anti-adhesion activity (AAA) against uropathogenic bacteria is routinely used in in vitro bioassays to determine the activity in whole product formulations, isolated compounds, and ex vivo bioassays to assess urinary activity following intake. D-mannose is another dietary supplement taken for UTI prevention, based on the anti-adhesion mechanism. Compare the relative AAA of cranberry and D-mannose dietary supplements against the most important bacterial types contributing to the pathogenesis of UTI, and consider how certain components potentially induce in vivo activity. The current study used a crossover design to determine ex vivo AAA against both P- and Type 1-fimbriated uropathogenic Escherichia coli of either D-mannose or a cranberry fruit juice dry extract product containing 36 mg of soluble proanthocyanidins (PACs), using bioassays that measure urinary activity following consumption. AAA of extracted cranberry compound fractions and D-mannose were compared in vitro and potential induction mechanisms of urinary AAA explored. The cranberry dietary supplement exhibited both P-type and Type 1 in vitro and ex vivo AAA, while D-mannose only prevented Type 1 adhesion. Cranberry also demonstrated more robust and consistent ex vivo urinary AAA than D-mannose over each 1-week study period at different urine collection time points. The means by which the compounds with in vitro activity in each supplement product could potentially induce the AAA in urines was discussed relative to the data. Results of the current study provide consumers and healthcare professionals with additional details on the compounds and mechanisms involved in the positive, broad-spectrum AAA of cranberry against both E. coli bacterial types most important in UTIs and uncovers limitations on AAA and effectiveness of D-mannose compared to cranberry. [ABSTRACT FROM AUTHOR]

Considering the established pharmacokinetics and toxicity profiles, drug repurposing has emerged as an alternative therapeutic approach for treating cancer. Mefloquine has previously demonstrated inhibitory effects on multiple cancer types. This study aims to explore the impact of mefloquine on nasopharyngeal carcinoma (NPC). We found that mefloquine, at pharmacologically achievable concentrations, displayed anti-NPC activity while sparing normal counterparts. Mefloquine inhibits proliferation and induces death by reducing the levels of Cyclin A2, Bcl-2, and Bcl-xL. Intriguingly, we observed an increase in the levels of the anti-apoptotic protein Mcl-1. Mefloquine exerts its effects on NPC cells by inducing lysosomal-mediated ROS production, and the heightened expression of Mcl-1 is a consequence of ROS generation in mefloquine-treated NPC cells. The combination of an Mcl-1 inhibitor with mefloquine synergistically inhibits NPC growth in mice without causing substantial toxicity. These findings demonstrate the effectiveness and limited toxicity of mefloquine as a monotherapy and in combination with an Mcl-1 inhibitor. Our research underscores the promise of the mefloquine and Mcl-1 inhibitor combination as a potential treatment for NPC. Additionally, the elevation of Mcl-1 is a compensatory response in cells exposed to oxidative stress, offering a potential target to overcome resistance induced by pro-oxidant therapies. [ABSTRACT FROM AUTHOR]

Two series of vanillin derivatives containing 1,3,4-oxadiazole and 1,3-thiazolidin-4-one scaffolds were prepared and evaluated for their antifungal activity. The results revealed that compounds 6j (29.73 μg/ml) and 7a (38.15 μg/ml) displayed excellent inhibitory activity against the spore of Fusarium solani. The inhibitory activity of compound 7d (10.53 μg/ml) against the spore of Alternaria solani was more than 42-fold that of vanillin. Compound 7a (37.54 μg/ml) showed better antifungal activity against the spore of B. cinerea than positive controls. The cytotoxicity assay confirmed that compounds 6k, 7a, and 7d showed good selectivity and less toxicity to normal mammalian cells. [ABSTRACT FROM AUTHOR]

Based on the major components in the leaves, the ashwagandha has been found to exist in several chemotypic forms in India. From the leaves of various accessions of Withania somnifera, which were maintained in our institute, three new steroids namely, 4-acetoxy-20β-hydroxy-1-oxo-witha-2,5,24-trienolide (7), 24,25-dihydro-14α-hydroxy withanolide D (9), 5α,6β,17α,27-tetrahydroxy-1-oxo-witha-2,24-dienolide (12) together with thirteen known withanolides were identified by spectroscopic methods. From the roots and stem of one accession and leaves of another, a new alkyl ester glucoside (4) has also been isolated. The new withanolides 7, 9 and 12 have been tentatively named as withanolide 135 A, withanolide 135B and withanolide 108, respectively. [ABSTRACT FROM AUTHOR]

Aim: Impaired wound healing in patients with diabetes can develop into nonhealing ulcerations. Because bone marrow mesenchymal stem cells (BMSCs) exosomes can promote wound healing, this study aims to investigate the mechanism of BMSCs‐isolated exosomal miR‐221‐3p in angiogenesis and diabetic wound healing. Methods: To mimic diabetes in vitro, human umbilical vein endothelial cells (HUVECs) were subjected to high glucose (HG). Exosomes were derived from BMSCs and identified by transmission electron microscopy (TEM), western blot analysis and dynamic light scattering (DLS). The ability to differentiate BMSCs was assessed via Oil red O staining, alkaline phosphatase (ALP) staining and alizarin red staining. The ability to internalise PKH26‐labelled exosomes was assessed using confocal microscopy. Migration, cell viability and angiogenesis were tested by scratch, MTT and tube formation assays separately. The miRNA and protein levels were analysed by quantitative reverse transcriptase polymerase chain reaction (qRT‐PCR) or western blotting. The relationship among miR‐221‐3p, FOXP1 and SPRY1 was determined using the dual‐luciferase reporter, ChIP and RIP assays. Results: Exosomal miR‐221‐3p was successfully isolated from BMSCs and delivered into HUVECs. HG was found to suppress the angiogenesis, cell viability and migration of HUVECs and exosomal miR‐221‐3p separated from BMSCs inhibited the above phenomenon. FOXP1 could transcriptionally upregulate SPRY1, and the silencing of FOXP1 reversed the HG‐stimulated angiogenesis inhibition, cell viability and migration in HUVECs via the downregulation of SPRY1. Meanwhile, miR‐221‐3p directly targeted FOXP1 and the overexpression of FOXP1 reversed the positive effect of exosomal miR‐221‐3p on HUVEC angiogenesis. Conclusion: Exosomal miR‐221‐3p isolated from BMSCs promoted angiogenesis in diabetic wounds through the mediation of the FOXP1/SPRY1 axis. Furthermore, the findings of this study can provide new insights into probing strategies against diabetes. [ABSTRACT FROM AUTHOR]

Background: Occlusal contacts can be stained and thereby visualised employing occlusal indicators. Qualitative and quantitative indicators are differentiated. The hybrid system OccluSense supposedly combines analogue contact marking and digital registration of contacts. The reliability and validity of its contact marking have not yet been validated. Objectives: The aim of this controlled randomised in‐vitro study was to examine the reliability and validity of analogue contact staining with OccluSense compared to Arti‐Fol and the reference standard Gnatho‐Film. Materials and Methods: An experimental apparatus was designed to simulate static occlusion. The occlusal contacts were stained 50 times with Gnatho‐Film to determine the average number and location of contacts registered. For comparison, the contacts were pre‐stained with Gnatho‐Film and then registered with Arti‐Fol or OccluSense 50 times each. Every staining was statistically evaluated and compared to Gnatho‐Film alone, regarding the number and location of contacts. Based on the observed characteristic staining behaviour of OccluSense, a modified evaluation strategy was developed for its colour markings (OccluSense (mod.)). Results: Both evaluations of OccluSense determine that the same number of contacts was registered in over 94% of all cases. Neither OccluSense nor Arti‐Fol stain the exact same number of contacts as Gnatho‐Film, but the modified evaluation OccluSense (mod.) did improve the results for validity. Conclusion: When employing the modified evaluation strategy, OccluSense staining achieves similar reliability and validity as the reference standard. Pre‐colouring of occlusal contacts with Gnatho‐Film and the modified evaluation strategy, might become standard for analysing occlusal contacts stained by OccluSense in the future. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to present optimized device‐specific low‐dose cone‐beam computed tomography (CBCT) protocols with sufficient image quality for pre‐surgical diagnostics and three‐dimensional (3D) modelling of cleft defects. Methods: Six paediatric skulls were acquired, and an artificial bony cleft was created. A high‐resolution CBCT scan acted as a reference standard (Accuitomo 170, Morita, Kyoto, Japan) for comparing eight low‐dose protocols of Newtom VGi‐evo (QR Verona, Cefla, Verona, Italy), which included Eco and Regular protocols with different field of views (FOVs). Delineation of lamina dura, cementoenamel junction (CEJ), trabecular bone and bony bridge were assessed. A 3D model of the defect was also evaluated. Result: The dose area product of low‐dose protocols ranged from 31 to 254 mGy*cm2. Despite the dose difference of up to eight times between applied protocols, trabecular bone and CEJ exhibited appropriate image quality in all scans. However, Regular small FOV protocols (5 × 5 and 8 × 5 cm2), for both lamina dura and bony bridge, demonstrated a significant improvement in image quality compared to Eco FOV counterparts. Based on 3D defect analysis, no significant difference existed between low‐dose protocols and the reference standard. Conclusion: The findings highlight the possibility of achieving a considerable reduction (up to eight times) in the radiation dose using low‐dose CBCT protocols while maintaining sufficient image quality for assessing anatomical structures and 3D modelling in cleft cases. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Immediate dentin sealing (IDS) was introduced to overcome the disadvantages of delayed dentin sealing like pollution of dentin tubules, microleakage, and bond strength destruction over time. The effect of IDS on the bond strength of indirect restorations is still debatable. Purpose: This study was conducted to determine the effect of IDS on the bond strength of ceramic restorations to dentin. Materials and Method: In this systematic review and meta-analysis, the study protocol was registered on the PROSPERO database under the registration number CRD420202014 27. MEDLINE (PubMed), Web of Science, Scopus, and ProQuest databases were searched until January 2021 and updated in January 2022. Worldcat.org and Opengrey.eu, ProQuest dissertation and thesis, and Google Scholar were searched to explore the grey literature. The in vitro studies evaluating the bond strength of ceramic restoration to dentin with and without IDS were included. Seven criteria were assessed to evaluate the risk of bias in the study. Statistical analyses were conducted using RevMan 5.3. The inverse variance method was used to determine the mean difference of micro-tensile bond strength (µTBS) and shear bond strength (SBS). Results: A total of 10 studies (20 datasets) were included in the meta-analysis. Regarding the µTBS analysis, IDS had a significantly higher bond strength than Delayed Dentin Sealing (DDS) (MD:1.16, 95%CI:0.28_2.03, I² =0%). However, no significant difference was found between them in the SBS analysis (MD:0.25, 95%CI: -0.56-1.06, I² =96%). All studies were categorized to have a moderate or high risk of bias. Conclusion: Most in vitro evidence showed favorable results for the effect of IDS on the bond strength and durability of indirect restorations. The adhesive system and the type of ceramic and its treatment before cementation are determining factors. Due to the heterogeneity of the outcomes and studies with a moderate/high risk of bias, the quality of the evidence was low. [ABSTRACT FROM AUTHOR]

Statement of the Problem: During endodontic therapy, irrigation solutions applied in the root canal may affect the physicochemical properties of the dentinal wall, thereby changing its microhardness. This may adversely affect the sealing ability and adhesion of dental materials. Therefore, many studies have focused on the search for an ideal root canal irrigant that has a minimal effect on dentinal microhardness. Purpose: This in vitro study was conducted to determine the changes in dentin microhardness after root canal irrigation with different endodontic irrigants. Materials and Method: Ninety-five freshly extracted maxillary central incisor teeth with straight single canals were selected. These teeth were sectioned transversely at the level of the cementoenamel junction. The working length of each tooth was determined, and canal space was prepared by the HyFlex CM rotary file system. During instrumentation, normal saline was used for irrigation. Then, teeth were split longitudinally into two segments. According to the irrigating solution employed, samples were divided into five groups (n=19): normal saline (Group A), 3% sodium hypochlorite (Group B), 2% chlorhexidine (Group C), 5% calcium hypochlorite (Group D), and 0.2% nanochitosan (Group E).3 mL of the corresponding irrigating solution was administered for total15 minutes in each prepared sample. The Vickers micro-hardness tester was then used to assess micro-hardness. The data was analyzed using one-way analysis of variance (ANOVA). Results: All tested irrigating solutions decreased the dentinal microhardness. Samples irrigated with 5% calcium hypochlorite demonstrated dentinal microhardness of 42.43± 1.62, which is the lowest among all the tested groups, followed by nano chitosan, sodium hypochlorite, and chlorhexidine. Samples treated with control group (saline) demonstrated the maximum microhardness of dentin in the present study. Conclusion: Within the limitations of this research, it can be concluded that the tested novel irrigating solutions, 5% calcium hypochlorite and 0.2% nanochitosan, were more detrimental to radicular dentin microhardness when compared with conventional endodontic irrigants. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Dental caries are among the most common oral and dental diseases affecting adults and children. To prevent caries, either the factors that cause caries should be reduced or the host resistance should be increased. Several compounds, such as bioglass, chitosan, and silver diamine fluoride (SDF), can enhance enamel remineralization. Purpose: This study was conducted to investigate the effects of chitosan, bioglass, chitosan-bioglass, and SDF compounds on remineralizing primary enamel lesions. Materials and Method: In this in vitro study, seventy-two primary canine teeth were collected. The teeth were exposed to a demineralization solution for 72 hours to create primary caries lesions. The primary Vickers microhardness test (VMT) was conducted to measure the initial values. The samples were randomly divided into six groups (n=12): Group 1: bioglass-chitosan solution; Group 2: chitosan; Group 3: bioglass solution; Group 4: SDF; Group 5: remineralization solution; Group 6: distilled water. The solutions of Groups 1, 2, and 3 were applied to the samples for 7 days, while the SDF solution was applied only once. The samples were immersed in an artificial saliva solution, which was refreshed daily. After the treatment, the final Vickers microhardness test (VMT) values were recorded. The data were analyzed statistically using a two-way ANOVA and Tukey's test (p< 0.05). Results: The results indicated a statistically significant effect of remineralizing compounds on both pre-treatment and post-treatment microhardness (p< 0.0001). However, no significant difference in microhardness was observed between the groups studied (p= 0.225). Conclusion: All the compounds utilized in this study demonstrated a significant remineralizing effect on enamel lesions caused by primary caries in primary teeth. The chitosan-bioglass and bioglass groups exhibited the highest levels of remineralization, respectively. However, the comparison between the groups yielded insignificant results due to the dispersion of the samples. Therefore, further studies with larger sample sizes are recommended. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Dental caries and periodontal disease are the most common oral problems. Chemical antibacterial agents often have side effects; thus, researchers have long been in search for organic and herbal products to prevent dental caries and periodontal disease. Purpose: The present study has aimed to assess the effects of Dracocephalum moldavica essential oil on Streptococcus mutans, Streptococcus salivarius, Streptococcus sobrinus, and Lactobacillus acidophilus compared to Chlorhexidine (CHX). Materials and Method: In this in vitro study, the plants were collected from Zanjan Province, Iran. Analysis of the essential oil was carried out by gas chromatography/mass chromatography. Micro-broth dilution and disc diffusion methods were used for assessment of the antimicrobial activity, and minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were evaluated. Results: The mean diameter of the growth inhibition zones in the well plate method for Dracocephalum moldavica showed that it had greater antimicrobial activity against Lactobacillus acidophilus than others (p Value= 0.01). Furthermore, Dracocephalum moldavica had higher antimicrobial activity than CHX. The results of MIC and MBC showed that Dracocephalum moldavica had lower antibacterial activity than CHX. Conclusion: Dracocephalum moldavica essential oil demonstrated antibacterial properties against cariogenic bacteria. Given that other favorable properties of these essential oils are confirmed, they may be suitable for use as antibacterial agents in the formulation of oral healthcare products. [ABSTRACT FROM AUTHOR]

Background Sidestep cutting technique is highly individual and has been shown to influence knee joint loading. However, studies assessing whether individualized technique feedback improves technique and ACL injury-relevant knee joint loads instantly in a sport-specific task are lacking. Purpose To determine the instant effects of individualized augmented technique feedback and instructions on technique and the peak external knee abduction moment (pKAM) in a handball-specific sidestep cut. Additionally, to determine the effects of technique modifications on the resultant ground reaction force and its frontal plane moment arm to the knee joint center. Study Design Controlled laboratory cohort study Methods Three-dimensional biomechanics of 48 adolescent female handball players were recorded during a handball-specific sidestep cut. Following baseline cuts to each side, leg-specific visual and verbal technique feedback on foot strike angle, knee valgus motion, or vertical impact velocity using a hierarchically organized structure accounting for the variables' association with performance was provided. Subsequently, sidestep cuts were performed again while verbal instructions were provided to guide technique modifications. Combined effects of feedback and instructions on technique and pKAM as well as on the resultant ground reaction force and its frontal plane moment arm to the knee joint center were assessed. Results On average, each targeted technique variable improved following feedback and instructions, leading to instant reductions in pKAM of 13.4% to 17.1%. High inter-individual differences in response to feedback-instruction combinations were observed. These differences were evident in both the adherence to instructions and the impact on pKAM and its components. Conclusion Most players were able to instantly adapt their technique and decrease ACL injury-relevant knee joint loads through individualized augmented technique feedback, thereby potentially reducing the risk of injury. More research is needed to assess the retention of these adaptations and move towards on-field technique assessments using low-cost equipment. Level of Evidence: Level 3 [ABSTRACT FROM AUTHOR]

Periprosthetic joint infections (PJIs) are devastating potential complications after arthroplasty surgery with significant therapeutic challenges. Many authors advocate for two-stage revision arthroplasty for PJI of the shoulder which includes explanation with antibiotic spacer placement. The optimal antibiotic/cement combination for PJI in the shoulder is not known. The purpose of this study is to analyze various cement and antibiotic concentrations against Coagulase negative staphylococcus species, S. epidermidis and S. lugdunensis. Five strains of coagulase negative Staph were taken from clinically documented orthopedic infections Both Simplex and Palacos cement were used to create antibiotic laden beads and mixed with either ertapenem, vancomycin, gentamicin, or a combination of ertapenem + vancomycin or ertapenem + gentamicin. The bacteria were plated on lysogeny broth agar plates and 3 beads were added per plate. Samples were analyzed for zone of inhibition at 24 hours, 72 hours, and 1 week. After 1 week, beads were transferred to new plates with bacteria and the process was repeated for 6 weeks. Results showed that ertapenem beads with both Simplex and Palacos cement showed the largest zones of inhibition for all samples. Vancomycin in Palacos cement and vancomycin in combination with ertapenem in Simplex and Palacos cement showed consistent zones of inhibition for the duration of the experiments. Ertapenem in combination with either vancomycin or gentamicin may allow for a powerful initial burst of killing followed by consistent antibiotic elution as opposed to gentamicin alone. While many premade spacers on the market are infused with gentamicin, our in vitro models demonstrate more efficacious bacterial eradication for antibiotics such as ertapenem and vancomycin specifically for certain low virulence organisms that are commonly found in PJI around the shoulder. [ABSTRACT FROM AUTHOR]

Objective: To assess the effects of Thunbergia laurifolia L. extract (TLE) on gestational diabetes mellitus (GDM) in a rat model. Methods: Thunbergia laurifolin L. leaves were subjected to ethanolic extraction. In vivo study, 50 pregnant rats were randomly divided into 5 groups (10 for each): non-GDM group, GDM induced by streptozotocin (STZ, 60 mg/kg i.p.), metformin (MET) 100 mg/kg, TLE 50, and 500 mg/kg groups. Administration was performed on gestation day 7 until term (day 21). The effects of TLE on blood glucose, insulin levels, lipid profiles, liver enzymes, and maternal performances were assessed. In in vitro study, the effect of TLE was examined using the organ bath for uterine force measurement. Results: In in vivo study, TLE significantly reduced blood glucose as compared to GDM (P<0.05) with gradually increased insulin level. This effect was consistent with islets of Langerhans restoration. Histologically, the uterine muscular layer displayed a marked increase in fiber area in response to both doses as compared to GDM (P<0.05). Additionally, TLE significantly reduced total cholesterol, triglyceride, and alanine transaminase levels (P<0.05). Intriguingly, TLE also led to a notable augmentation in gravid uterus size, live fetuses count, and implantation numbers, while significantly reducing the post-implantation loss rate associated with fetal classification (P<0.05). Thus, GDM improvements were close to those produced by MET. In in vitro study, TLE exerted a concentration-dependent inhibition of spontaneous uterine contractility (half-maximal inhibition concentration=1.2 mg/L). This inhibitory effect extended to potassium chloride depolarization and oxytocin-mediated contractions. When combined with its major constituent, rosmarinic acid, TLE produced an enhanced inhibitory effect (P<0.05). Conclusions: TLE ameliorated blood glucose levels, enhanced uterine muscular structure, and improved maternal and fetal performance in GDM. TLE also displayed tocolytic properties. These findings underscore the need for further exploration of TLE as a potential tocolytic agent to mitigate GDM-associated complications. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the effect of mirabegron, a β3‐adrenoceptor agonist with widespread clinical use for treating overactive bladder disease, on isolated healthy human ureter strips. Materials and Methods: This was a prospective study employing a series of in vitro organ bath experiments using ureteral tissues of kidney grafts from 10 healthy donors. The ureteral strips were subjected to cumulative mirabegron concentrations (10−9–10−4.5 M). Effects on frequency or amplitude of spontaneous, 10 mM KCl‐ or EFS‐induced contractions were evaluated. Results: Mirabegron decreased the frequency of spontaneous ureteric contraction in a concentration‐dependent manner. Statistically significant decrease in the frequency of spontaneous contraction was observed at 10−8–10−4.5 M. In 10 mM KCl medium, statistically significant change in frequency was observed at 10−9–10−4.5 M. Statistically significant decrease in the amplitudes of spontaneous contraction was observed at 10−7–10−4.5 M. In a 10 mM KCl medium, statistically significant change in amplitudes was observed at 10−8–10−4.5 M. Conclusions: Mirabegron reduced the amplitude and frequency of human ureter activity in in vitro organ bath studies. This effect was achieved in a dose‐dependent manner on isolated tissue strips. Although monotherapy with mirabegron remains uncertain, this study has the potential to elucidate the mechanism underlying the effectiveness of mirabegron, particularly in combination therapy for ureteral stones. [ABSTRACT FROM AUTHOR]

Based on the major components in the leaves, the ashwagandha has been found to exist in several chemotypic forms in India. From the leaves of various accessions of Withania somnifera, which were maintained in our institute, three new steroids namely, 4-acetoxy-20β-hydroxy-1-oxo-witha-2,5,24-trienolide (7), 24,25-dihydro-14α-hydroxy withanolide D (9), 5α,6β,17α,27-tetrahydroxy-1-oxo-witha-2,24-dienolide (12) together with thirteen known withanolides were identified by spectroscopic methods. From the roots and stem of one accession and leaves of another, a new alkyl ester glucoside (4) has also been isolated. The new withanolides 7, 9 and 12 have been tentatively named as withanolide 135 A, withanolide 135B and withanolide 108, respectively. [ABSTRACT FROM AUTHOR]

Aims Aortic valve calcification (AVC) of surgical valve bioprostheses (BPs) has been poorly explored. We aimed to evaluate in vivo and ex vivo BP AVCs and its prognosis value. Methods and results Between 2011 and 2019, AVC was assessed using in vivo computed tomography (CT) in 361 patients who had undergone surgical valve replacement 6.4 ± 4.3 years earlier. Ex vivo CT scans were performed for 37 explanted BPs. The in vivo CT scans were interpretable for 342 patients (19 patients [5.2%] were excluded). These patients were 77.2 ± 9.1 years old, and 64.3% were male. Mean in vivo AVC was 307 ± 500 Agatston units (AU). The AVC was 562 ± 570 AU for the 183 (53.5%) patients with structural valve degeneration (SVD) and 13 ± 43 AU for those without SVD (P < 0.0001). In vivo and ex vivo AVCs were strongly correlated (r = 0.88, P < 0.0001). An in vivo AVC > 100 AU (n = 147, 43%) had a specificity of 96% for diagnosing Stage 2–3 SVD (area under the curve = 0.92). Patients with AVC > 100 AU had a worse outcome compared with those with AVC ≤ 100 AU (n = 195). In multivariable analysis, AVC was a predictor of overall mortality (hazard ratio [HR] and 95% confidence interval = 1.16 [1.04–1.29]; P = 0.006), cardiovascular mortality (HR = 1.22 [1.04–1.43]; P = 0.013), cardiovascular events (HR = 1.28 [1.16–1.41]; P < 0.0001), and re-intervention (HR = 1.15 [1.06–1.25]; P < 0.0001). After adjustment for Stage 2–3 SVD diagnosis, AVC remained a predictor of overall mortality (HR = 1.20 [1.04–1.39]; P = 0.015) and cardiovascular events (HR = 1.25 [1.09–1.43]; P = 0.001). Conclusion CT scan is a reliable tool to assess BP leaflet calcification. An AVC > 100 AU is tightly associated with SVD and it is a strong predictor of overall mortality and cardiovascular events. [ABSTRACT FROM AUTHOR]