Advantages of remimazolam for sedation in impacted tooth extraction.

OBJECTIVES: This study aims to compare the sedative effects of remimazolam and midazolam during impacted tooth extraction to provide a comfortable sedation treatment for patients with dental anxiety. METHODS: A prospective randomized controlled trial was conducted, in which 60 patients undergoing intravenous sedation for mandibular impacted third molar extraction were evenly divided into either the remimazolam or midazolam group. Prior to receiving a nerve blocker, the patients were sedated with remimazolam or midazolam. Various parameters were recorded and analyzed, including onset time, awakening time, recovery time, modified dental anxiety scale (MDAS) scores before and after surgery, patient-doctor satisfaction levels, postoperative side effects within 24 hours, heart rate (HR), and mean arterial pressure (MAP) at different time points. RESULTS: Compared with the midazolam group, patients in the remimazolam group demonstrated significantly shorter onset, awakening, and recovery times as well as lower postoperative MDAS scores and higher levels of patient-doctor satisfaction. Fewer postoperative side effects were reported in the remimazolam group, although the differences were not statistically significant. CONCLUSIONS: The use of remimazolam demonstrates faster onset and recovery, superior efficacy in reducing dental anxiety, and enhanced satisfaction among patients and doctors, thereby presenting distinct advantages for sedation treatment for patients with dental anxiety.

Efficacy of ornidazole for pericoronitis: a meta-analysis and systematic review.

Introduction: Timely and effective treatments of pericoronitis are very important. We aimed to evaluate the role of ornidazole in the treatment of pericoronitis, to provide insights for clinical pericoronitis treatment. Material and methods: The PubMed, Clinical trials, EMBASE, Science Direct, Cochrane Library, China National Knowledge Infrastructure (CNKI), Weipu and Wanfang databases were searched to find randomized controlled trials (RCTs) of ornidazole in the treatment of pericoronitis from the establishment of the database to March 15, 2023. Review Manager 5.3 software was used for meta-analysis. Results: A total of 16 RCTs involving 2004 patients were included. The results of the meta-analysis showed that the effective rate of ornidazole treatment was significantly higher than that of the routine treatment group (RR = 1.22, 95% CI (1.15, 1.29), p < 0.001). Ornidazole treatment was beneficial to reduce the oral bacterial density (MD = -26.13, 95% CI (-32.08, -21.51)), time to pain disappearance (MD = -0.64, 95% CI (-0.92, -0.17)) and time to disappearance of redness and swelling of the teeth crown (MD = -1.45, 95% CI (-2.43, -1.01)) compared to the routine treatment (all p = 0.05). No publication bias was found by the funnel plots and Egger test (p = 0.206). Conclusions: Ornidazole is effective in the treatment of pericoronitis, with more advantages. Still, the effects and safety of ornidazole in the treatment of pericoronitis need to be evaluated by more high-quality RCTs with larger sample sizes.

Construction a Long-Circulating Delivery System of Liposomal Curcumin by Coating Albumin.

Although the bioavailability and stability of curcumin can be greatly improved by liposomes encapsulation, its application is still limited due to the short circulating time. In this present work, we aim to construct a long-circulating delivery system of liposomal curcumin (Cur-Lips) by coating bovine serum albumin (BSA), namely, BSA-coated liposomal curcumin (BSA-Cur-Lips). The effects of coating albumin on the physicochemical properties of Cur-Lips were investigated. It was found that BSA-Cur-Lips was more spherical, more homogeneous in size, and significantly larger than Cur-Lips. Combining sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), Coomassie bright blue staining, and X-ray photoelectron spectroscopy analysis (XPS), we confirmed that albumin molecules were stably located on the surface of BSA-Cur-Lips. In addition, the impacts of the coating albumin on the Cur-Lips release and phagocytosis by mouse macrophages Raw264.7 in vitro were investigated. We found that no significant initial burst drug release effect was observed for both Cur-Lips and BSA-Cur-Lips and the presence of albumin can enhance the liposome structure stability and slow down the release of Cur. More importantly, the macrophage phagocytosis of Cur-Lips was significantly reduced after coating albumin. In conclusion, coating albumin is a promising approach for developing a long-circulating delivery system of liposomal curcumin, and its properties including low phagocytosis, slow drug release, enhanced stability, and nontoxicity give this system great prospects for practical use.

Comparison Between PET-CT-Guided Neck Dissection and Elective Neck Dissection in cT1-2N0 Tongue Squamous Cell Carcinoma.

Objective: Neck management in cT1-2N0 tongue squamous cell carcinoma (SCC) remains controversial. Our goal was to compare the survival difference between PET-CT-guided neck dissection and elective neck dissection (END) for the treatment of cT1-2 tongue SCC. Methods: Patients with surgically treated cT1-2N0 tongue SCC were retrospectively enrolled. These patients were divided into two groups. Group A: The decision of whether to perform neck dissection was mainly based on the results of preoperative PET-CT examinations. Group B: Patients received END treatment without preoperative PET-CT examinations. The study endpoints were regional control (RC) and disease-specific survival (DSS). The Kaplan-Meier method was used to calculate the survival rates. Results: Group A consisted of 66 patients, and 16 patients underwent neck dissection owing to positive PET-CT results. Group B consisted of 169 patients. The 5-year RC rates in group A and group B were 86 and 87%, respectively, and the difference was not significant (p = 0.731). The 5-year DSS rates in group A and group B were 93 and 90%, respectively, and the difference was not significant (p = 0.583). Conclusions: Neck dissection can be safely avoided when the PET-CT scan reveals no neck lymph node involvement.

[Chondrocyte cocultures with stromal vascular fraction of adipose tissue promote cartilage regeneration in vivo].

OBJECTIVE: This study aimed to compare the cartilage regeneration of the stromal vascular fraction (SVF) cells and adipose-derived mesenchymal stem cells (ASCs) cocultured with chondrocytes seeded on the scaffolds. METHODS: The cellular morphologies and proliferation capabilities on the scaffolds were evaluated. The scaffolds with the cocul-ture of ASCs/SVF and chondrocytes were implanted into the full thickness cartilage defective rabbit joints for 10 weeks. RESULTS: The cells seeded into the scaffolds showed good adhesion and proliferation. Implantation with SVF and chondrocytes revealed desirable in vitro healing outcomes. CONCLUSIONS: The SVF cells were better than ASCs in terms of the formation of cartilage matrix in a coimplantation model. Without in vitro expansion, the SVF cells are good cell sources for cartilage repair.

Significance of PET-CT for Detecting Occult Lymph Node Metastasis and Affecting Prognosis in Early-Stage Tongue Squamous Cell Carcinoma.

Objective: We aimed to clarify the significance of PET-CT for detecting occult lymph node metastasis and for affecting prognosis in early-stage tongue squamous cell carcinoma (SCC). Methods: Patients with surgically treated primary cT1-2N0 tongue SCC who agreed to undergo a preoperative PET-CT scan were prospectively enrolled. The primary study outcomes were occult neck lymph node metastasis and locoregional control (LRC). The Kaplan-Meier method was used to analyze the LRC rate, and then the factors that were significant in the Kaplan-Meier method were assessed in the Cox model to determine the independent factors. Results: A total of 135 patients were included, and the median maximum standardized uptake value (SUV max) of the primary tumor was 9.0. When analyzing the PET-CT results, 18 patients were recognized as having neck lymph node metastasis, and 12 patients were proven to have pathologic lymph nodes. A total of 117 patients did not have neck lymph node metastasis reported by PET-CT, and five patients were proven to have pathologic lymph nodes. The sensitivity and specificity of PET-CT for predicting occult metastasis were 70.6 and 94.9%, respectively. In patients with an SUV max ≤ 9.0, the 5-year LRC rate was 95%; in patients with an SUV max >9.0, the 5-year LRC rate was 85%, and the difference was significant. Further Cox model analyses confirmed the independence of the SUV max for predicting LRC. Conclusion: PET-CT has a high specificity for predicting occult lymph node metastasis, and an SUV max >9.0 is significantly associated with worse LRC in cT1-2N0 tongue SCC.

Improving the Stability of Liposomal Curcumin by Adjusting the Inner Aqueous Chamber pH of Liposomes.

Curcumin (CURC) is a hydrophobic molecule and its water solubility can be greatly improved by liposome encapsulation. However, investigations on the stability of pH-sensitive molecules incorporated into liposomal membranes are limited. In this study, CURC-loaded liposomes with varied internal pH values (pH 2.5, 5.0, or 7.4) were prepared and designated as CURC-LP (pH 2.5), CURC-LP (pH 5.0), and CURC-LP (pH 7.4). Physical properties including particle size, ζ-potential, morphology, entrapment efficiency, and physical stabilities of these CURC-LPs were assessed. In addition, the chemical stability of liposomal CURC to different external physiological environments and internal microenvironmental pH levels were investigated. We found that among these CURC-LPs, CURU-LP (pH 2.5) has the highest entrapment efficiency (73.7%), the best physical stabilities, and the slowest release rate in vitro. Liposomal CURC remains more stable in an acid external environment. In the physiological environment, the chemical stability of liposomal CURC is microenvironmental pH-dependent. In conclusion, we prove that the stability of liposomal CURC is external physiological environment- and internal microenvironmental pH-dependent. These findings suggest that creating an acidic microenvironment in the internal chamber of liposomes is beneficial to the stability of liposomal CURC, as well as for other pH-sensitive molecules.

Chondrocyte Co-cultures with the Stromal Vascular Fraction of Adipose Tissue in Polyhydroxybutyrate/Poly-(hydroxybutyrate-co-hydroxyhexanoate) Scaffolds: Evaluation of Cartilage Repair in Rabbit.

Chondral defects are challenging to repair because of the poor self-healing capacity of articular cartilage. The aim of this study was to compare and investigate the cartilage regeneration of stromal vascular fraction (SVF) cells and adipose-derived stem cells (ASCs) co-cultured with chondrocytes seeding on scaffolds composed of polyhydroxybutyrate (PHB)/poly-(hydroxybutyrate-co-hydroxyhexanoate) (PHBHHx). In this study, the cellular morphologies and proliferation capabilities on scaffolds were evaluated. Next, scaffolds with 1:1 co-culture of ASCs/SVF and chondrocytes were implanted into the full-thickness cartilage defects in rabbit knee for 10 weeks. Cells seeded on the scaffolds showed better adhesion, migration, and proliferation in vitro. Importantly, implantation with scaffolds with SVF and chondrocytes revealed more desirable in vivo healing outcomes. Our results illustrate a one-step surgical procedure for the regeneration of focal cartilage defects using a mixture of SVF from adipose tissue and uncultured chondrocytes.

Sentinel lymph node biopsy in cN0 neck management of parotid cancer.

Our goals was to evaluate how sentinel lymph node biopsy (SLNB) benefit neck management in patients with parotid cancer. Patients diagnosed with cN0 parotid cancer by preoperative fine needle puncture were prospectively enrolled. The neck status was evaluated by SLNB. If node metastasis was proved by SLNB, a neck dissection of level I-V a was performed, or a wait-and-see policy was conducted for the patient. All related information was extracted and analyzed. Positive SLNB result occurred in 33 (16.7%) patients, and level II metastasis was noted in 100% of the patients. Isolated level III metastasis was noted in 3 (9.1%) patients. During our follow-up with mean time of 49.5 months, 20 patients developed regional recurrence, in which 6 patients had neck dissection as part of their initial management. All the recurrent neck disease was successfully salvaged. Therefore, SLNB was a reliable procedure for neck management in parotid cancer.

Kappa opioid receptor signaling protects cartilage tissue against posttraumatic degeneration.

Osteoarthritis is the most common form of arthritis, and pain relief with opioid-like drugs is a commonly used therapeutic for osteoarthritic patients. Recent studies published by our group showed that the kappa opioid receptor (KOR) is highly expressed during human development in joint-forming cells. However, the precise role of this receptor in the skeletal system remains elusive. The main aim of the current study was to investigate the role of KOR signaling in synovial and cartilaginous tissues in pathological conditions. Our data demonstrate that KOR null mice exhibit accelerated cartilage degeneration after injury when compared with WT mice. Activation of KOR signaling increased the expression of anabolic enzymes and inhibited cartilage catabolism and degeneration in response to proinflammatory cytokines such as TNF-α. In addition, selective KOR agonists increased joint lubrication via the activation of cAMP/CREB signaling in chondrocytes and synovial cells. Taken together, these results demonstrate direct effects of KOR agonists on cartilage and synovial cells and reveals a protective effect of KOR signaling against cartilage degeneration after injury. In addition to pain control, local administration of dynorphin or other KOR agonist represents an attractive therapeutic approach in patients with early stages of osteoarthritis.

Adventitial Cells and Perictyes Support Chondrogenesis Through Different Mechanisms in 3-Dimensional Cultures With or Without Nanoscaffolds.

In previous studies, mesenchymal stromal cells (MSCs) derived from bone marrow and fat tissues were shown to increase proliferation and matrix production of chondrocytes (CH) in co-culture. The aim of this study was to investigate the roles of pericytes (CD31(neg)CD45(neg)CD146+CD34(neg)) and adventitial cells (CD31(neg)CD45(neg)CD146(neg)CD34+) sub-populations of MSCs in supporting proliferation and matrix deposition of CH. The MSCs were derived from synovial membrane and attaching fat tissue. Then, the pericytes and adventitial cells were sorted from total MSCs and co-cultured with articular CH respectively. In pellet co-culture model, the pericytes showed more prominent effects on glycosaminoglycans (GAGs) production and Collagen II synthesis than the adventitial cells which had stronger effects on promoting CH proliferation. In addition, quantitative polymerase chain reaction (qPCR) was performed to examine the expression of a group of secreted growth factors and co-culture performed on electrospun scaffolds based on Poly(3-hydroxybutyrate-co-4-hydroxybutyrate) (P3HB4HB), to verify the trophic effects of different MSC sub-populations in 3-Dimensional (3D) environment. In conclusion, it was found that the pericytes and adventitial cells support CH in different ways; the adventitial cells more supporting the proliferation of CH, while pericytes are better in stimulating GAGs and collagen production of CH.

Electrospun fibers for dental and craniofacial applications.

Electrospinning has been employed extensively in tissue engineering to generate nanofibrous scaffolds from either natural or synthetic biodegradable polymers. Three-dimensional electrospun scaffolds can create a multi-scale environment capable of facilitating cell adhesion, proliferation, and differentiation. One such multi-scale scaffold incorporates nanofibrous features to mimic the extracellular matrix along with a porous network for the regeneration of a variety of tissues. This review will discuss nanofibrous scaffolds and their tissue-engineering applications in bone, cartilage, periodontium, tooth, and incorporated drug delivery systems. Combination with other technologies, electrospun scaffolds can contribute to the field of craniofacial regeneration and advance technology for tissue-engineered replacements in many physiological systems in near future.

[Relationship between dental calcification stages of the third molar and ages among teenagers in Chengdu].

OBJECTIVE: To investigate the relationship between the stages of calcification of the third molar and age among children in Chengdu. METHODS: The study subjects consisted of children between 2009 and 2011 at the Department of Orthodontics, West China Hospital of Stomatology, Sichuan University. Panoramic radiographs were obtained. The stages of calcification of the third molar were analyzed by Demirjian's method. The development of the third molar between the male and female was evaluated by independent samples t-test analysis. The Spearman rank correlation was applied to analyze the stages of calcification of the third molar and chronological age. RESULTS: The development of the third molar of the male was different from that of the female at stage A of calcification of the third molar(P=0.026). The Spearman rank correlation coefficient revealed highly significant relationships between the stages of calcification of the third molar and chronological age of the three groups (male, r=0.808, P=0.000; female, r= 0.729, P=0.000; all, r=0.760, P=0.000). Furthermore, the linear regression equations were established as follows: Yall= 4.898+2.036X: Ymale=4.987+2.046X; Yfemale=4.819+2.036X. CONCLUSION: The stages of calcification of the third molar may be an available indicator in judging chronological age of teenager.

Toxicity of biodegradable nanoscale preparations.

Nowadays, biodegradable nanoscale preparations such as liposomes, micelles, nanoparticles (NPs), and solid lipid nanoparticles (SLN) have attracted increasing attention from major researchers. Meanwhile the biosafety of the nanomaterials brings more and more attention. Toxicity of the biodegradable nanoscale preparations varies depending on their particle size, shape, surface structure, etc. This article aims to review the toxicity of the above-mentioned nanoscale preparations and the relative methodology. It may be significant for successful use of more nanoscale preparations in clinical practice.

[Relationships between dental calcification stages and cervical vertebral bone ages among children and adolescents in Chengdu].

OBJECTIVE: To investigate the relationship between the stages of calcification of various teeth and cervical vertebral bone ages among children and adolescents in Chengdu. METHODS: The study subjects consist of 256 children and adolescents in Chengdu with age ranging from 10 to 16 years. All panoramic radiographs and cephalometric radiographs were obtained. The relationship with the stages of chronological ages, calcification of various teeth and cervical vertebral bone ages were analyzed. RESULTS: The Spearman rank correlation coefficient revealed highly significant relationships between cervical vertebral bone ages and chronological ages (r = 0.726, P < 0.01). Dental ages and chronological ages had medium relationship (r = 0.629, P < 0.01), also dental ages and cervical vertebral bone ages medium relationship (r = 0.668, P < 0.01). CONCLUSION: Cervical vertebral bone ages, chronological ages and dental calcification stages have correlation among children and adolescents in Chengdu. The cervical vertebral bone ages have high connection with chronological ages. Cervical vertebral bone age might be a better indicator in judging growth and development of children and adolescents during orthodontic treatment.

[Morphology of the soft palate in normal individuals when pronouncing: a digital cephalometric study].

OBJECTIVE: To investigate the morphology of the soft palate in normal individuals with digital radiography, when they pronounced the high vowel of "i", and to provide the references for therapy of the cleft palate. METHODS: In this study, the sample comprised 27 normal subjects. With the digital cephalometry, the morphology of the soft palate when pronouncing the high vowel of "i" was observed. And the dimensional difference of the soft palate when pronouncing between different gender was studied. RESULTS: When pronouncing the high vowel of "i", the morphology of the soft palate was like the shape of the knee. And it could be divided into two parts: horizontal and vertical. The length of the vertical part in male group was (24.92 +/- 2.03) mm, the length of the vertical part in the female group was (20.66 +/- 2.77) mm. The length of the vertical part was different between male and female group (P < 0.001). CONCLUSION: The morphology of the palate when pronouncing the high vowel of "i" is similar. And the velar length of the vertical part of the male is longer than the female.

[Effect of nano-granule titanium films on synthesis of osteoblasts].

OBJECTIVE: To compare the synthetic ability of osteoblasts on the surface of different nano-granule titanium films and investigate the correlation between nanophase titanium films and cellular biocompatibility. METHODS: Four different nano-granule titanium films were produced by direct current magnetron sputtering, at ambient, 100 degrees C, 250 degrees C, 380 degrees C substrate temperature, respectively. Rat osteoblasts were seeded on the surface of four treated groups of titanium film samples and non-treated Ti sample(control group). The production of osteocalcin (OC) in all five groups were detected by using double antibody sandwich enzyme-linked immunosorbent assay. RESULTS: The production of OC increased gradually from day 7 to day 14 in all groups. In the control group, it showed significant differences with other five groups on day 7. On day 14, the production of OC in 100 degrees C group was the highest, and it showed significant differences with 380 degrees C, control group and blank group. In 250 degrees C group, the production of OC also showed significant differences with 380 degrees C, control group and blank group (P < 0.05). CONCLUSION: Titanium with nano-modified surface had good biocompatibility and different nano-granule titanium films could affect the synthesis of osteoblasts.