Using old laboratory equipment with modern Web-of-Things standards: a smart laboratory with LabThings Retro.

There has been an increasing, and welcome, open hardware trend towards science teams building and sharing their designs for new instruments. These devices, often built upon low-cost microprocessors and microcontrollers, can be readily connected to enable complex, automated and smart experiments. When designed to use open communication web standards, devices from different laboratories and manufacturers can be controlled using a single protocol and even communicate with each other. However, science labs still have a majority of old, perfectly functional equipment which tends to use older, and sometimes proprietary, standards for communications. In order to encourage the continued and integrated use of this equipment in modern automated experiments, we develop and demonstrate LabThings Retro. This allows us to retrofit old instruments to use modern Web-of-Things standards, which we demonstrate with closed-loop feedback involving an optical microscope, digital imaging and fluid pumping.

3D surface defect map for assessing buccolingual profile of single tooth gaps following alveolar ridge preservation.

AIM: A new, non-invasive approach suggests using single intraoral optical scanning to analyze the ridge profile of single-tooth gaps following alveolar ridge preservation in the absence of a baseline scan. This method involves creating a three-dimensional (3D) surface map to identify and assess contour changes and ridge profiles based on the adjacent teeth. MATERIALS AND METHODS: The present study was designed as a cross-sectional pilot analysis on a convenience sample of patients undergoing alveolar ridge preservation. Intraoral optical scans were taken on 23 patients, capturing data from 30 edentulous sites. The digital models were then imported into an image analysis software for a 3D surface defect map analysis performed by one examiner. This analysis characterized the buccolingual profile of the single tooth gap relative to the adjacent teeth. 10 linear divergence points, spaced 0.5 mm apart in a corona-apical direction, were identified at the midfacial aspect of the sites. Based on these points the sites were plotted and grouped in three different buccolingual profiles (linear, concave, and convex). Clinical parameters including Keratinized mucosa Width (KMW), and soft tissue phenotype with Colorvue biotype probes were also recorded. RESULTS: Three different buccolingual patterns (linear, convex, and concave) were identified. Seven sites exhibited a linear profile, 10 sites displayed a concave shape, and 13 showed a convex profile. The linear profile had surface discrepancies similar to the neighboring teeth. In contrast, the convex profile revealed mid-buccal discrepancy localized only at the crestal aspect, while the concave had an extended divergence ranging from 1 to 5 mm below the soft tissue margin. Univariate and multiple logistic regression analyses did not reveal any statistically significant variables influencing profilometric analysis; however, when combining phenotype and KMW, thick phenotypes demonstrated a higher proportion of concavity (OR = 4.83) compared to thin ones, suggesting a significant trend. With every 1 mm of increase in KMW, the probability of showing a concavity decreased (p = 0.057). CONCLUSION: A 3D surface defect map represents a useful tool for objectively quantifying ridge defects and profiles by assessing profilometric and surface differences compared to adjacent dentition using a single intraoral scan. This method also indicates that KMW may play a critical role in preventing concavity defects. The 3D defect map can guide decision-making during soft tissue augmentation procedures by emphasizing the specific location of the defect and providing more detailed insights into its localization. These parameters can enable the tailoring of flap management and soft tissue grafting strategies to address the patient's individual needs.

The past, present and future of polymicrobial infection research: Modelling, eavesdropping, terraforming and other stories.

Over the last two centuries, great advances have been made in microbiology as a discipline. Much of this progress has come about as a consequence of studying the growth and physiology of individual microbial species in well-defined laboratory media; so-called "axenic growth". However, in the real world, microbes rarely live in such "splendid isolation" (to paraphrase Foster) and more often-than-not, share the niche with a plethora of co-habitants. The resulting interactions between species (and even between kingdoms) are only very poorly understood, both on a theoretical and experimental level. Nevertheless, the last few years have seen significant progress, and in this review, we assess the importance of polymicrobial infections, and show how improved experimental traction is advancing our understanding of these. A particular focus is on developments that are allowing us to capture the key features of polymicrobial infection scenarios, especially as those associated with the human airways (both healthy and diseased).

A Multi-Omics Approach to Disclose Metabolic Pathways Impacting Intestinal Permeability in Obese Patients Undergoing Very Low Calorie Ketogenic Diet.

A very low calorie ketogenic diet (VLCKD) impacts host metabolism in people marked by an excess of visceral adiposity, and it affects the microbiota composition in terms of taxa presence and relative abundances. As a matter of fact, there is little available literature dealing with microbiota differences in obese patients marked by altered intestinal permeability. With the aim of inspecting consortium members and their related metabolic pathways, we inspected the microbial community profile, together with the set of volatile organic compounds (VOCs) from untargeted fecal and urine metabolomics, in a cohort made of obese patients, stratified based on both normal and altered intestinal permeability, before and after VLCKD administration. Based on the taxa relative abundances, we predicted microbiota-derived metabolic pathways whose variations were explained in light of our cohort symptom picture. A totally different number of statistically significant pathways marked samples with altered permeability, reflecting an important shift in microbiota taxa. A combined analysis of taxa, metabolic pathways, and metabolomic compounds delineates a set of markers that is useful in describing obesity dysfunctions and comorbidities.

Echo-intensity characterization at implant sites and novel diagnostic ultrasonographic markers for peri-implantitis.

AIM: To apply high-frequency ultrasound (HFUS) echo intensity for characterizing peri-implant tissues at healthy and diseased sites and to investigate the possible ultrasonographic markers of health versus disease. MATERIALS AND METHODS: Sixty patients presenting 60 implants diagnosed as healthy (N = 30) and peri-implantitis (N = 30) were assessed with HFUS. HFUS scans were imported into a software where first-order greyscale outcomes [i.e., mean echo intensity (EI)] and second-order greyscale outcomes were assessed. Other ultrasonographic outcomes of interest involved the vertical extension of the hypoechoic supracrestal area (HSA), soft-tissue area (STA) and buccal bone dehiscence (BBD), among others. RESULTS: HFUS EI mean values obtained from peri-implant soft tissue at healthy and diseased sites were 122.9 ± 19.7 and 107.9 ± 24.7 grey levels (GL); p = .02, respectively. All the diseased sites showed the appearance of an HSA that was not present in healthy implants (area under the curve = 1). The proportion of HSA/STA was 37.9% ± 14.8%. Regression analysis showed that EI of the peri-implant soft tissue was significantly different between healthy and peri-implantitis sites (odds ratio 0.97 [95% confidence interval: 0.94-0.99], p = .019). CONCLUSIONS: HFUS EI characterization of peri-implant tissues shows a significant difference between healthy and diseased sites. HFUS EI and the presence/absence of an HSA may be valid diagnostic ultrasonographic markers to discriminate peri-implant health status.

Multipad agarose plate: a rapid and high-throughput approach for antibiotic susceptibility testing.

We describe a phenotypic antibiotic susceptibility testing (AST) method that can provide an eightfold speed-up in turnaround time compared with the current clinical standard by leveraging advances in microscopy and single-cell imaging. A newly developed growth plate containing 96 agarose pads, termed the multipad agarose plate (MAP), can be assembled at low cost. Pads can be prepared with dilution series of antibiotics. Bacteria are seeded on the pads and automatically imaged using brightfield microscopy, with a fully automated segmentation pipeline quantifying microcolony formation and growth rate. Using a test set of nine antibiotics with very different targets, we demonstrate that accurate minimum inhibitory concentration (MIC) measurements can be performed based on the growth rate of microcolonies within 3 h of incubation with the antibiotic when started from exponential phase. Faster, reliable and high-throughput methods for AST, such as MAP, could improve patient care by expediting treatment initiation and alleviating the burden of antimicrobial resistance.

Interrogation of RNA-protein interaction dynamics in bacterial growth.

Characterising RNA-protein interaction dynamics is fundamental to understand how bacteria respond to their environment. In this study, we have analysed the dynamics of 91% of the Escherichia coli expressed proteome and the RNA-interaction properties of 271 RNA-binding proteins (RBPs) at different growth phases. We find that 68% of RBPs differentially bind RNA across growth phases and characterise 17 previously unannotated proteins as bacterial RBPs including YfiF, a ncRNA-binding protein. While these new RBPs are mostly present in Proteobacteria, two of them are orthologs of human mitochondrial proteins associated with rare metabolic disorders. Moreover, we reveal novel RBP functions for proteins such as the chaperone HtpG, a new stationary phase tRNA-binding protein. For the first time, the dynamics of the bacterial RBPome have been interrogated, showcasing how this approach can reveal the function of uncharacterised proteins and identify critical RNA-protein interactions for cell growth which could inform new antimicrobial therapies.

Parodontgel® on Wound Healing and Patient-Reported Outcome Measures (PROMs) after Tunneled Coronally Advanced Flap (TCAF).

The adjunctive use of healing gels following periodontal plastic surgery is not common in clinical practice, and no definitive benefits have yet been demonstrated. Case Presentation. A 33-year-old male patient with a central lower incisor class RT1 recession sought treatment due to sensitivity and dissatisfaction with the appearance of his smile. The patient had no history of periodontal disease; however, he was under orthodontic treatment contributing to the gingival recession and irregular gum contours. Treatment. The patient underwent two sequential surgical procedures. Initially, an apically repositioned flap (APF) was performed to correct the frenulum reducing flap tension and improving the gum line aesthetics. Subsequently, after 8 weeks, a tunneled coronally advanced flap (TCAF) was executed to further refine the gum contours and achieve root coverage. Postoperative Healing Protocol. To enhance the healing process and alleviate postoperative discomfort, a healing gel containing hyaluronic acid as the active molecule was applied to the surgical sites. The gel was expected to reduce pain perception and minimize the need for painkiller intake during the critical first week of recovery. The patient was asked to fill a pain chart for the initial 7 days, recording pain levels on a visual analogue scale (VAS 0-10) and the number of paracetamol tablets taken as painkillers. Results. After both the APF and TCAF surgeries, the patient reported pain levels with a mean VAS score of 4.33 and 4.25, respectively. The painkiller intake during the first week was noted to be 3 tablets for the APF and 2 tablets for the TCAF. Notably, the application of the healing gel with hyaluronic acid did not cause any adverse reactions, indicating its potential safety and efficacy in this context. Conclusion. The application of a healing gel containing hyaluronic acid after periodontal plastic surgery showed promising results in reducing postoperative pain and the need for painkillers during the initial week of recovery. However, further investigations through randomized clinical trials are required to establish the potential benefits and broader applicability of such healing gel applications in the context of periodontal plastic surgery.

Impact of keratinized mucosa on implant-health related parameters: A 10-year prospective re-analysis study.

AIM: To investigate whether the lack of keratinized mucosa (KM) affects peri-implant health after 10 years of loading. MATERIALS AND METHODS: Data from 74 patients with 148 implants from two randomized controlled studies comparing different implant systems were included and analyzed. Clinical parameters including bleeding on probing (BOP), probing depth (PD), plaque index, marginal bone loss (MBL), and KM width (KMW) at buccal sites were collected at baseline (time of the final prosthesis insertion), 5-year and 10 years postloading. Multivariable logistic and linear regression models by means of a generalized estimated equation (GEE) were used to evaluate the influence of buccal KM on peri-implant clinical parameters; BOP, MBL, PD, and adjusted for implant type (one-piece or two-piece) and compliance. RESULTS: A total of 35 (24.8%) implants were healthy, 67 (47.5%) had mucositis and 39 (27.6%) were affected by peri-implantitis. In absence of buccal KM (KM = 0 mm), 75% of the implants exhibited mucositis, while in the presence of KM (KMW >0 mm) 41.2% exhibited mucositis. Regarding peri-implantitis, the corresponding percentages were 20% (KM = 0 mm) and 26.7% (KM >0 mm). Unadjusted logistic regression showed that the presence of buccal KM tended to reduce the odds of showing BOP at buccal sites (OR: 0.28 [95% CI, 0.07 to 1.09], p = 0.06). The adjusted logistic regression model revealed that having buccal KM (OR: 0.21 [95% CI, 0.05 to 0.85], p = 0.02) and using two-piece implants (OR: 0.34 [95% CI, 0.15 to 0.75], p = 0.008) significantly reduced the odds of showing BOP. Adjusted linear regression by means of GEE showed that KM and two-piece implants were associated with reduced MBL and MBL changes (p < 0.05). CONCLUSION: The lack of buccal KM appears to be linked with peri-implant parameters such as BOP and MBL, but the association is weak. The design of one-piece implants may account for their increased odds of exhibiting BOP.

Uncovering of transplanted connective tissue graft: Clinical and histological evaluation.

BACKGROUND: Periodontal plastic surgery aims to restore recessions and dehiscence around teeth and implants. Several techniques, such as subepithelial connective tissue graft (CTG), were proposed with the main outcome of improving volume and root coverage. Nevertheless, this surgery might not improve the keratinized tissue width. Thus, the primary aim of this case report was to describe the possible increase in keratinized tissue after a subepithelial CTG and simultaneously use the previously harvested graft as a source for covering an adjacent tooth. METHODS: A 38-year-old patient presented brushing discomfort 2 years after undergoing periodontal plastic surgery with a CTG from the palate to cover a recession. Despite the increased thickness of the soft tissue, brushing discomfort was not reduced because the tissue quality remained unchanged. Therefore, a surgical procedure in the area of teeth 3.2-3.4 was performed to remove the more superficial masticatory mucosa and to induce keratinization of the previously grafted connective tissue. RESULTS: After 6 months, the epithelium appears to be clinically and histologically keratinized, with characteristics comparable to those of the original tissue. CONCLUSIONS: The connective tissue grafted maintains the potential to induce keratinization over time, if it is exposed. KEY POINTS: Why is this case new information? To the best of our knowledge, this is the first case report in the literature with a histological evaluation in a human of the tissue grafted exposed after 2 years. What are the keys to successful management of this case? The graft covered by the alveolar mucosa did not induce keratinization of the epithelium of the overlying mucosa. What are the primary limitations to success in this case? The main limitation of this study is that it is a singular case report.

Risk indicators for gingival recession in the esthetic zone: A cross-sectional clinical, tomographic, and ultrasonographic study.

BACKGROUND: To evaluate the risk indicators associated with midfacial gingival recessions (GR) in the natural dentition esthetic regions. METHODS: Cone-beam computed tomography (CBCT) results of thirty-seven subjects presenting with 268 eligible teeth were included in the cross-sectional study. Clinical measurements included presence/absence of midfacial GR; the depth of the midfacial, mesial, and distal gingival recession; the recession type (RT); keratinized tissue width (KT); and attached gingiva width (AG). Questionnaires were utilized to capture patient-reported esthetics and dental hypersensitivity for each study tooth. Buccal bone dehiscence (cBBD) and buccal bone thickness (cBBT) were measured on the CBCT scans. High-frequency ultrasonography was performed to assess gingival thickness (GT) and buccal bone dehiscence (uBBD). Intraoral optical scanning was obtained to quantify the buccolingual position of each study site (3D profile analysis). Multilevel logistic regression analyses with generalized estimation equations were performed to assess the factors associated with the conditions of interest. RESULTS: The presence of midfacial GR was significantly associated with the history of periodontal treatment for pocket reduction (OR 7.99, p = 0.006), KT (OR 0.62, p < 0.001), cBBD (OR 2.30, p = 0.015), GT 1.5 mm from the gingival margin (OR 0.18, p = 0.04) and 3D profile 1 mm from the gingival margin (OR 1.04, p = 0.001). The depth of midfacial GR was significantly correlated to previous history of periodontal treatment (OR 0.96, p = 0.001), KT (OR -0.18, p < 0.001), presence of bone fenestration (OR 0.24, p = 0.044), and cBBD (OR 0.43, p < 0.001). The depth of midfacial GR was also the only factor associated with patient-reported esthetics (OR -3.38, p = 0.022), while KT (OR 0.77, p = 0.018) and AG (OR 0.82, p = 0.047) were significantly correlated with patient-reported dental hypersensitivity. CONCLUSIONS: Several risk indicators of midfacial and interproximal GR in the esthetic region were identified. The use of imaging technologies allowed for detection of parameters associated with the conditions of interest, and, therefore, their incorporation in future clinical studies is advocated. Ultrasonography could be preferred over CBCT for a noninvasive assessment of periodontal phenotype.

Long-term treatment outcomes of single maxillary buccal peri-implant soft tissue dehiscences: A 10-year prospective study.

INTRODUCTION: To evaluate the 10-year clinical outcomes following surgical treatment of shallow isolated peri-implant soft-tissue dehiscences (PSTD) at single tissue level dental implants. METHODS: The baseline population included 16 patients (16 implants) displaying an isolated peri-implant maxillary buccal soft-tissue dehiscence. The recipient bed was prepared with a minimally-invasive split-thickness flap limited to the buccal aspect to stabilize the tuberosity connective tissue graft (CTG) onto the periosteum. At the end of treatment, patients were enrolled in an individualized supportive peri-implant care (SPC) program. The aesthetic outcome was evaluated on photographs by three clinicians using a visual analog scale (VAS). RESULTS: SPC during the 10-years proceeded uneventfully in all patients. A total of 12 patients completed the 10-year examination, as 3 patients dropped-out and 1 implant was lost. Complete PSTD coverage was obtained at 7 implant sites (i.e., 58%) while the mean PSTD coverage amounted to 89.6% ± 17.1% without statistically significant differences between 1 and 10 years (p > 0.05). Stable peri-implant parameters (i.e., PD and BoP) and full-mouth scores (i.e., FMPS, FMBS) were recorded throughout the observation period (p > 0.05). The aesthetic improvements obtained in the short-term were maintained up to 10 years. CONCLUSION: Within their limits, the present results indicate that the proposed surgical technique is a simple and reliable treatment option for the treatment of single maxillary buccal PSTDs in selected cases with positive results up to 10 years in patients under regular SPC (NCT04983758-this clinical trial was not registered prior to participant recruitment).

Timing of soft tissue augmentation around implants: A clinical review and decision tree.

PURPOSE: The goal of soft tissue augmentation is to improve the volume around implants and thus achieve better aesthetic and functional properties. The present review aims to make recommendations and guide clinicians in performing soft tissue augmentation procedures, focusing on the importance of timing. OVERVIEW: Soft tissue augmentation can be performed at different time points: before or after implant placement, at implant placement (immediate/delayed), at healing abutment connection or after final restoration. Before/after implant placement or at healing abutment connection are considered the gold standard time points at which to perform soft tissue augmentation due to the possibility of achieving complete coverage of the soft tissue graft or its substitute through simple flap elevation and the easy handling of tissue. On the other hand, performing soft tissue augmentation at implant placement or after crown delivery seems to be less predictable due to the different healing approaches and the unexpected shrinkage that occurs. CONCLUSION: Timing needs to be considered when performing soft tissue augmentation, taking into account the advantages and disadvantages related to operator experience, implant position and patient expectations. Employing a reliable approach at the appropriate time of intervention could limit complications.

Doppler ultrasonographic evaluation of tissue revascularization following connective tissue graft at implant sites.

AIM: To assess the Doppler ultrasonographic tissue perfusion at dental implant sites augmented with connective tissue graft (CTG) using coronally advanced flap (CAF) or tunnel technique (TUN). MATERIALS AND METHODS: Twenty-eight patients presenting with isolated healthy peri-implant soft-tissue dehiscence (PSTD) were included in this randomized clinical trial. PSTDs were treated with either CAF + CTG or TUN + CTG. Ultrasound scans were taken at baseline, 1 week, 1 month, 6 months and 12 months. Tissue perfusion at the mid-facial, mesial and distal aspects of the implant sites was assessed by colour Doppler velocity (CDV) and power Doppler imaging (PDI). Early vascularization of the graft and the flap at 1 week and at 1 month were evaluated via dynamic tissue perfusion measurements (DTPMs), including flow intensity (FI), mean perfusion relief intensity (pRI) and mean perfused area (pA). RESULTS: Regression analysis did not reveal significant differences in terms of mid-facial CDV and PDI changes between CAF and TUN over 12 months (p > .05), while significant differences between the two groups were observed at the interproximal areas (p < .001 for both CDV and PDI changes). Higher early DTPMs were observed at the TUN-treated sites in terms of mean FI of the graft (p = .027) and mean FI (p = .024) and pRI of the flap (p = .031) compared with CAF-treated sites at 1 week. Assessment of the FI direction showed that CTG perfusion at 1 week and at 1 month mainly occurred from the flap towards the implant/bone. Early tissue perfusion outcomes were found to be associated with the 12-month mean PSTD coverage and mucosal thickness gain. CONCLUSIONS: Doppler ultrasonography shows tissue perfusion changes occurring at implant sites augmented with CTG. The main differences in tissue perfusion between CAF and TUN were observed at the interproximal sites, with early perfusion associated with clinical and volumetric outcomes at 12 months.

Do soft tissue augmentation techniques provide stable and favorable peri-implant conditions in the medium and long term? A systematic review.

OBJECTIVES: To review the available literature on the medium- and long-term effects of soft tissue augmentation (STA) at implant sites and to explore the effects of the different approaches on clinical-, patient-reported, and health-related parameters. MATERIALS AND METHODS: A comprehensive electronic and manual search was performed to identify prospective clinical studies that assessed the medium- and long-term (≥36 months) outcomes following STA, including number of sites maintaining peri-implant health and number of sites developing peri-implant disease, incidence of complications, stability of the clinical, volumetric, and radiographic parameters, and patient-reported outcome measures (PROMs). RESULTS: Fifteen studies were included in the qualitative analysis. STA was performed with either a bilaminar- or an apically positioned flap (APF) approach, in combination with autogenous grafts (free gingival graft [FGG] and connective tissue graft [CTG]) or substitutes (acellular dermal matrix [ADM] and xenogeneic cross-linked collagen matrix [CCM]). An overall high survival rate was observed. Most of the augmented implant sites maintained peri-implant health in the medium and long term, with the incidence of peri-implant mucositis and peri-implantitis ranging from 0% to 50% and from 0% to 7.14%, respectively. The position of the soft tissue margin following APF + FGG and bilaminar approaches involving CTG or CCM was found to be stable over time. No substantial changes were reported for plaque score/index, bleeding on probing/bleeding index, and probing depth between early time points and following visits. CTG-based STA procedures resulted in a stable or increased dimension of keratinized mucosa width (KMW) and mucosal thickness (MT)/volumetric outcomes over time, when compared with early follow-ups. Most of the included studies described stable marginal bone levels at the grafted implant sites over time. No substantial changes for patient-reported outcomes and professionally assessed esthetic results were reported at different time points. CONCLUSIONS: Implants that received STA showed overall high survival rate and relatively low incidence of peri-implantitis in the medium and long term. Augmented sites seem to maintain the level of soft tissue margin and marginal bone over time, while non-augmented implants may exhibit apical shift of the soft tissue margin. The overall favorable early outcomes obtained with STA are maintained in the medium and long term, with an increase in KMW and MT that may be expected over time at CTG-augmented sites.

The "Iceberg" Connective Tissue Graft Technique for Peri-implant Papilla Augmentation Following Interproximal Bone Reconstruction.

Implants with deficient papillae and black triangle are common findings. The treatment of these esthetic complications is considered challenging, and with limited predictability. Therefore, the aim of the present report is to describe a novel technique for papilla augmentation (the "Iceberg" connective tissue graft [iCTG]) after extraction and interproximal bone reconstruction in the anterior region. A 35-year-old patient presented with a hopeless tooth with interproximal clinical attachment loss extending up the apical third of the adjacent tooth. Interproximal bone reconstruction was performed through alveolar ridge preservation by directly applying recombinant human platelet-derived growth factor-BB (rhPDGF-BB) to the exposed root surface of the adjacent tooth. A mixture of autogenous bone chips (obtained from the ramus) and bovine bone xenograft particles, previously mixed with the growth factor, was also used. The patient was able to come back for implant therapy only 2 years later. An incomplete regeneration of the interproximal bone was observed. Therefore, to compensate the interproximal deficiency, the iCTG approach, involving a double layer CTG with different origins, was utilized. Two small grafts from the tuberosity were sutured to the mesial and distal ends of a wider CTG harvested from the palate, aiming at gaining additional volume at the interproximal sites. The composite graft was then sutured on top of the implant platform, with the flap that was then released and closed by primary intention. After conditioning of the peri-implant tissues, the case was finalized with a satisfactory outcome. The described iCTG could be an effective approach for reconstructing peri-implant papilla following interproximal bone reconstruction.

Efficacy of two diode lasers in the removal of calculus from the root surface: An in vitro study.

INTRODUCTION: Scaling and root planning (SRP) is still the gold standard of nonsurgical periodontal therapy, and it has been accompanied by several supportive therapies in recent years. One of the most studied methods is the diode laser, thanks to its thermal and bactericidal properties. Our trial intended to verify whether it could influence the chemical bond between calculus and the root surface. OBJECTIVES: The aim of the study was to assess the efficacy of the diode laser prior the mechanical removal of calculus in an in vitro application. The reduction in time and the number of strokes required to clean the untreated root surfaces were evaluated as primary outcomes. The pressure was considered as a secondary outcome. METHODS: A total of 75 extracted human teeth with subgingival calculus were assigned equally among three treatment groups (n = 25) according to the size of the occupied areas, which were classified by evaluating the pixel numbers. The groups were assigned to either no pretreatment application (A), Laser Diode Fox III (Sweden & Martina) (B) or Wiser Laser Evolution (Doctor Smile) (C). The weight for instrumentation was calibrated for an After Five curette (Hu-Friedy, Chicago). A new set of tools was used for each group, and the curettes were sharpened after each use with the Sidekick sharpener (Hu-Friedy, Chicago). RESULTS: A Kruskal-Wallis test was used to assess the significance for each considered parameter. The results were statistically significant for each parameter for the two groups where the laser was used compared to the control group. CONCLUSIONS: Despite the limitations of an in vitro study, data showed that the diode laser had an overall positive effect on root debridement, facilitating SRP in terms of stroke count, time, and pressure.

Echo intensity and gray-level co-occurrence matrix analysis of soft tissue grafting biomaterials and dental implants: an in vitro ultrasonographic pilot study.

OBJECTIVE: To characterize different allogeneic and xenogeneic soft tissue graft substitutes and to assess their echo intensity and grayscale texture-related outcomes by using high-frequency ultrasonography (HFUS). METHODS: Ten samples from each of the following biomaterials were scanned using HFUS: bilayered collagen matrix (CM), cross-linked collagen matrix (CCM), multilayered cross-linked collagen matrix (MCCM), human-derived acellular dermal matrix (HADM), porcine-derived acellular dermal matrix (PADM), collagen tape dressing (C) and dental implants (IMPs). The obtained images were then imported in a commercially available software for grayscale analysis. First-order grayscale outcomes included mean echo intensity (EI), standard deviation, skewness, and kurtosis, while second-order grayscale outcomes comprised entropy, contrast, correlation, energy and homogeneity derive from the gray-level co-occurrence matrix analysis. Descriptive statistics were performed for visualization of results, and one-way analysis of variance with Bonferroni post-hoc tests were performed to relative assessments of the biomaterials. RESULTS: The statistical analysis revealed a statistically significant difference among the groups for EI (p < .001), with the group C showing the lowest EI, and the IMP group presenting with the greatest EI values. All groups showed significantly higher EI when compared with C (p < .001). No significant differences were observed for energy, and correlation, while a statistically significant difference among the groups was found in terms of entropy (p < 0.01), contrast (p < .001) and homogeneity (p < .001). IMP exhibited the highest contrast, that was significantly higher than C, HADM, PADM, CCM and CM. CONCLUSIONS: HFUS grayscale analysis can be applied to characterize the structure of different biomaterials and holds potential for translation to in-vivo assessment following soft tissue grafting-related procedures.

Root Coverage and Volumetric Outcomes of a Novel Porcine-Derived Acellular Dermal Matrix with the Tunneled Coronally Advanced Flap (TCAF) for Treatment of Multiple Adjacent Gingival Recessions: A Clinical Prospective Study.

BACKGROUND: Multiple adjacent gingival recessions (MAGRs) are commonly treated with autogenous grafts. However, several intra- and post-surgical complications have been described following autogenous grafts, leading clinicians to explore the use of different biomaterials for the treatment of these conditions. The aim of the present study was to evaluate the root coverage outcomes of a novel porcine-derived acellular dermal matrix (PADM) in combination with the tunneled coronally advanced flap (TCAF) for the treatment of MAGRs. METHODS: Ten patients with 33 type 1 recession defects (RT1) were treated with PADM, in combination with the tunneled coronally advanced flap (TCAF). The outcomes of interest included the mean root coverage (mRC), the frequency of complete root coverage (CRC), changes in keratinized tissue width, volumetric gain at the treated sites assessed with digital intraoral scanning, as well as patient-reported outcome measures. RESULTS: All treated sites healed uneventfully, and no complications were noted throughout the study. At 6 months, a statistically significant reduction in recession was noted at the treated sites, exhibiting an overall mRC of 89.14 ± 19.15% and a CRC of 72.7%. The average volume gain after 6 months was 26.28 ± 11.71 in mm3 (Vol) and 0.63 ± 0.28 in mm (ΔD). The region-specific volumetric analysis revealed an overall higher linear dimensional gain at the Mid-Root aspect (ranging from 0.72 mm to 0.78 mm when assessed 1-4 mm apical to the cemento-enamel junction) compared to the other regions. CONCLUSIONS: The present study presents the clinical and volumetric outcomes of PADM, in combination with TCAF for the treatment of MAGRs. A significant amount of volumetric gain was also observed as a result of the treatment at 6 months, along with satisfactory, esthetic and patient-reported outcomes.

Environmental conditions define the energetics of bacterial dormancy and its antibiotic susceptibility.

Bacterial cells that stop growing but maintain viability and the capability to regrow are termed dormant and have been shown to transiently tolerate high concentrations of antimicrobials. Links between tolerance and cellular energetics as a possible explanation for the tolerance, have been investigated and have produced mixed and seemingly contradictory results. Because dormancy merely indicates growth arrest, which can be induced by various stimuli, we hypothesize that dormant cells may exist in a range of energetic states that depend on the environment. To energetically characterize different dormancies, we first induce them in a way that results in dormant populations and subsequently measure both of their main energy sources, the proton motive force magnitude and the concentration of ATP. We find that different types of dormancy exhibit characteristic energetic profiles that vary in level and dynamics. The energetic makeup was associated with survival to some antibiotics but not others. Our findings portray dormancy as a state that is rich in phenotypes with various stress survival capabilities. Because environmental conditions outside of the lab often halt or limit microbial growth, a typologization of dormant states may yield relevant insights on the survival and evolutionary strategies of these organisms.