Comparing Video Analysis to Computerized Detection of Limb Position for the Diagnosis of Movement Control during Back Squat Exercise with Overload.

Incorrect limb position while lifting heavy weights might compromise athlete success during weightlifting performance, similar to the way that it increases the risk of muscle injuries during resistance exercises, regardless of the individual's level of experience. However, practitioners might not have the necessary background knowledge for self-supervision of limb position and adjustment of the lifting position when improper movement occurs. Therefore, the computerized analysis of movement patterns might assist people in detecting changes in limb position during exercises with different loads or enhance the analysis of an observer with expertise in weightlifting exercises. In this study, hidden Markov models (HMMs) were employed to automate the detection of joint position and barbell trajectory during back squat exercises. Ten volunteers performed three lift movements each with a 0, 50, and 75% load based on body weight. A smartphone was used to record the movements in the sagittal plane, providing information for the analysis of variance and identifying significant position changes by video analysis (p < 0.05). Data from individuals performing the same movements with no added weight load were used to train the HMMs to identify changes in the pattern. A comparison of HMMs and human experts revealed between 40% and 90% agreement, indicating the reliability of HMMs for identifying changes in the control of movements with added weight load. In addition, the results highlighted that HMMs can detect changes imperceptible to the human visual analysis.

Endoscopic treatment of an esophageal perforation in eosinophilic esophagitis by insertion of a self-expanding metal stent.

We present the case of a 29-year-old patient with multiple allergies, mild asthma and rhinoconjunctivitis who reported a history of esophageal impactions after ingestion of solid foods. These episodes resolved spontaneously at home and by self-induced vomiting and never required endoscopic removal. The patient presented to the emergency department due to a sensation of food impaction lasting more than 12 hours after eating meat the night before, which did not subside with the intake of liquids or self-induced vomiting. Endoscopic evaluation was requested for foreign body extraction. A meat bolus impacted in the distal esophagus was easily removed using a Roth basket, revealing a severe esophageal stricture that prevented passage of the endoscope into the gastric cavity. Furthermore, in the same area where the foreign body was previously located, a deep esophageal tear was seen. Given the high suspicion of perforation, the patient was examined, and thoracic and cervical crepitation was observed. It was decided to immediately insert, with only endoscopic control, a partially covered Ultraflex® esophageal stent measuring 18 mm in diameter and 15 cm in length. After insertion, clinical improvement and cessation of crepitation were observed.

Translation and validation into Spanish of the oral health self-efficacy scale in Chilean older adults.

BACKGROUND: Population ageing poses a challenge to improving the well-being of older adults, particularly in terms of oral health. Promoting self-efficacy in oral health behaviours is crucial for maintaining this population's health and quality of life. The Oral Health Self-Efficacy Scale (OHSES) has been widely used to assess dental self-efficacy and is considered comprehensive and reliable. However, there is a need to validate OHSES for Spanish-speaking older adults. This study aimed to assess the reliability and validity of the translated questionnaire for use in the older Chilean population. METHODS: A sample of 188 older adults, aged 60 years and above residing independently in the community, were recruited by accessing databases from the National Senior Citizen Service and various community organisations within the region of La Araucanía. The participants underwent comprehensive oral examinations and oral health interviews, focusing on variables such as OHSES, Oral health-related quality of life (OHIP-14Sp), assessment of remaining teeth, knowledge and attitudes toward oral health, and sociodemographic characteristics. The validity of the translated questionnaire was assessed through translation and cross-cultural adaptation, cognitive debriefing, and face and content validation. The psychometric properties of the questionnaire were evaluated through measures of internal consistency (Cronbach's alpha), content validity (Content validity index), construct validity (factor analysis and Pearson correlation analysis), and test-retest reliability (intraclass correlation). RESULTS: The Spanish version of OHSES demonstrated adequate face and content validity. The confirmatory factor analysis confirmed a two-factor scale with 7 items for a better fit. The scale demonstrated high internal consistency (Cronbach's alpha = 0.821) and acceptable test-retest reliability (ICC = 0.411). Correlations were found between the OHSES score, the number of remaining teeth, knowledge and attitudes towards oral health, and the OHIP-14Sp (p < 0.01). CONCLUSIONS: This study confirms the validity of the Spanish version of the Oral Health Self-Efficacy Scale for older adults in Chile. The scale is expected to be helpful in assessing self-efficacy in dental interventions and collecting data for international comparisons. This research opens new dimensions in patient-reported assessment of oral health.

Molecular Biomarkers in Peri-Implant Health and Disease: A Cross-Sectional Pilot Study.

BACKGROUND: The aim of this feasibility study was to investigate the concentration level of CCL-20/MIP-3α, BAFF/BLyS, IL-23, RANKL, and Osteoprotegerin in the Peri-Implant Crevicular Fluid (PICF), from patients diagnosed with peri-implant mucositis and peri-implantitis, and to compare them with PICF from patients with healthy implants. METHODS: Participants with at least one dental implant with healthy peri-implant tissues, peri-implant mucositis, or peri-implantitis were included. PICF was collected using paper strips from healthy and diseased peri-implant sites (n = 19). Biomarker levels were analyzed using a custom Multiplex ELISA Assay Kit. RESULTS: In comparison to peri-implant health, the peri-implant mucositis group showed an increased concentration of CCL-20 MIP-3α, BAFF/BLyS, IL-23, RANKL, and Osteoprotegerin. The peri-implantitis group had the lowest median concentration of Osteoprotegerin (1963 ng/mL); this group had a similar concentration of RANKL (640.84 ng/mL) when compared to the peri-implant health group. BAFF/BLyS (17.06 ng/mL) showed the highest concentration in the peri-implantitis group. CONCLUSIONS: This feasibility study suggests that IL-23 and RANKL may help to elucidate the pathogenesis during the conversion from peri-implant health to peri-implantitis. Further research is required in BAFF/BLyS for the early diagnosis of peri-implantitis.

The Effect of Microcosm Biofilm Decontamination on Surface Topography, Chemistry, and Biocompatibility Dynamics of Implant Titanium Surfaces.

Since the inception of dental implants, a steadily increasing prevalence of peri-implantitis has been documented. Irrespective of the treatment protocol applied for the management of peri-implantitis, this biofilm-associated pathology, continues to be a clinical challenge yielding unpredictable and variable levels of resolution, and in some cases resulting in implant loss. This paper investigated the effect of microcosm biofilm in vitro decontamination on surface topography, wettability, chemistry, and biocompatibility, following decontamination protocols applied to previously infected implant titanium (Ti) surfaces, both micro-rough -Sandblasted, Large-grit, Acid-etched (SLA)-and smooth surfaces -Machined (M). Microcosm biofilms were grown on SLA and M Ti discs. These were treated with TiBrushes (TiB), combination of TiB and photodynamic therapy (PDT), combination of TiB and 0.2%CHX/1%NaClO, plus or minus Ultraviolet-C (UV-C) radiation. Surface topography was evaluated by Scanning Electron Microscopy (SEM) and Laser Surface Profilometry. Surface function was analysed through wettability analysis. Surface chemistry evaluation of the discs was performed under SEM/Energy-dispersive X-ray spectroscopy (EDX) and X-ray photoelectron spectroscopy (XPS). Biocompatibility was tested with the cytocompatibility assay using human osteoblast-like osteosarcoma cell line (MG-63) cells. Elemental analysis of the discs disclosed chemical surface alterations resulting from the different treatment modalities. Titanium, carbon, oxygen, sodium, aluminium, silver, were identified by EDX as the main components of all the discs. Based on the data drawn from this study, we have shown that following the decontamination of Ti surfaces the biomaterial surface chemistry and topography was altered. The type of treatment and Ti surface had a significant effect on cytocompatibility (p = 0.0001). Although, no treatment modality hindered the titanium surface biocompatibility, parameters such as the use of chemical agents and micro-rough surfaces had a higher cytotoxic effect in MG-63 cells. The use of smooth surfaces, and photofunctionalisation of the TiO2 layer had a beneficial effect on cytocompatibility following decontamination.

Implant-Supported Maxillary and Mandibular Rehabilitation in a Patient With Hallermann-Streiff Syndrome.

ABSTRACT: Hallermann-Streiff syndrome is a rare congenital abnormality involving multiple craniofacial malformations, such as micrognathia, prominent frontal and nasal bones, vision defects, and dental anomalies. In most patients, patients affected with this disease have multiple dental problems involving a severe loss of teeth and maxillary atrophy. Specialized individual and multidisciplinary treatments are often required in these patients. The objective of this report was to demonstrate the rehabilitation approach of a patient with Hallermann-Streiff syndrome using total implant-support prostheses, with optimal aesthetic and functional results, which significantly improved the patient's quality of life.

Herpes simplex virus type 7 and Epstein-Barr virus as strange causes of a gastric ulcer.

Esophageal, gastric and duodenal ulcers are found in immunocompromised patients due to virus, mainly cytomegalovirus (CMV), and less frequently Epstein-Barr virus (EBV), varicella zoster virus (VZV) and herpes simplex virus (HSV) type 1 or 2.

Dasatinib-induced colitis: discovering the side effects of immunotherapy.

The effects of immunotherapy are numerous and are still being discovered. We present a case report of a patient who received dasatinib for chronic myeloid leukemia. A colonoscopy was performed due to a positive fecal occult blood test and colitis was observed. Furthermore, she also had a cytomegalovirus infection. This case highlights the importance to detect cases of immunomodulatory drugs induced colitis by the fecal occult blood test.

Endoscopic Approach to Remove a Dental Implant With Simultaneous Laser-Cystectomy.

BACKGROUND: Removal of dental implants from the maxillary sinus may require surgical treatment of comorbidities. METHOD: Canine fossa endoscopy with an additional laterobasal access originally has been used for flapless sinus floor augmentation. The combined technique is presented to remove a titanium screw from the maxillary sinus. The same portals served for dissection of a mucocele using a diode laser. CONCLUSIONS: The combination of canine fossa endoscopy and laterobasal access allows an appropriate instrumentation and triangulation of the scope for the endoscopically assisted implant removal and dissection of the mucocele.

[Association between chronic periodontitis and rheumatoid arthritis. A systematic review]. / ¿La periodontitis crónica modifica la morbilidad de la artritis reumatoide?: Aspectos clínicos y moleculares. Una revisión sistemática.

Rheumatoid arthritis (RA) and chronic periodontitis (CP) may be related due to a bidirectional etiology. The evidence shows that CP could alter the clinical course of RA. We performed a systematic search to determine if CP alters the morbidity of RA, analyzing its clinical and molecular aspects. Of 552 initial articles found, 16 were selected for a thorough review. There is a greater prevalence of CP in patients with RA. Patients with RA have significantly higher values of periodontal clinical parameters than healthy controls. Arthritis activity is significantly greater in patients who suffer from CP and decreases with nonsurgical periodontal treatment. There is a significant relationship between the severity of CP and RA activity.

Sex, Scavengers, and Chaperones: Transcriptome Secrets of Divergent Symbiodinium Thermal Tolerances.

Corals rely on photosynthesis by their endosymbiotic dinoflagellates (Symbiodinium spp.) to form the basis of tropical coral reefs. High sea surface temperatures driven by climate change can trigger the loss of Symbiodinium from corals (coral bleaching), leading to declines in coral health. Different putative species (genetically distinct types) as well as conspecific populations of Symbiodinium can confer differing levels of thermal tolerance to their coral host, but the genes that govern dinoflagellate thermal tolerance are unknown. Here we show physiological and transcriptional responses to heat stress by a thermo-sensitive (physiologically susceptible at 32 °C) type C1 Symbiodinium population and a thermo-tolerant (physiologically healthy at 32 °C) type C1 Symbiodinium population. After nine days at 32 °C, neither population exhibited physiological stress, but both displayed up-regulation of meiosis genes by ≥ 4-fold and enrichment of meiosis functional gene groups, which promote adaptation. After 13 days at 32 °C, the thermo-sensitive population suffered a significant decrease in photosynthetic efficiency and increase in reactive oxygen species (ROS) leakage from its cells, whereas the thermo-tolerant population showed no signs of physiological stress. Correspondingly, only the thermo-tolerant population demonstrated up-regulation of a range of ROS scavenging and molecular chaperone genes by ≥ 4-fold and enrichment of ROS scavenging and protein-folding functional gene groups. The physiological and transcriptional responses of the Symbiodinium populations to heat stress directly correlate with the bleaching susceptibilities of corals that harbored these same Symbiodinium populations. Thus, our study provides novel, foundational insights into the molecular basis of dinoflagellate thermal tolerance and coral bleaching.

Rapid thermal adaptation in photosymbionts of reef-building corals.

Climate warming is occurring at a rate not experienced by life on Earth for 10 s of millions of years, and it is unknown whether the coral-dinoflagellate (Symbiodinium spp.) symbiosis can evolve fast enough to ensure coral reef persistence. Coral thermal tolerance is partly dependent on the Symbiodinium hosted. Therefore, directed laboratory evolution in Symbiodinium has been proposed as a strategy to enhance coral holobiont thermal tolerance. Using a reciprocal transplant design, we show that the upper temperature tolerance and temperature tolerance range of Symbiodinium C1 increased after ~80 asexual generations (2.5 years) of laboratory thermal selection. Relative to wild-type cells, selected cells showed superior photophysiological performance and growth rate at 31°C in vitro, and performed no worse at 27°C; they also had lower levels of extracellular reactive oxygen species (exROS). In contrast, wild-type cells were unable to photosynthesise or grow at 31°C and produced up to 17 times more exROS. In symbiosis, the increased thermal tolerance acquired ex hospite was less apparent. In recruits of two of three species tested, those harbouring selected cells showed no difference in growth between the 27 and 31°C treatments, and a trend of positive growth at both temperatures. Recruits that were inoculated with wild-type cells, however, showed a significant difference in growth rates between the 27 and 31°C treatments, with a negative growth trend at 31°C. There were no significant differences in the rate and severity of bleaching in coral recruits harbouring wild-type or selected cells. Our findings highlight the need for additional Symbiodinium genotypes to be tested with this assisted evolution approach. Deciphering the genetic basis of enhanced thermal tolerance in Symbiodinium and the cause behind its limited transference to the coral holobiont in this genotype of Symbiodinium C1 are important next steps for developing methods that aim to increase coral bleaching tolerance.

Proteomics links the redox state to calcium signaling during bleaching of the scleractinian coral Acropora microphthalma on exposure to high solar irradiance and thermal stress.

Shipboard experiments were each performed over a 2 day period to examine the proteomic response of the symbiotic coral Acropora microphthalma exposed to acute conditions of high temperature/low light or high light/low temperature stress. During these treatments, corals had noticeably bleached. The photosynthetic performance of residual algal endosymbionts was severely impaired but showed signs of recovery in both treatments by the end of the second day. Changes in the coral proteome were determined daily and, using recently available annotated genome sequences, the individual contributions of the coral host and algal endosymbionts could be extracted from these data. Quantitative changes in proteins relevant to redox state and calcium metabolism are presented. Notably, expression of common antioxidant proteins was not detected from the coral host but present in the algal endosymbiont proteome. Possible roles for elevated carbonic anhydrase in the coral host are considered: to restore intracellular pH diminished by loss of photosynthetic activity, to indirectly limit intracellular calcium influx linked with enhanced calmodulin expression to impede late-stage symbiont exocytosis, or to enhance inorganic carbon transport to improve the photosynthetic performance of algal symbionts that remain in hospite. Protein effectors of calcium-dependent exocytosis were present in both symbiotic partners. No caspase-family proteins associated with host cell apoptosis, with exception of the autophagy chaperone HSP70, were detected, suggesting that algal loss and photosynthetic dysfunction under these experimental conditions were not due to host-mediated phytosymbiont destruction. Instead, bleaching occurred by symbiont exocytosis and loss of light-harvesting pigments of algae that remain in hospite. These proteomic data are, therefore, consistent with our premise that coral endosymbionts can mediate their own retention or departure from the coral host, which may manifest as "symbiont shuffling" of Symbiodinium clades in response to environmental stress.

Dimethylsulfoniopropionate, superoxide dismutase and glutathione as stress response indicators in three corals under short-term hyposalinity stress.

Corals are among the most active producers of dimethylsulfoniopropionate (DMSP), a key molecule in marine sulfur cycling, yet the specific physiological role of DMSP in corals remains elusive. Here, we examine the oxidative stress response of three coral species (Acropora millepora, Stylophora pistillata and Pocillopora damicornis) and explore the antioxidant role of DMSP and its breakdown products under short-term hyposalinity stress. Symbiont photosynthetic activity declined with hyposalinity exposure in all three reef-building corals. This corresponded with the upregulation of superoxide dismutase and glutathione in the animal host of all three species. For the symbiont component, there were differences in antioxidant regulation, demonstrating differential responses to oxidative stress between the Symbiodinium subclades. Of the three coral species investigated, only A. millepora provided any evidence of the role of DMSP in the oxidative stress response. Our study reveals variability in antioxidant regulation in corals and highlights the influence life-history traits, and the subcladal differences can have on coral physiology. Our data expand on the emerging understanding of the role of DMSP in coral stress regulation and emphasizes the importance of exploring both the host and symbiont responses for defining the threshold of the coral holobiont to hyposalinity stress.

Bone grafts utilized in dentistry: an analysis of patients' preferences.

BACKGROUND: Many procedures currently require the use of bone grafts to replace or recover bone volume that has been resorbed. However, the patient's opinion and preferences must be taken into account before implementing any treatment. Researchers have focused primarily on assessing the effectiveness of bone grafts rather than on patients' perceptions. Thus, the aim of this study was to explore patients' opinions regarding the different types of bone grafts used in dental treatments. METHODS: One hundred patients were randomly chosen participated in the study. A standardized survey of 10 questions was used to investigate their opinions regarding the different types of bone grafts used in dental treatments. Descriptive statistics were calculated for the different variables, and absolute frequencies and percentages were used as summary measures. A value of p <0.05 was selected as the threshold for statistical significance. RESULTS: The highest rate of refusal was observed for allografts and xenografts. The grafts with the lowest rates of refusal were autologous grafts (3 %) and alloplastics (2 %). No significant differences were found between the various types of bone grafts in the sociodemographic variables or the refusal/acceptance variable. Similarly, no significant relations were observed between a specific religious affiliation and the acceptance/refusal rates of the various types of graft. CONCLUSIONS: Allografts and xenografts elicited the highest refusal rates among the surveyed patients, and autologous bone and alloplastics were the most accepted bone grafts. Moreover, no differences were found in the sociodemographic variables or religious affiliations in terms of the acceptance/refusal rates of the different bone grafts.

A 3D-Planned Inward Fragmentation Technique for the Removal of Impacted Mandibular Third Molars: A Case Series.

Background/Objectives: The extraction of impacted mandibular third molars (M3Ms) carries significant risks, especially regarding the inferior alveolar nerve (IAN). This study aimed to evaluate the effectiveness of a 3D-planned inward fragmentation technique (3Dp-IFT) to improve surgical outcomes, reduce complications, and preserve bone structure in cases involving complex M3M impactions. Methods: Twenty-three patients aged between 18 and 36 years requiring M3M removal were included. Preoperative planning involved the use of cone-beam computed tomography (CBCT) for precise localization of the furcation area, followed by the creation of a 3D navigation template using PlastyCAD software version 1.7. The surgical procedure was performed under local anesthesia, with meticulous endoscopic assistance to ensure accurate access and minimize trauma. Postoperative outcomes, such as bone loss, pain, swelling, and mouth opening range, were carefully measured. The data were systematically organized and analyzed descriptively using Microsoft Excel. Results: No disturbances to the IAN or lingual nerve were observed. The mean buccal bone loss was 2.2 mm, with a standard deviation of 1.2 mm. Postoperative pain and swelling were generally low, with significant reductions within the first week. The use of the 3D navigation template significantly improved surgical access, enhancing safety and minimizing complications. Conclusions: The 3Dp-IFT technique represents a significant advancement in the minimally invasive removal of M3M by allowing precise access to critical anatomical areas while minimizing bone loss and postoperative complications. This approach is particularly beneficial for complex cases involving M3M near the IAN, thereby improving surgical safety and patient outcomes.

A rural teledentistry care experience: a geriatric approach to assessing oral health status and treatment needs in older adults from a Mapuche community in Chile.

Background: Limited attention has been given to oral health challenges faced by older Indigenous populations, especially in rural settings, where disparities exist. This study aims to assess oral health in a rural Mapuche community in southern Chile, utilizing geriatric technology support, and exploring the connection between geriatric health and oral well-being to fill a gap in this context. Methods: A cross-sectional study was conducted involving 76 independent older adults from a rural Mapuche community who required dental care. Assessments were in a remote care setting gathering extensive data including comprehensive geriatric assessments, medical and dental conditions using a geriatric teledentistry platform (TEGO®). Statistical analysis involved descriptive analysis, logistic regression, and both multiple correspondence analysis and k-means cluster analysis. Results: The sample comprised individuals with limited formal education and a high degree of vulnerability. Geriatric assessments unveiled cognitive deterioration, frailty, depression risk, and multimorbidity. A distribution of the DMFT index, number of remaining teeth, number of occluding pairs, number of teeth with restorative needs and other relevant clinical findings was conducted based on sociodemographic, and medical-geriatric-dental characteristics, and additionally, a Multinomial Logistic Regression Analysis of Dentition Variables in Relation to Geriatric Assessments was performed. The dental burden was substantial, with an average DMFT index of 25.96 (SD 4.38), high prevalence of non-functional dentition (89.3%), periodontal disease (83%), xerostomia (63.2%) and oral mucosal lesions (31.5%). Age, lower education, depression, daily medication number and sugary consumption frequency were associated with a decreased average number of teeth (p < 0.05). Multiple correspondence analysis and k-means cluster analysis identified 4 clusters, with the edentulous and functional dentition groups being the most distinct. Conclusion: This study uncovers a substantial dental burden and intricate medical-geriatric conditions interlinked among Indigenous older adults in a rural Chilean Mapuche community. The implementation of a geriatric technological ecosystem in the community enabled the resolution of less complex oral health issues and facilitated remote consultations with specialists, reducing the necessity for travel to health centers. This underscores the need for innovative dental public health initiatives to address health disparities and improve the overall well-being of older Indigenous adults.

Micro-Computed Tomography Analysis of Peri-Implant Bone Defects Exposed to a Peri-Implantitis Microcosm, with and without Bone Substitute, in a Rabbit Model: A Pilot Study.

Peri-implantitis is an inflammatory condition characterized by inflammation in the peri-implant connective tissue and a progressive loss of supporting bone; it is commonly associated with the presence of biofilms on the surface of the implant, which is an important factor in the development and progression of the disease. The objective of this study was to evaluate, using micro-CT, the bone regeneration of surgically created peri-implant defects exposed to a microcosm of peri-implantitis. Twenty-three adult New Zealand white rabbits were included in the study. Bone defects of 7 mm diameter were created in both tibiae, and a cap-shaped titanium device was placed in the center, counter-implanted with a peri-implantitis microcosm. The bone defects received a bone substitute and/or a resorbable synthetic PLGA membrane, according to random distribution. Euthanasia was performed 15 and 30 days postoperatively. Micro-CT was performed on all samples to quantify bone regeneration parameters. Bone regeneration of critical defects occurred in all experimental groups, with a significantly greater increase in cases that received bone graft treatment (p < 0.0001), in all measured parameters, at 15 and 30 days. No significant differences were observed in the different bone neoformation parameters between the groups that did not receive bone grafts (p > 0.05). In this experimental model, the presence of peri-implantitis microcosms was not a determining factor in the bone volume parameter, both in the groups that received regenerative treatment and in those that did not.

Managing venous thrombosis in a pediatric patient with short bowel and congenital nephrotic syndromes: a case report emphasizing rivaroxaban level monitoring.

Direct Oral Anticoagulants (DOACs) typically exhibit a predictable pharmacokinetic and pharmacodynamic response at a fixed dose, not necessitating monitoring under standard conditions. Yet, in specific clinical scenarios that can impair it, like Congenital Nephrotic Syndrome (CNS) or Short Bowel Syndrome (SBS) due to absorption issues, anti-thrombin III (AT-III) deficiency and non-selective proteinuria, adjusting the dosage to achieve appropriate plasma concentrations could prove beneficial. We report a 3-month-old female with catheter-related jugular thrombosis affected by CNS concomitant to SBS and failure of both treatments with heparin and warfarin, that was switched to dose-adjusted pediatric rivaroxaban. Rivaroxaban was adjusted to reach peak levels between 189 and 419 ng/ml and the lower trough levels between 6 and 87 ng/ml. Increasing doses were needed due to SBS related malabsorption but a complete permeabilization of the vein was achieved without bleeding complications. The use of anti-Xa adjusted rivaroxaban could be an alternative to improve anticoagulation and secondary thromboprophylaxis in pediatric patients SBS and an option to children with CNS.

Poly-3-hydroxybutyrate-silver nanoparticles membranes as advanced antibiofilm strategies for combatting peri-implantitis.

Dental implant success is threatened by peri-implantitis, an inflammation leading to implant failure. Conventional treatments struggle with the intricate microbial and host factors involved. Antibacterial membranes, acting as barriers and delivering antimicrobials, may offer a promising solution. Thus, this study highlights the potential of developing antibacterial membranes of poly-3-hydroxybutyrate and silver nanoparticles (Ag Nps) to address peri-implantitis challenges, discussing design and efficacy against potential pathogens. Electrospun membranes composed of PHB microfibers and Ag Nps were synthesized in a blend of DMF/chloroform at three different concentrations. Various studies were conducted on the characterization and antimicrobial activity of the membranes. The synthesized Ag Nps ranged from 4 to 8 nm in size. Furthermore, Young's modulus decreased, reducing from 13.308 MPa in PHB membranes without Ag Nps to 0.983 MPa in PHB membranes containing higher concentrations of Ag Nps. This demonstrates that adding Ag Nps results in a less stiff membrane. An increase in elongation at break was noted with the rise in Ag Nps concentration, from 23.597 % in PHB membranes to 60.136 % in PHB membranes loaded with Ag Nps. The antibiotic and antibiofilm activity of the membranes were evaluated against Pseudomonas aeruginosa, Staphylococcus aureus, Streptococcus mutans, and Candida albicans. The results indicated that all PHB membranes containing Ag Nps exhibited potent antibacterial activity by inhibiting the growth of biofilms and planktonic bacteria. However, inhibition of C. albicans occurred only with the PHB-Ag Nps C membrane. These findings emphasize the versatility and potential of Ag Nps-incorporated membranes as a multifunctional approach for preventing and addressing microbial infections associated with peri-implantitis. The combination of antibacterial and antibiofilm properties in these membranes holds promise for improving the management and treatment of peri-implantitis-related complications.