Allogenic Bone Graft in Dentistry: A Review of Current Trends and Developments.

In an effort to prepare non-autologous bone graft or biomaterial that would possess characteristics comparable to autologous bone, many different allogenic bone derivatives have been created. Although different existing processing methods aim to achieve the very same results, the specific parameters applied during different stages material preparation can result in significant differences in the material's mechanical and biological properties The properties, including osteoconductive, osteoinductive, and even osteogenic potential, can differ vastly depending on particular preparation and storage techniques used. Osteogenic properties, which have long been thought to be characteristic to autogenic bone grafts only, now seem to also be achievable in allogenic materials due to the possibility to seed the host's stem cells on a graft before its implantation. In this article, we aim to review the available literature on allogenic bone and its derivatives as well as the influence of different preparation methods on its performance.

An Experimental Anodized and Low-Pressure Oxygen Plasma-Treated Titanium Dental Implant Surface-Preliminary Report.

Chemical composition and physical parameters of the implant surface, such as roughness, regulate the cellular response leading to implant bone osseointegration. Possible implant surface modifications include anodization or the plasma electrolytic oxidation (PEO) treatment process that produces a thick and dense oxide coating superior to normal anodic oxidation. Experimental modifications with Plasma Electrolytic Oxidation (PEO) titanium and titanium alloy Ti6Al4V plates and PEO additionally treated with low-pressure oxygen plasma (PEO-S) were used in this study to evaluate their physical and chemical properties. Cytotoxicity of experimental titanium samples as well as cell adhesion to their surface were assessed using normal human dermal fibroblasts (NHDF) or L929 cell line. Moreover, the surface roughness, fractal dimension analysis, and texture analysis were calculated. Samples after surface treatment have substantially improved properties compared to the reference SLA (sandblasted and acid-etched) surface. The surface roughness (Sa) was 0.59-2.38 µm, and none of the tested surfaces had cytotoxic effect on NHDF and L929 cell lines. A greater cell growth of NHDF was observed on the tested PEO and PEO-S samples compared to reference SLA sample titanium.

Antimicrobial Efficacy of Different Decontamination Methods as Tested on Dental Implants with Various Types of Surfaces.

BACKGROUND Peri-implantitis is an inflammatory reaction affecting both hard and soft tissues surrounding dental implants. This pathological condition is caused by a polymicrobial aggressive biofilm that colonizes the implant and abutment surface at the peri-implant crevice level. The present in vitro study evaluated different methods of implant surface decontamination and assessed whether the type of the implant surface influences the results. MATERIAL AND METHODS The study was conducted in an in vitro model of peri-implantitis using 30 implants. The implants were divided into 3 equal groups based on the surface characteristics: machined-surface, sand-blasted and acid-etched, and HA-coated. Implants were coated with E. coli biofilm. After an incubation period, they were decontaminated with 4 different methods: sonic scaler application, sonic scaler application with the chemical agent Perisolv® combination, Er: YAG laser treatment, and PDT therapy with methylene blue as a photosensitizer. RESULTS The highest level of decontamination was achieved for machined-surface implants and for the combined chemical-mechanical and Er: YAG laser treatment. CONCLUSIONS The results of our study suggest that the method of implant decontamination should be customized to the type of implant surface.

Cytotoxic Effect of Vanicosides A and B from Reynoutria sachalinensis Against Melanotic and Amelanotic Melanoma Cell Lines and in silico Evaluation for Inhibition of BRAFV600E and MEK1.

Vanicosides A and B are the esters of hydroxycinnamic acids with sucrose, occurring in a few plant species from the Polygonaceae family. So far, vanicosides A and B have not been evaluated for anticancer activity against human malignant melanoma. In this study, we tested these two natural products, isolated from Reynoutria sachalinensis rhizomes, against two human melanoma cell lines (amelanotic C32 cell line and melanotic A375 cell line, both bearing endogenous BRAFV600E mutation) and two normal human cell lines-keratinocytes (HaCaT) and the primary fibroblast line. Additionally, a molecular docking of vanicoside A and vanicoside B with selected targets involved in melanoma progression was performed. Cell viability was studied using an MTT assay. A RealTime-Glo™ Annexin V Apoptosis and Necrosis assay was used for monitoring programmed cell death (PCD). Vanicoside A demonstrated strong cytotoxicity against the amelanotic C32 cell line (viability of the C32 cell line was decreased to 55% after 72 h incubation with 5.0 µM of vanicoside A), significantly stronger than vanicoside B. This stronger cytotoxic activity can be attributed to an additional acetyl group in vanicoside A. No significant differences in the cytotoxicity of vanicosides were observed against the less sensitive A375 cell line. Moreover, vanicosides caused the death of melanoma cells at concentrations from 2.5 to 50 µM, without harming the primary fibroblast line. The keratinocyte cell line (HaCaT) was more sensitive to vanicosides than fibroblasts, showing a clear decrease in viability after incubation with 25 µM of vanicoside A as well as a significant phosphatidylserine (PS) exposure, but without a measurable cell death-associated fluorescence. Vanicosides induced an apoptotic death pathway in melanoma cell lines, but because of the initial loss of cell membrane integrity, an additional cell death mechanism might be involved like permeability transition pore (PTP)-mediated necrosis that needs to be explored in the future. Molecular docking indicated that both compounds bind to the active site of the BRAFV600E kinase and MEK-1 kinase; further experiments on their specific inhibitory activity of these targets should be considered.

Chemical Composition of East Asian Invasive Knotweeds, their Cytotoxicity and Antimicrobial Efficacy Against Cariogenic Pathogens: An In-Vitro Study.

BACKGROUND Giant knotweeds originating from East Asia, such as Reynoutria japonica, and Reynoutria sachalinensis, and their hybrid such as Reynoutria x bohemica, are invasive plants in Europe and North America. However, R. japonica is also a traditional East Asian drug (Polygoni cuspidati rhizoma) used in Korean folk medicine to improve oral hygiene. The aim of this study was to evaluate the antibacterial activity of acetone extracts of Reynoutria species against dominant caries pathogen such as Streptococcus mutans and alternative pathogens, as well as characterize the phytochemical composition of extracts and examine their cytotoxicity. MATERIAL AND METHODS Ultrasonic extraction was used to obtain polyphenol-rich extracts. The extracts were characterized by HPLC-DAD-ESI-MS. To test bacterial viability, the minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) against S. mutans, S. salivarius, S. sanguinis, and S. pyogenes were determined. The cytotoxicity of the extracts to human fibroblasts derived from gingiva was evaluated using the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. RESULTS The R. japonica extract had the highest bacteriostatic and bactericidal activity against pathogens causing caries, mainly dominant caries pathogen S. mutans (mean MIC 1000 µg/mL and MBC 2000 µg/mL), which was most likely associated with a higher content of stilbene aglycons and anthraquinone aglycons in the extract. Moreover, the R. japonica extract demonstrated the lowest cytotoxic effect on human fibroblasts and exhibited cytotoxic activity only at the concentration causing the death of all S. mutans. CONCLUSIONS The results indicate that the R. japonica acetone extract can be considered as a natural, antimicrobial agent for caries control.

Phytochemical Diversity in Rhizomes of Three Reynoutria Species and their Antioxidant Activity Correlations Elucidated by LC-ESI-MS/MS Analysis.

The rhizome of Reynoutria japonica is a well-known traditional herb (Hu zhang) used in East Asia to treat various inflammatory diseases, infections, skin diseases, scald, and hyperlipidemia. It is also one of the richest natural sources of resveratrol. Although, it has been recently included in the European Pharmacopoeia, in Europe it is still an untapped resource. Some of the therapeutic effects are likely to be influenced by its antioxidant properties and this in turn is frequently associated with a high stilbene content. However, compounds other than stilbenes may add to the total antioxidant capacity. Hence, the aim of this research was to examine rhizomes of R. japonica and the less studied but morphologically similar species, R. sachalinensis and R. x bohemica for their phytochemical composition and antioxidant activity and to clarify the relationship between the antioxidant activity and the components by statistical methods. HPLC/UV/ESI-MS studies of three Reynoutria species revealed 171 compounds, comprising stilbenes, carbohydrates, procyanidins, flavan-3-ols, anthraquinones, phenylpropanoids, lignin oligomers, hydroxycinnamic acids, naphthalenes and their derivatives. Our studies confirmed the presence of procyanidins with high degree of polymerization, up to decamers, in the rhizomes of R. japonica and provides new data on the presence of these compounds in other Reynoutria species. A procyanidin trimer digallate was described for the first time in, the studied plants. Moreover, we tentatively identified dianthrone glycosides new for these species and previously unrecorded phenylpropanoid disaccharide esters and hydroxycinnamic acid derivatives. Furthermore, compounds tentatively annotated as lignin oligomers were observed for the first time in the studied species. The rhizomes of all Reynoutria species exhibited strong antioxidant activity. Statistical analysis demonstrated that proanthocyanidins should be considered as important contributors to the total antioxidant capacity.

An evaluation of superhydrophilic surfaces of dental implants - a systematic review and meta-analysis.

BACKGROUND: The characteristics of a dental implant surface have a decisive influence on the process of osseointegration. According to the current state of knowledge, surface modification can not only affect the morphology of cells, and in this way have a positive impact on osseointegration. METHODS: The objective of this study was to compare survival rates and marginal bone loss as well as assess the degree of stability of Straumann SLAactive® and Thomenn Incell® implants with a superhydrophilic surface. Authors present review of data published between 01.01.2008 and 12.31.2016 that was found in PubMed/MEDLINE internet database, An Internet search of databases produced a total of 1230 studies, 20 publications were finally selected for the present study based on the established selection and exclusion criteria. RESULTS: The statistical analysis was performed. A Cumulative Implant Survival Rate (CSR%) was 98.5%, Marginal bone loss (MBL) after 6 months was M = 0.60 mm and 0.6 5 mm after 12 months and secondary stability in a group Thommen implants M = 71.3 ISQ and M = 75.2 ISQ in group of Straumann. CONCLUSION: Despite certain differences in the values of the studied parameters, both of the systems, i.e. Thommen Inicell and Straumann SLActive, demonstrated a high survival rate, a high level of implant stability and low marginal bone loss.

Short Implants and Conventional Implants in The Residual Maxillary Alveolar Ridge: A 36-Month Follow-Up Observation.

BACKGROUND Short dental implants are considered an alternative method of treatment to the maxillary sinus elevation and bone augmentation procedure at the sites of a reduced alveolar ridge height. The aim of the study was to determine the most effective therapeutic approach for a single tooth replacement in a reduced maxillary alveolar crest. MATERIAL AND METHODS We enrolled 30 partially edentulous patients having a residual crestal height of 6 mm and a minimal width of the alveolar ridge of 6-7 mm: 15 patients received regular dental implants (OsseoSpeed™ L11 Ø4 mm and L13 Ø4 mm) and the implantation was preceded by the sinus lift procedure from a lateral window approach with the application of a xenogeneic bone graft, whereas the remaining 15 patients received short implants (OsseoSpeed™ L6 mm Ø4 mm) without the sinus lift and augmentation procedure. All implants were loaded with single non-splinted crowns. Radiological examination (CBCT, RVG) was performed before the surgery and after 36 months. Primary and secondary stabilization with Osstell ISQ® and Periotest® were assessed. RESULTS Good results in primary and secondary stability were achieved in both systems. The marginal bone level (MBL) loss was low (0.22±0.46 mm and 0.34±0.24 mm, for short and conventional implants, respectively). No significant difference in MBL between groups was found. CONCLUSIONS Short implants can be successfully used to support single crowns in the lateral part of the maxilla.

Schneiderian Membrane Perforation Rate and Increase in Bone Temperature During Maxillary Sinus Floor Elevation by Means of Er: YAG Laser-An Animal Study in Pigs.

PURPOSE: To assess the time of preparation, bone temperature increase, and the Schneiderian membrane perforation rate during maxillary sinus floor elevation. MATERIALS AND METHODS: The research included 30 maxillary sinuses (n = 30) of a pig, divided into 2 groups (n = 15). The lateral bony windows were created using Er:YAG laser (200 mJ, 15 Hz, energy density: 25.48 J/cm) and a diamond bur (control). The membrane was elevated using laser (50 mJ, 50 Hz) and hand instruments. The bone temperature was measured by K-type thermocouple. RESULTS: Significantly lower rates of the Schneiderian membrane perforation were found in the laser group (6.67%) compared with the bur (33%) (P < 0.05). The significant higher increase in temperature (mean 7.6°C) was found in the experimental group as compared with the control group (mean 2°C) (P = 0.0000033). The average time necessary for the laser bony window osteotomy was 10 minutes and 37 seconds, whereas using the bur required middling 5 minutes and 50 seconds (P = 0.000283). CONCLUSION: The application of Er:YAG laser may significantly reduce the risk of iatrogenic perforation of the Schneiderian membrane and does not cause an irreversible thermal damage in a pig model.

Soft-Tissue Augmentation around Dental Implants with a Connective Tissue Graft (CTG) and Xenogeneic Collagen Matrix (CMX)-5-Year Follow-Up.

Proper horizontal and vertical thickness of the gingival connective tissue has been proven to be one of the success criteria in dental implant and reconstructive surgery. When thin tissue is found, gingiva augmentation methods can be used to increase the quality and volume of the tissue. Many methods have been described, among them pedicle soft-tissue flaps or autogenic tissue grafts. As an alternative to patients' own tissue, xenogenic materials can be used for grafting. The fundamental issue is to choose a material that will ensure the maximum therapeutic effect, while also minimizing the negative influence on the patient's health. The aim of this study was to compare gingival augmentation procedures using a palatal connective tissue graft (CTG) and an xenogenic soft-tissue substitute, Geistlich Mucograft (xenogeneic collagen matrix; CMX), and assess whether the timing of the graft surgery influences the clinical outcomes. The original study was a randomized control trial with a total of 75 implants placed. The patients received the soft-tissue thickening 3 months before the implant placement or 3 months after the implant placement (depending on the group). A connective tissue graft (CTG) or Geistlich Mucograft were used (depending on the group). For both the CTG and Geistlich Mucograft, better clinical outcomes were observed for maintaining the alveolar bone level and the thickness of the attached gingiva compared to the control group with no gingival augmentation. The Geistlich Mucograft showed good clinical performance in comparison to the control. Soft-tissue augmentation with the CTG before the implant placement was found to be most efficient method in terms of a stable increase of the tissue thickness since, throughout the entire observation period, the greatest increase of 1.035 mm (SD = 0.73 mm) in thickness was observed. Statistically important differences in the tissue thickness baseline compared after 5 years were observed for groups G1 vs. G2b (no augmentation vs. CTG before), G1 vs. G3b (no augmentation vs. CTG after) and for groups G2b vs. G3a (CTG before vs. CMX after).

Bone tissue 3D bioprinting in regenerative dentistry through the perspective of the diamond concept of healing: A narrative review.

Three-dimensional bioprinting technology appears to be a promising solution for the treatment and reconstruction of a wide range of maxillofacial bone defects. In this review, the authors discuss different bioprinting solutions and options in the context of the 4 factors of bone healing: structures or scaffolds, osteogenic cells, growth factors, and stabilization (diamond concept of healing), as well as the influence of a 5th factor - vascularization. Bone is a complex tissue; hence, bone bioprinting may require different technical approaches and mixed methods. Ultraviolet (UV) crosslinkable hydrogels, such as gelatin methacryloyl (GelMA), are among the most promising bioinks; they are enhanced by hydroxyapatite or 1-2.5 mm beta-tricalcium phosphate (ß-TCP) granules and porous scaffolds with recommended pore sizes greater than 300 µm. The advantages of mesenchymal stem cells (MSCs) are their significant availability, low tumorigenicity, and great potential for differentiation into osteoblasts or endothelial cells (ECs). Although growth factors require advanced delivery systems, they provide excellent improvement in the functionality of printed tissues. A proper vasculature system supplies cells with oxygen and nutrients, removes waste products, promotes osteogenesis, prevents ischemic necrosis, and improves the mechanical properties of bone. With all of these aspects perfectly balanced and working in synergy, the clinical use of bioprinting is only a matter of time.

Oral Wound Healing Potential of Polygoni Cuspidati Rhizoma et Radix Decoction-In Vitro Study.

Polygoni Cuspidati Rhizoma et Radix (syn. rhizomes of Reynoutria japonica Houtt.) is a pharmacopoeial raw material in Europe and China. In traditional medicine, one of the applications for Reynoutria japonica rhizomes is wound healing. In a recent in vitro study, we demonstrated that ethanol and acetone extracts from this herbal drug have the potential to heal oral gum wounds. However, considering that a majority of herbal medicines have been traditionally administered as water decoctions, in the present study, a decoction of Reynoutria japonica rhizomes was prepared and detailed tests to determine its in vitro gingival wound healing activity were conducted. We used the primary human gingival fibroblasts (HGF) incubated with a decoction to determine cell viability (MTT assay), cell proliferation (the confocal laser scanning microscope-CLSM), and cell migration (wound healing assay). Moreover, the collagen type III expression was examined using immunocytochemical staining. The studied decoction was qualitatively and quantitatively characterized using the validated HPLC/DAD/ESI-HR-QTOF-MS method. The Folin-Ciocalteu assay was used to determine the total phenols and tannins content. Additionally, HPLC-RI analysis of decoction and the previously obtained ethanol and acetone extracts was used to determine the composition of saccharides. Low concentration (from 50 to 1000 µg/mL) of decoction after 24 h incubation caused a significant increase in HGF cell viability. No cytotoxic effect was observed at any tested concentration (up to 2000 µg/mL). The lowest active concentration of decoction (50 µg/mL) was selected for further experiments. It significantly stimulated human gingival fibroblasts to proliferate, migrate, and increase the synthesis of collagen III. Phytochemical analysis showed significantly fewer polyphenols in the decoction than in the ethanol and acetone extracts tested earlier. In contrast, high levels of polysaccharides were observed. In our opinion, they may have a significant effect on the oral wound healing parameters analyzed in vitro. The results obtained encourage the use of this raw material in its traditional, safe form-decoction.

An Experimental Anodized Titanium Surface for Transgingival Dental Implant Elements-Preliminary Report.

The characteristics such as microtopography, physical and chemical properties influence the behavior of an implant in a soft tissue. Anodization-as a potent method of titanium alloy surface modification-of the transgingival abutment or healing screw, has achieved some improvement. One of the possible surface treatment method is low-pressure radiofrequency oxygen plasma treatment. The aim of the study was to evaluate the chemical properties and cytocompatibility of the experimental surface. Titanium discs made of grade-23 titanium alloy (Ti-6Al-4V) anodized (A sample) with different voltage parameters (28, 67, 78, and 98 V) were included in the study. Half of the samples regarded as the "S" group were additionally treated with low-pressure radiofrequency oxygen plasma treatment. The surfaces were characterized using scanning electron microscopy, X-ray spectroscopy and Raman spectroscopy, and electrochemically investigated via a corrosion test. Furthermore, two cell lines were used, including the CHO-compatible reference line and a primary human fibroblast line for the MTT assay; direct (contact) cytotoxicity of the materials was tested with the cells, and the growth of fibroblasts on the surfaces of the different materials was tested. The morphology of the "S"-treated samples did not differ from the morphology of only-anodized samples. However, the oxygen concentration on the surface in that group slightly increased by about 1% as a result of post-trial treatment. The highest corrosion resistance was observed for both A-78 V and S-78 V samples. The cytotoxicity assay revealed no changes in cell morphology or vitality. The MTT test proved comparable culture viability among all groups; however, the "S" samples showed statistically significantly higher fibroblast proliferation and adhesion scores compared to the "A" samples. Through the in vitro study, the low-pressure radiofrequency oxygen plasma treatment of the anodized Ti-6Al-4V alloy presented itself as an auspicious option in the field of transgingival element surface modification of implants.

Role of implant loading time in the prevention of marginal bone loss after implant-supported restorations: A targeted review.

The implant-supported restoration of missing teeth is a recognized method of treatment that ensures a functional, esthetic and durable effect, along with patient satisfaction. However, the preferable time of dental implant loading is under debate. Currently, 3 protocols are used: immediate loading; early loading; and conventional (late) loading. Immediate loading provides benefits such as short treatment time, the elimination of the second surgery required for later loading protocols, the protection of the gingival papilla, an immediate esthetic effect, and high patient satisfaction. This review aimed to summarize the evidence on the impact of loading time on marginal bone loss (MBL) around dental implants, which is considered a useful measure of implantological treatment effects. A literature search was conducted based on the PubMed/MEDLINE database. The search focused on studies providing the MBL values by protocol. Out of the 1,366 hits received in the initial search, 10 studies were included in the qualitative analysis. At 12 months, the MBL range was 0.17-1.86 mm in patients undergoing the immediate protocol, 0.14-1.22 mm in patients undergoing the early protocol, and 0.44-0.91 mm in patients undergoing the late protocol. The studies were heterogeneous, but no significant differences in the occurrence of MBL were reported between the immediately and early loaded implants as compared with the conventionally loaded ones. Further studies are needed to determine other factors that might be related to the type of protocol, important for optimal patient treatment.

Fractal Dimension and Texture Analysis in the Assessment of Experimental Laser-Induced Periodic Surface Structures (LIPSS) Dental Implant Surface-In Vitro Study Preliminary Report.

Laser-induced periodic surface structures (LIPSS) are the sub-wavelength periodic nanostructures generated by the femtosecond laser. Implant topography and its nanostructural changes can be important for biomedical applications. In order to compare the surface topography of different implants, appropriate mathematical and physical descriptive methods should be provided. The aim of the study was to evaluate the experimental LIPSS-based-Low Spatial Frequency LIPSS (LSFL) dental implant surfaces. Novel methods of surface analysis, such as Fractal Dimension Analysis and Texture Analysis, were compared to the standard surface roughness evaluation. Secondary, cell viability, and attachment tests were applied in order to evaluate the biological properties of the new titanium surface and to compare their correlation with the physical properties of the new surfaces. A Normal Human Dermal Fibroblast (NHDF) cytotoxicity test did not show an impact on the vitality of the cells. Our study has shown that the laser LIPSS implant surface modifications significantly improved the cell adhesion to the tested surfaces. We observed a strong correlation of adhesion and the growth of cells on the tested surface, with an increase in implant surface roughness with the best results for the moderately rough (2 µm) surfaces. Texture and fractal dimension analyses are promising methods to evaluate dental implants with complex geometry.

Proanthocyanidins and Flavan-3-ols in the Prevention and Treatment of Periodontitis-Immunomodulatory Effects, Animal and Clinical Studies.

This paper continues the systematic review on proanthocyanidins and flavan-3-ols in the prevention and treatment of periodontal disease and covers the immunomodulatory effects, and animal- and clinical studies, while the other part discussed the direct antibacterial properties. Inflammation as a major response of the periodontal tissues attacked by pathogenic microbes can significantly exacerbate the condition. However, the bidirectional activity of phytochemicals that simultaneously inhibit bacterial proliferation and proinflammatory signaling can provide a substantial alleviation of both cause and symptoms. The modulatory effects on various aspects of inflammatory and overall immune response are covered, including confirmed and postulated mechanisms of action, structure activity relationships and molecular targets. Further, the clinical relevance of flavan-3-ols and available outcomes from clinical studies is analyzed and discussed. Among the numerous natural sources of flavan-3-ols and proanthocyanidins the most promising are, similarly to antibacterial properties, constituents of various foods, such as fruits of Vaccinium species, tea leaves, grape seeds, and tannin-rich medicinal herbs. Despite a vast amount of in vitro and cell-based evidence of immunomodulatory there are still only a few animal and clinical studies. Most of the reports, regardless of the used model, indicated the efficiency of these phytochemicals from cranberries and other Vaccinium species and tea extracts (green or black). Other sources such as grape seeds and traditional medicinal plants, were seldom. In conclusion, the potential of flavan-3-ols and their derivatives in prevention and alleviation of periodontal disease is remarkable but clinical evidence is urgently needed for issuing credible dietary recommendation and complementary treatments.

Dentists can provide reliable shear wave elastography measurements of the stiffness of masseter muscles: A possible scenario for a faster diagnostic process.

BACKGROUND: Masseter muscle pathologies include hypertrophy and the experience of pain, which clinically manifest with increased stiffness and tension. Assessment of muscle stiffness has been gaining importance among physicians dealing with temporomandibular disorders (TMD). Currently, shear wave elastography (SWE) is still often performed by radiologists, while dentists diagnose, treat and monitor TMD. OBJECTIVES: In this cohort study, we investigated whether dentists trained to use SWE can obtain reliable measurements of masseter muscle stiffness following participation in a short training program and hands-on workshop. MATERIAL AND METHODS: A group of healthy volunteers was examined by an experienced radiologist and a novice dentist before and after the training. RESULTS: The mean values of stiffness obtained by the operators were consistent and ranged from 10.20 kPa to 10.84 kPa. Intraobserver agreement was excellent for measurements of the radiologist (intraclass correlation coefficient (ICC) 0.92 and 0.93, respectively). The training improved the agreement between measurements made by the dentist from poor before the training (ICC = 0.46) to good after the training (ICC = 0.89). Also, the operator agreement between the radiologist and dentist increased from poor (ICC = 0.48) before the training to good (ICC = 0.84) after the training. CONCLUSIONS: The diagnostic accuracy of measuring masseter muscle stiffness was acceptable among dentists after the training. For this reason, the patient can be diagnosed by a single TMD specialist. This can shorten the diagnostic process and reduce treatment costs.

Monitoring of Changes in Masticatory Muscle Stiffness after Gum Chewing Using Shear Wave Elastography.

This study aimed to investigate if intensive exercise affects the stiffness of the masticatory muscles measured with shear-wave elastography. The study included a cohort of healthy adults (n = 40) aged 40 ± 11 years. In each individual, the stiffness of both the masseter and temporalis muscle was examined three times: at baseline, after 10 min of intensive exercise (chewing gum), and after 10 min of relaxation. Stiffness values (median (IQR)) of both the masseter and temporalis muscle were the lowest at the baseline (11.35 (9.7-12.65) and 10.1 (9.1-10.95)), increased significantly after the exercise (12.5 (11.1-13.25) and 10.3 (10.2-10.52)) and then dropped significantly after 10 min of relaxing (11.75 (9.95-12.6) and 10.2 (9.65-11.9)). The stiffness of the temporalis muscle was significantly lower than that of the masseter muscle. The values of the stiffness of the masseters correlated significantly with the values of the stiffness of the temporalis muscles. Shear wave elastography proved to be a sensitive method for showing changes in the stiffness of the muscles involved in the mastication occurring as a response to the effort, which increased the muscle stiffness. Further research is needed to broaden knowledge on the impact of eating habits and the occurrence of parafunctions on the development of temporomandibular disorders and the condition of masticatory muscles.

Aesthetic Outcomes of Early Occlusal Loaded SLA Dental Implants with Hydroxyl Ion Modified Surface-A 12 Months Prospective Study.

BACKGROUND: Many efforts have been made recently to arrange a newer, more hydrophilic and more osteoconductive implant surface. One of the possible options in this matter is modification with hydroxyl ion. MATERIALS AND METHODS: Forty implants with the diameters 3.5 and 4.0 mm were inserted as a single missing tooth restoration protocol in the frontal aspect of the maxilla. All implants were loaded early in a 4 week period. Prior to and during the surgery, the following indices were considered: height of keratinized tissue, the thickness of soft tissue, and the initial level of bone tissue. After 12 months, the implant and the tissues in its direct vicinity were evaluated once more with the following indices: marginal bone loss (MBL), height of keratinized tissue (HKT), probing pocket depth (PPD), pink and white aesthetics scores (PES, WES), as well as pain sensations combined with the procedure (VAS). All results were related to the diameter of the implant and thickness of periodontal biotype. RESULTS: High aesthetic outcomes were reported regardless of soft tissue thickness and implant diameter. The VAS score was higher for the 4.0 implant group, and the thickness of soft tissue had no influence on VAS. In case of implantation in thin or soft tissue, higher MBL levels were reported (0.26 mm), while in case of a thick phenotype, MBL was 0.06 mm. CONCLUSIONS: Hydrophilic surface implants can be used for a protocol of early functional occlusal loading. The initial thickness of soft tissue does not influence aesthetic outcomes and does not raise pain perception, although it may elevate crestal bone resorption.

Short (6 mm) and Regular Dental Implants in the Posterior Maxilla-7-Years Follow-up Study.

Short 6 mm dental implants are considered as an alternative to the maxillary sinus elevation and bone augmentation procedure where there is a reduced alveolar ridge height. The aim of this study was to compare the implant survival rate between short dental implants (6 mm) and regular length implants (11-13 mm) when placed in combination with bone grafting and loaded with a single non splinted crown, seven years after placing the implant. It was conducted as a controlled clinical study of 30 patients with partial edentulism in the posterior maxilla. The protocol included radiological and clinical evaluation of the C/I ratio (length of the superstructure divided by the length of the implant crestal part), marginal bone level (MBL), ultrasonography measurement of soft tissue surrounding implant (STT), patient-reported outcomes, and biological and technical complications. A total number of 28 implants (93%) remained integrated during follow-up period. MBL of 0.50 and 0.52 mm was observed for short implants and regular implants, respectively. MBL was checked for correlation with STT, and a negative correlation was found between MBL: STT. Our study has demonstrated a significantly lower implant survival rate for short implants compared to regular implants (87% compared to 100%). Despite the loss of several implants, good clinical results were achieved in the remaining implants in both groups. It is, therefore, worth considering short implants as an alternative to regular implants with a sinus lift surgery.