Comparison of Positioning Accuracy Between 2 Different Implant Systems Using Mucosa-Supported Surgical Templates: A Retrospective Clinical Study.

Although guided implant surgery is widely practiced, clinical studies examining the differences in accuracy between implanting systems that use the same surgical guide are currently lacking. This study aimed to evaluate and compare the effects of different dental implanting systems on positioning accuracy using a uniform type of stereolithographic surgical guide to account for cumulative errors in guide production. One hundred BEGO Semados S implants (group A) and 91 NobelActive implants (group B) were inserted into patients using the same type of guide. The accuracy was assessed by matching the preoperative and postoperative cone-beam computerized tomography. The implant shoulder, tip, depth, and angular deviation were registered. Statistically significant differences between groups were determined using Student t test, bivariate correlation test, and generalized estimating equation. The angular deviation was 3.16 ± 1.74° in group A and 2.58 ± 1.41° in group B (P = .013); the depth deviation was 0.44 ± 0.23 mm in group A and 0.51 ± 0.22 mm in group B (P = .032). In terms of vertical accuracy, the Bego implant system is superior to the Nobel implant system using the same type of surgical guide, while the angle accuracy is opposite. Therefore, it is important to control the depth when using the template-guided surgery with the Nobel implant system. Similarly, angle control should be emphasized in the Bego implant system. Measurements of the deviations provide the basis for a clinical reference that will be useful in preoperative analysis for improving the safety and accuracy of guided implant surgical procedures.

A novel approach to full-mouth rehabilitation of dentinogenesis imperfecta type II: Case series with review of literature.

RATIONALE: Dentinogenesis imperfecta (DI) is an autosomal-dominant disorder. The most common clinical manifestations, including obliterated tooth tissues and severe tooth wear, usually lead to tooth extractions. It remains a great challenge for dentists to preserve the residual tooth tissue and establish the esthetics and occlusion of dentitions. PATIENTS CONCERNS: 25-year-old twin sisters, who had suffered from dentinogenesis imperfecta type II for more than 10 years, presented with continuous tooth wear and discomfort from wearing a removable partial denture for more than 3 years. DIAGNOSIS: Intraoral examination showed extensive tooth wear with enamel exfoliation and typical amber-brown color with an opalescent discoloration. Their panoramic radiographs revealed completely obliterated tooth tissues and severe tooth wear. INTERVENTIONS AND OUTCOMES: The dentitions were restored with post-and-core crowns and pin lays after preparing root post paths and pin holes guided by computer-aided design/computer-aided manufacturing (CAD/CAM) procedures, resulting in a successful repair. LESSONS: Severe tooth wear and tooth tissue obliteration are typical clinical manifestations in DI-affected dentitions, increasing the complexity and difficulty in dental restorations. Early diagnosis and appropriate treatments are essential to achieve a favorable prognosis. CAD/CAM procedures, permitting accurate and effective treatment, possess promising potential in the treatment of DI-affected dentitions.

MiR-191-5p alleviates microglial cell injury by targeting Map3k12 (mitogen-activated protein kinase kinase kinase 12) to inhibit the MAPK (mitogen-activated protein kinase) signaling pathway in Alzheimer's disease.

Alzheimer's disease (AD) is a progressive neurodegenerative disease. Multiple reports have elucidated that microRNAs are promising biomarkers for AD diagnosis and treatment. Herein, the effect of miR-191-5p on microglial cell injury and the underlying mechanism were explored. APP/PS1 transgenic mice were utilized to establish mouse model of AD. Amyloid-ß protein 1-42 (Aß1-42)-treated microglia were applied to establish in vitro cell model of AD. MiR-191-5p expression in hippocampus and microglia was measured by reverse transcription quantitative polymerase chain reaction. The viability and apoptosis of microglia were evaluated by Cell Counting Kit-8 assays and flow cytometry analyses, respectively. The binding relationship between miR-191-5p and its downstream target mitogen-activated protein kinase kinase kinase 12 (Map3k12) was determined by luciferase reporter assays. Pathological degeneration of hippocampus was tested using hematoxylin-eosin staining and Nissl staining. Aß expression in hippocampus was examined via immunohistochemistry. In this study, miR-191-5p was downregulated in Aß1-42-stimulated microglia and hippocampal tissues of APP/PS1 mice. MiR-191-5p overexpression facilitated cell viability and inhibited apoptosis rate of Aß1-42-treated microglia. Mechanically, miR-191-5p targeted Map3k12 3'-untranslated region to downregulate Map3k12 expression. MiR-191-5p inhibited Aß1-42-induced microglial cell injury and inactivated the MAPK signaling by downregulating Map3k12. Overall, miR-191-5p alleviated Aß1-42-induced microglia cell injury by targeting Map3k12 to inhibit the MAPK signaling pathway in microglia.

Growth differentiation factor 11 mitigates cardiac radiotoxicity via activating AMPKα.

Cardiac radiotoxicity largely impedes the therapeutic benefits of radiotherapy to malignancies. Growth differentiation factor 11 (GDF11) is implicated in the pathogenesis of cardiac diseases under different pathological conditions. This study aims to investigate the role and underlying mechanisms of GDF11 on cardiac radiotoxicity. Mice were injected with cardiotropic adeno-associated virus 9 carrying the full-length mouse GDF11 gene or negative control under a cTnT promoter from the tail vein, and then received a single dose of 20 Gray (Gy) whole-heart irradiation (WHI) for 16 weeks to imitate cardiac radiotoxicity. Compound C (CC, 20 mg/kg) was intraperitoneally injected every two days at 1 week before WHI stimulation to inhibit 5' AMP-activated protein kinase α (AMPKα). Cardiac GDF11 expression was significantly suppressed at both the protein and mRNA levels. GDF11 overexpression decreased oxidative stress, apoptosis, and fibrosis in radiated hearts, thereby mitigating cardiac radiotoxicity, and dysfunction. Further detection revealed that GDF11 activated AMPKα to reduce radiation-induced oxidative damage and that AMPKα inhibition by CC offset the cardioprotective effects by GDF11. GDF11 mitigates cardiac radiotoxicity via activating AMPKα and it is a promising candidate to treat cardiac radiotoxicity.

[Accuracy of 6D computed-derived implant guides made in China for dental implant surgery in edentulous patients].

PURPOSE: To evaluate the accuracy of 6D computed-derived implant guides made in China, in order to provide methods and basis for reducing deviation. METHODS: 3D rapid prototyping technique was used to fabricate implant guides for auxiliary surgical implantation in edentulous patients, and the position deviation between the preoperative design and the actual implant was measured. Sixteen edentulous patients with 172 implantation sites were measured. In 10 patients, six implants were implanted in the maxilla, 4 implants in the mandible, and 6 implants were implanted both in the maxilla and mandible of 6 patients. A total of 28 implants were tilted implant in 14 patients. Preoperative cone-beam CT(CBCT) data were imported into the 6D Dental Planning Software to design and make the implant guides. Digital guides were used to assist implant placement. Preoperative design and postoperative CBCT were imported into the software for 3D reconstruction and registration, and then exported to Geomagic Studio software for analysis to obtain the deviation between the preoperative design and the implantation, so as to analyze the accuracy of the guides. The differences were analyzed by SPSS 25.0 software package with paired t-test and single factor analysis of variance. RESULTS: The distance deviation of implant neck center point was (0.83±0.27) mm and the horizontal deviation was (0.60±0.21) mm. The distance deviation of implant bottom center point was (1.11±0.35) mm, and the vertical deviation was (0.45±0.19) mm. The angle deviation was (3.16±1.73)°. CONCLUSIONS: The 6D computed-derived implant guides made in China can improve the accuracy and efficiency of implant surgery for edentulous patients and obtain a better long-term clinical effect to meet clinical requirements well. Since the deviation is similar to other implant guide plate systems that reported aborad, it must be taken into account in the process of clinical design, in order to avoid risks and unnecessary complications. This method is worthy of wide clinical application.

Disease progression patterns and risk factors associated with mortality in deceased patients with COVID-19 in Hubei Province, China.

BACKGROUND: Detailed descriptions of the patterns of disease progression of deceased coronavirus disease 2019 (COVID-19) patients have not been well explored. OBJECTIVES: This study sought to explore disease progression patterns and risk factors associated with mortality of deceased patients with COVID-19. MATERIALS AND METHODS: Epidemiological, clinical, laboratory, and imaging data (from 15 January to 26 March 2020) of laboratory-confirmed COVID-19 patients were collected retrospectively from two hospitals, Hubei province, China. Disease progression patterns of patients were analyzed based on laboratory data, radiological findings, and Sequential Organ Failure Assessment (SOFA) score. Risk factors associated with death were analyzed. RESULTS: A total of 792 patients were enrolled in this study, of whom 68 died and 724 survived. Complications during hospitalization, such as sepsis, severe acute respiratory distress syndrome, acute cardiac injury, and acute kidney injury, were markedly more frequent in deceased patients than in surviving patients. Deceased patients presented progressive deterioration pattern in laboratory variables, chest computed tomography evaluation, and SOFA score, while surviving patients presented initial deterioration to peak level involvement followed by improvement pattern over time. Days 10 to 14 after illness onset was a critical stage of disease course. Older age, number of preexisting comorbidities ≥2, and SOFA score were independently associated with death for COVID-19. CONCLUSIONS: Multiorgan dysfunction was common in deceased COVID-19 patients. Deceased patients presented progressive deterioration pattern, while surviving patients presented a relatively stable pattern during disease progression. Older age, number of preexisting comorbidities ≥2, and SOFA score were independent risk factors for death for COVID-19.