The Effects of Three Chlorhexidine-Based Mouthwashes on Human Osteoblast-Like SaOS-2 Cells. An In Vitro Study.

Several decontamination methods for removing biofilm from implant surfaces during surgical peri-implantitis treatment have been reported, including the intraoperative usage of chlorhexidine (CHX)-based antiseptics. There is a lack of information on possible adverse effects on bone healing. The study aimed to examine the impact of three CHX-based mouthwashes on osteoblast-like cells (SaOS-2) in vitro. Cells were cultured for three days in 96-well binding plates. Each well was randomly treated for either 30, 60 or 120 s with 0.05% CHX combined with 0.05% cetylpyridinium chloride (CPC), 0.1% CHX, 0.2% CHX or sterile saline (NaCl) as control. Cell viability, cytotoxicity and apoptosis were assessed at day 0, 3 and 6. Cell viability resulted in being higher in the control group at all time points. At day 0, the CHX 0.2 group showed significantly higher cytotoxicity values compared to CHX 0.1 (30 s), CHX + CPC (30 s, 60 s and 120 s) and control (60 s and 120 s), while no significant differences were identified between CHX + CPC and both CHX 0.1 and NaCl groups. All test mouthwashes were found to induce apoptosis to a lower extent compared to control. Results indicate that 0.2% CHX presented the highest cytotoxic effect. Therefore, its intraoperative use should be carefully considered.

Variability in deceased donor care in Canada: a report of the Canada-DONATE cohort study.

PURPOSE: Canadian donor management practices have not been reported. Our aim was to inform clinicians and other stakeholders about the range of current practices. METHODS: This prospective observational cohort study enrolled consecutive, newly consented organ donors from August 1 2015 to July 31 2018 at 27 academic and five community adult intensive care units in British Columbia, Alberta, Ontario, and Quebec. Research staff prospectively recorded donor management data. Provincial organ donation organizations verified the organs donated. We formally compared practices across provinces. RESULTS: Over a median collection period of eight months, 622 potential donors were classified at baseline as having neurologic determination of death (NDD donors; n = 403) or circulatory death (DCD donors; n = 219). Among NDD donors, 85.6% underwent apnea testing (rarely with carbon dioxide insufflation), 33.2% underwent ancillary testing, and subsequent therapeutic hypothermia (34-35°C) was rare. Neurologic determination of death donors were more hemodynamically unstable with most having received vasopressin and norepinephrine infusions, with a large majority having received high-dose corticosteroids and intravenous thyroxine. Among DCD donors, 61.6% received corticosteroids, and 8.9% received thyroxine. Most donors did not receive lung-protective ventilation strategies. Invasive procedures after donation consent included bronchoscopy (71.7%), cardiac catheterization (NDD donors only; 21.3%), and blood transfusions (19.3%). Physicians ordered intravenous antemortem heparin for 94.8% of DCD donors. The cohort donated 1,629 organs resulting in 1,532 transplants. Case selection, death determinations, and hormone, nutrition and heparin practices all varied across provinces. CONCLUSION: These study findings highlight areas for knowledge translation and further clinical research. Interprovincial discrepancies will likely pose unique challenges to national randomized trials. TRIAL REGISTRATION: www.clinicaltrials.gov (NCT03114436); registered 10 April, 2017.

RéSUMé: OBJECTIF: Les pratiques canadiennes de prise en charge des donneurs n'ont pas été rapportées. Notre objectif était d'informer les cliniciens et autres parties intéressées quant à l'éventail des pratiques actuelles. MéTHODE: Cette étude de cohorte observationnelle et prospective a recruté des donneurs d'organes consécutifs ayant récemment consenti au don entre le 1er août 2015 et le 31 juillet 2018 dans 27 unités de soins intensifs universitaires et cinq unités de soins intensifs pour adultes en milieu communautaire en Colombie-Britannique, en Alberta, en Ontario et au Québec. Le personnel de recherche a enregistré de manière prospective les données de prise en charge des donneurs. Les organismes de dons d'organes provinciaux ont vérifié les organes donnés. Nous avons formellement comparé les pratiques d'une province à l'autre. RéSULTATS: Sur une période médiane de collecte de huit mois, 622 donneurs potentiels ont été catégorisés au départ comme ayant un diagnostic de décès neurologique (donneurs DDN; n = 403) ou un décès cardiocirculatoire (donneurs DDC; n = 219). Parmi les donneurs DDN, 85,6 % ont subi un test d'apnée (rarement avec insufflation de dioxyde de carbone), 33,2 % ont subi des tests complémentaires, et une hypothermie thérapeutique subséquente (34-35°C) était rare. Les donneurs par diagnostic de décès neurologique étaient plus instables hémodynamiquement, la plupart ayant reçu des perfusions de vasopressine et de norépinéphrine, et une vaste majorité de ces donneurs ont reçu des corticostéroïdes à forte dose ainsi que de la thyroxine intraveineuse. Parmi les donneurs par DDC, 61,6 % avaient reçu des corticostéroïdes, et 8,9 % de la thyroxine. La plupart des donneurs n'avaient pas bénéficié de stratégies de ventilation protectrice des poumons. Les interventions invasives réalisées après le consentement au don comprenaient la bronchoscopie (71,7 %), le cathétérisme cardiaque (donneurs DDN seulement; 21,3 %) et les transfusions sanguines (19,3 %). Les médecins ont prescrit de l'héparine intraveineuse ante mortem chez 94,8 % des donneurs DDC. La cohorte a donné 1629 organes, résultant en 1532 greffes. La sélection de cas, la détermination de décès et les pratiques hormonales, nutritionnelles et hépariniques variaient toutes d'une province à l'autre. CONCLUSION: Ces résultats soulignent des domaines propices à la transmission de connaissances et aux recherches cliniques plus poussées. Les différences interprovinciales poseront probablement des défis uniques pour les études randomisées nationales. Enregistrement de l'étude : www.clinicaltrials.gov (NCT03114436); enregistrée le 10 avril 2017.

The Peroxiredoxin Family: An Unfolding Story.

Peroxiredoxins (Prxs) are a large and conserved family of peroxidases that are considered to be the primary cellular guardians against oxidative stress in all living organisms. Prxs share a thioredoxin fold and contain a highly-reactive peroxidatic cysteine in a specialised active-site environment that is able to reduce their peroxide substrates. The minimal functional unit for Prxs are either monomers or dimers, but many dimers assemble into decameric rings. Ring structures can further form a variety of high molecular weight complexes. Many eukaryotic Prxs contain a conserved GGLG and C-terminal YF motif that confer sensitivity to elevated levels of peroxide, leading to hyperoxidation and inactivation. Inactive forms of Prxs can be re-reduced by the enzyme sulfiredoxin, in an ATP-dependent reaction. Cycles of hyperoxidation and reactivation are considered to play an integral role in a variety of H2O2-mediated cell signalling pathways in both stress and non-stress conditions. Prxs are also considered to exhibit chaperone-like properties when cells are under oxidative or thermal stress. The roles of various types of covalent modifications, e.g. acetylation and phosphorylation are also discussed. The ability of Prxs to assemble into ordered arrays such as nanotubes is currently being exploited in nanotechnology.

The Pyruvate Dehydrogenase Complex and Related Assemblies in Health and Disease.

The family of 2-oxoacid dehydrogenase complexes (2-OADC), typified by the pyruvate dehydrogenase multi-enzyme complex (PDC) as its most prominent member, are massive molecular machines (Mr, 4-10 million) controlling key steps in glucose homeostasis (PDC), citric acid cycle flux (OGDC, 2-oxoglutarate dehydrogenase) and the metabolism of the branched-chain amino acids, leucine, isoleucine and valine (BCOADC, branched-chain 2-OADC). These highly organised mitochondrial arrays, composed of multiple copies of three separate enzymes, have been widely studied as paradigms for the analysis of enzyme cooperativity, substrate channelling, protein-protein interactions and the regulation of activity by phosphorylation . This chapter will highlight recent advances in our understanding of the structure-function relationships, the overall organisation and the transport and assembly of PDC in particular, focussing on both native and recombinant forms of the complex and their individual components or constituent domains. Biophysical approaches, including X-ray crystallography (MX), nuclear magnetic resonance spectroscopy (NMR), cryo-EM imaging, analytical ultracentrifugation (AUC) and small angle X-ray and neutron scattering (SAXS and SANS), have all contributed significant new information on PDC subunit organisation, stoichiometry, regulatory mechanisms and mode of assembly. Moreover, the recognition of specific genetic defects linked to PDC deficiency, in combination with the ability to analyse recombinant PDCs housing both novel naturally-occurring and engineered mutations, have all stimulated renewed interest in these classical metabolic assemblies. In addition, the role played by PDC, and its constituent proteins, in certain disease states will be briefly reviewed, focussing on the development of new and exciting areas of medical and immunological research.

Non-surgical treatment of peri-implant mucositis and peri-implantitis at two-piece zirconium implants: A clinical follow-up observation after up to 3 years.

OBJECTIVES: To assess the long-term clinical outcomes following non-surgical therapy of peri-implant diseases at two-piece zirconium implants. MATERIAL AND METHODS: A total of 27 patients suffering from either (i) peri-implant mucositis (n = 24 implants), or (ii) peri-implantitis (n = 16 implants) completed a mean follow-up period of 32.8 ± 2.85 months (median: 34 months). The initial treatment procedures included (i) mechanical debridement + local antiseptic therapy using chlorhexidine digluconate (MD + CXH), or (ii) Er:YAG laser monotherapy (ERL). The primary outcome was disease resolution (i.e. absence of bleeding on probing (BOP) at mucositis sites/absence of BOP and probing pocket depths (PD) ≥6 mm at peri-implantitis sites). RESULTS: Resolution of peri-implant mucositis and peri-implantitis was obtained in 7/14 (50.0%; p = .003) and 5/13 (38.5%; p = .001) of the patients investigated. This corresponded to 54.2% (13/24) and 50.0% (8/16) at the implant level respectively. CONCLUSION: Both MD + CHX and ERL were effective on the long-term, but failed to achieve a complete disease resolution.

Combined surgical therapy of advanced peri-implantitis evaluating two methods of surface decontamination: a 7-year follow-up observation.

OBJECTIVES: To assess the long-term outcomes (>4 years) following combined surgical resective/regenerative therapy of advanced peri-implantitis lesions using two surface decontamination methods. MATERIAL & METHODS: Fifteen patients (n = 15 combined supra- and intrabony defects) completed a follow-up observation period of 7 years. The treatment procedure included access flap surgery, granulation tissue removal and implantoplasty at buccally and supracrestally exposed implant parts, and a randomly assigned decontamination of the unmodified intrabony implant surface areas using either (i) an Er:YAG laser (ERL) or (ii) plastic curettes + cotton pellets + sterile saline (CPS). Intrabony defects were filled using a natural bone mineral and covered by a native collagen membrane. RESULTS: At 7 years, both ERL and CPS were associated with similar mean bleeding on probing reductions (CPS: 89.99 ± 11.65% versus ERL: 86.66 ± 18.26%) and clinical attachment level gains (CPS: 2.76 ± 1.92 mm versus ERL: 2.06 ± 2.52 mm). CONCLUSION: Combined surgical resective/regenerative therapy of advanced peri-implantitis was effective on the long-term, but not influenced by the initial method of surface decontamination.

Effects of different titanium zirconium implant surfaces on initial supragingival plaque formation.

OBJECTIVES: The aim of the current study was the evaluation of biofilm development on different implant surfaces. MATERIAL AND METHODS: Initial biofilm formation was investigated on five different implant surfaces, machined titanium (MTi), modified machined acid-etched titanium (modMATi), machined titanium zirconium (MTiZr), modified machined and acid-etched titanium zirconium (modMATiZr) and sandblasted large grid and acid-etched titanium zirconium surface (SLATiZr) for 24 and 48 h. Biocompatibility was tested after tooth brushing of the samples via cell viability testing with human gingival fibroblasts. RESULTS: After 24 h of biofilm collection, mean plaque surface was detected in the following descending order: After 24 h: MTiZr > MTi > SLATiZr > modMATiZr > modMATi. Both M surfaces showed significant higher biofilm formation than the other groups. After 48 h: MTiZr > MTi > SLATiZr > modMATiZr > modMATi. After tooth brushing: SLATiZr > modMATi > modMATiZr > MTi > MTiZr. All native samples depicted significant higher cell viability than their corresponding surfaces after biofilm removal procedure. CONCLUSIONS: The TiZr groups especially the modMATiZr group showed slower and less biofilm formation. In combination with the good biocompatibility, both modMA surfaces seem to be interesting candidates for surfaces in transgingival implant design.

Clinical performance of two-piece zirconia implants in the posterior mandible and maxilla: a prospective cohort study over 2 years.

OBJECTIVES: To assess the clinical performance of two-piece zirconium implants over a period of up to 2 years. MATERIAL & METHODS: A total of 52 patients with single-tooth gaps in the posterior mandible or maxilla received the same type of a two-piece zirconium implant system with customized heights of the transmucosal aspect. Fibreglass abutments were cemented and restored with fixed all-ceramic single crowns using a conventional loading protocol. The cumulative survival rate (primary outcome) was calculated according to the life table method, and Kaplan-Meier survival curves were used to estimate the survival function. Covariates (gender, implant position, implant diameter/length, oral surgeon) were tested using log-rank tests. RESULTS: A total of two target implants in 2 patients were lost after a functioning time of 8 months. The cumulative survival rate was 95.8%, and the mean survival time amounted to 32.9 months. Log-rank tests revealed a significant association for the covariate "oral surgeon" (P = 0.047). The Kaplan-Meier estimates of mechanical/technical and biological complications amounted to 2.1% and 37.5%, respectively. All implant sites revealed a marked increase of the vestibular mucosal level and gain of keratinized tissue at 24 months. CONCLUSION: Within the limitations of a prospective cohort study, it was concluded that this two-piece zirconium implant/fibreglass abutment system can be successfully used in the clinical indication investigated.

The influence of implantoplasty on the diameter, chemical surface composition, and biocompatibility of titanium implants.

OBJECTIVES: The objective of the study was to assess the influence of implantoplasty (IP) on the diameter, chemical surface composition, and biocompatibility of titanium implants in vitro. MATERIAL AND METHODS: Twenty soft tissue-level (TL; machined transmucosal-M and rough endosseous part-SLA) and 20 bone-level (BL; SLA) implants were allocated to IP covering 3 or 6 mm of the structured surface (SLA) area. The samples were subjected to diameter, energy-dispersive X-ray spectroscopy (EDX), and cell viability (ginigval fibroblasts, 6 days) assessments. RESULTS: Median diameter reductions varied between 0.1 (TL 3 mm) and 0.2 mm (TL 6 mm). EDX analysis revealed that IP and M surfaces were characterized by a comparable quantity (Wt%) of elements C, O, Na, Cl, K, and Si, but a significantly different quantity of elements Ti and Al. When compared to SLA surfaces, significant differences were noted for elements C, O, Na, Ti, and Al. At BL implants, the extension of IP (i.e., 3 to 6 mm) was associated with a significant increase in cell viability. CONCLUSIONS: IP applied to SLA implants was associated with (i) a minimal diameter reduction, (ii) an undisturbed cell viability, and (iii) a chemical elemental composition comparable to M surfaces. CLINICAL RELEVANCE: This specific IP procedure appears to be suitable for the management of exposed SLA implant surfaces.

Use of Collagen Matrix for Augmentation of the Peri-implant Soft Tissue at the Time of Immediate Implant Placement.

AIM: The aim of this study was to determine the treatment outcome of the use of a porcine monolayer collagen matrix (mCM) to augment peri-implant soft tissue in conjunction with immediate implant placement as an alternative to patient's own connective tissue. MATERIALS AND METHODS: A total of 27 implants were placed immediately in 27 patients (14 males and 13 females, with a mean age of 52.2 years) with simultaneous augmentation of the soft tissue by the use of a mCM. The patients were randomly divided into two groups: Group I: An envelope flap was created and mCM was left coronally uncovered, and group II: A coronally repositioned flap was created and the mCM was covered by the mucosa. Soft-tissue thickness (STTh) was measured at the time of surgery (T0) and 6 months postoperatively (T1) using a customized stent. Cone beam computed tomographies (CBCTs) were taken from 12 representative cases at T1. A stringent plaque control regimen was enforced in all the patients during the 6-month observation period. RESULTS: Mean STTh change was similar in both groups (0.7 ± 0.2 and 0.7 ± 0.1 mm in groups I and II respectively). The comparison of STTh between T0 and T1 showed a statistically significant increase of soft tissue in both groups I and II as well as in the total examined population (p < 0.001). The STTh change as well as matrix thickness loss were comparable in both groups (p > 0.05). The evaluation of the CBCTs did not show any signs of resorption of the buccal bone plate. CONCLUSION: Within the limitations of this study, it could be concluded that the collagen matrix used in conjunction with immediate implant placement leads to an increased thickness of peri-implant soft tissue independent of the flap creation technique and could be an alternative to connective tissue graft. CLINICAL SIGNIFICANCE: The collagen matrix used seems to be a good alternative to patient's own connective tissue and could be used for the soft tissue augmentation around dental implants.

MulRF: a software package for phylogenetic analysis using multi-copy gene trees.

SUMMARY: MulRF is a platform-independent software package for phylogenetic analysis using multi-copy gene trees. It seeks the species tree that minimizes the Robinson-Foulds (RF) distance to the input trees using a generalization of the RF distance to multi-labeled trees. The underlying generic tree distance measure and fast running time make MulRF useful for inferring phylogenies from large collections of gene trees, in which multiple evolutionary processes as well as phylogenetic error may contribute to gene tree discord. MulRF implements several features for customizing the species tree search and assessing the results, and it provides a user-friendly graphical user interface (GUI) with tree visualization. The species tree search is implemented in C++ and the GUI in Java Swing. AVAILABILITY: MulRF's executable as well as sample datasets and manual are available at http://genome.cs.iastate.edu/CBL/MulRF/, and the source code is available at https://github.com/ruchiherself/MulRFRepo. CONTACT: ruchic@ufl.edu SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

Effectivity of air-abrasive powder based on glycine and tricalcium phosphate in removal of initial biofilm on titanium and zirconium oxide surfaces in an ex vivo model.

OBJECTIVES: The purpose of the present study was the evaluation of effectiveness and efficiency of a powder consisting of glycine and tricalcium phosphate in comparison to two established powders based on glycine or sodium bicarbonate in biofilm removal on titanium and zirconium implant surfaces. MATERIALS AND METHODS: Biofilm was collected for 48 h by five volunteers. A total of 69 titanium and 69 zirconium samples were randomly assigned to test and control groups. Residual plaque areas (RPA) and treatment time were taken as parameters. RESULTS: Within the titanium groups, mean RPA was determined in the following descending order: sodium bicarbonate > glycine > glycine + tricalcium phosphate. Differences between the groups were significant, p < 0.05. Mean treatment time in the titanium groups was determined in the following descending order without significant differences, p > 0.05: glycine + tricalcium phosphate > sodium bicarbonate > glycine. Regarding the zirconium groups, mean RPA was detected in the following descending order, without significant differences, p > 0.05: glycine > sodium bicarbonate > glycine + tricalcium phosphate. Mean treatment time of the glycine + tricalcium phosphate group was significantly lower than in the control groups, p < 0.05. CONCLUSIONS: It can be concluded that glycine + tricalcium phosphate seemed to be more effective than the control groups for biofilm removal on titanium and zirconium implant surfaces. Especially on zirconium surfaces, decontamination with glycine + tricalcium phosphate seemed to be more efficient than treatment with glycine or sodium bicarbonate. CLINICAL RELEVANCE: The combination of glycine and tricalcium phosphate could improve the clinical outcomes of air-abrasive device in nonsurgical peri-implantitis therapy.

Nutritional Online Information for Cancer Patients: a Randomized Trial of an Internet Communication Plus Social Media Intervention.

We hypothesized that cancer patients using an Internet website would show an improvement in the knowledge about healthy eating habits, and this might be enhanced by social media interaction. A 6-month randomized intervention was set up. Eligible subjects were allocated in intervention (IG) and control groups (CG). IG had access to the website, and CG was provided with printed versions. All enrolled participants filled in Nutrition Questionnaire (NQ), Quality of Life Questionnaire (QoL) and Psychological Distress Inventory (PDI), at baseline and after 6 months. The difference between post- vs pre-questionnaires was calculated. Seventy-four subjects (CG 39; IG 35) completed the study. There was an increase in the score after the intervention in both groups for the NQ, even if not statistically significant. Dividing the IG into three categories, no (NI), low (LI) and high interactions (HI), we found a decreased score (improvement) in the CG (-0.2) and in the HI (-1.7), and an increased score (worsening) in the NI (+3.3) (p = NS) analysing the PDI. We found an increased score in the QoL both in CG and IG (adjusted LSMeans +3.5 and +2.8 points, respectively; p = NS). This study represents an example for support cancer patients. Despite the lack of significant effects, critical points and problems encountered may be of interest to researchers and organization working in the cancer setting. Intervention strategies to support patients during the care process are needed in order to attain the full potential of patient-centred care on cancer outcomes.

Non-surgical treatment of peri-implant mucositis and peri-implantitis at zirconia implants: a prospective case series.

OBJECTIVES: To assess the efficacy of non-surgical therapy for the management of peri-implant diseases at a two-piece zirconium implant system. MATERIAL & METHODS: Thirty-four patients with 45 implants participated in this study. Seventeen patients (24 implants) were diagnosed with peri-implant mucositis and received mechanical debridement + local antiseptic therapy using chlorhexidine digluconate (MD + CXH), while 17 patients (21 implants) diagnosed with peri-implantitis were assigned to Er:YAG laser therapy. In both groups, post-operative maintenance care included supramucosal plaque removal and local pocket irrigation using CHX. The primary endpoint was defined as disease resolution at 6 months (i.e. absence of bleeding upon probing (BOP) at mucositis sites/absence of BOP and probing pocket depths (PD) ≥6 mm at peri-implantitis sites). RESULTS: Resolution of peri-implant mucositis and peri-implantitis was obtained in 9/17 (52.9%) (p = 0.001) and 5/17 (29.4%) (p = 0.02) of the patients respectively. CONCLUSION: Non-surgical treatment of either peri-implant mucositis using MD + CHX or peri-implantitis using ERL at zirconia implants was associated with significant short-term clinical improvements. A complete disease resolution, however, was not achieved in the majority of the patients.

Taurolidine as an effective and biocompatible additive for plaque-removing techniques on implant surfaces.

OBJECTIVES: The aim of the present study was the evaluation of the effectiveness and efficiency of two plaque-removing techniques, plastic curettes (PC) and glycine powder airflow (GLY) in combination with taurolidine (T), chlorhexidine (CHX), or pure water (PW) as additives and compared to groups without previous treatment (NT). MATERIALS AND METHODS: Plaque was collected on titanium samples for 48 h in six subjects. Specimens were worn in a special splint in the upper jaw and randomly assigned to test and control groups. After biofilm removal procedures, clean implant surface (CIS) on the samples and treatment time were taken as parameters. RESULTS: Mean CIS was determined in the following descending order: T-GLY > CHX-GLY > NT-GLY > T-PC > PW-GLY > PW-PC > CHX-PC > NT-PC. Mean treatment time was determined in the following ascending order: T-GLY < CHX-GLY < PW-GLY < NT-GLY < T-PC < CHX-PC < PW-PC < NT-PC. CONCLUSIONS: Within the limits of this study, it can be concluded that T showed the highest CIS in the GLY and PC groups. T-GLY showed significantly more CIS than all other GLY groups. The T-PC group showed significantly more CIS than all other PC groups. The treatment times of the T groups were significantly lower than their corresponding PC or GLY groups. CLINICAL RELEVANCE: The results of the current study indicate that taurolidine seems to enhance effectiveness of plaque-removing procedures with plastic curettes and glycine powder airflow. Also, the efficiency of both treatment procedures seems to be increased.

Nonsurgical treatment of peri-implantitis using an air-abrasive device or mechanical debridement and local application of chlorhexidine. Twelve-month follow-up of a prospective, randomized, controlled clinical study.

OBJECTIVES: The purpose of this prospective, parallel group-designed, randomized controlled clinical study was the evaluation of the effectiveness of an air-abrasive device (AAD) for nonsurgical treatment of peri-implantitis. MATERIAL AND METHODS: Twenty five patients, showing at least one implant with initial to moderate peri-implantitis, underwent an oral hygiene programme and were randomly treated using either (1) AAD (amino acid glycine powder) or (2) mechanical debridement using carbon curettes and antiseptic therapy with chlorhexidine digluconate (mechanical debridement (MDA)). Clinical parameters were measured at baseline and 12 months after treatment (e.g. bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL)). RESULTS: At 12 months, the AAD group revealed significantly higher (p < 0.05; unpaired t test) decrease in mean BOP scores when compared with MDA-treated sites (41.2 ± 29.5 vs. 16.6 ± 33.4%). Both groups exhibited comparable PD reductions (AAD = 0.5 ± 0.9 mm vs. MDA = 0.4 ± 0.9 mm) and CAL gains (AAD = 0.6 ± 1.3 mm vs. MDA = 0.5 ± 1.1 mm) (p > 0.05; Mann-Whitney test, respectively). CONCLUSIONS: Within its limitations, the present study has indicated that both treatment procedures resulted in comparable but limited CAL gains at 12 months. Furthermore, it could be detected that AAD was associated with significantly higher BOP decrease than MDA. CLINICAL RELEVANCE: The present results have indicated that nonsurgical therapy of peri-implantitis using both AAD and MDA resulted in comparable PD reductions and CAL gains after 12 months of healing. The BOP reductions were significantly higher in the AAD in comparison to the MDA group. So, AAD may be more effective for nonsurgical therapy of peri-implantitis than MDA.

Rotating titanium brush for plaque removal from rough titanium surfaces--an in vitro study.

OBJECTIVES: The purpose of this study was the evaluation of the effectiveness of plaque removing of a new rotating brush made of titanium in comparison with the cleaning procedure with steel curettes. MATERIALS AND METHODS: Plaque was collected by six volunteers for 48 h. A total of 60 samples were randomly designated to two groups: the test group TiBrush and the control group with steel curettes. The residual plaque area (RPA) and the treatment time were determined as parameters. Scanning electron microscopy (SEM) was performed for detecting possible damages of the treatment procedures. RESULTS: The mean RPA within the TiBrush group (8.57 ± 4.85%) was significant lower than in the control group (28.99 ± 5.51%), while the mean treatment time was also significant lower in the TiBrush group (176.7 ± 15.2 sec) in comparison with the steel curettes (303.5 ± 11.5 sec). The outcomes of SEM analysis showed no surface alteration after TiBrush treatment. CONCLUSIONS: Within the limits of this study, this investigation concludes that TiBrush seems to be more effective in plaque removing capacity, while being gentler to the implant surface than the processing with steel curettes. These promising results could hold out an improvement of conventional periimplantitis treatment. Further studies are needed to prove these outcomes.

Impact of proangiogenic factors on organization and biodegradation of a collagen matrix. An immunohistochemical study in rats.

AIM: The aim of the present study was to investigate the impact of proangiogenic factors [erythropoetin (EPO), human growth hormone (HGH), fibroblast growth factor (FGF), and platelet derived growth factor (PDGF-BB)] on the organization and biodegradation of a porcine-derived collagen matrix (CM) in rats. MATERIAL AND METHODS: Collagen matrix specimens were soak-loaded either with EPO, HGH, FGF or PDGF-BB, each delivered in three concentrations (high, medium, low), and randomly allocated in unconnected subcutaneous pouches separated surgically on the back of 112 Wistar rats, which were divided into four groups (4, 7, 14 and 60 days of healing). Tissue biopsies were prepared for histological (e.g. CM thickness - TH, tissue contact - TC) and immunohistochemical (collagen type III - C3) analysis. RESULTS: Collagen matrix specimens of the control group were associated with an ingrowth of C3 fibres and subsequently an increase in TH at 7 (11%), 14 (20%) and 60 (21%). Factor application in different concentrations was commonly associated with a faster organization, but also significant biodegradation of CM at 7 (PDGF-M, FGF-M, HGH-H) and 14 days (EPO-H, HGH-L). All groups investigated revealed a comparable increase in mean TC values over time. CONCLUSION: Within the limits of the present study, it was concluded that all proangiogenic factors investigated were associated with a pronounced organization of CM by C3 fibres and a biodegradation of the matrix body. EPO may serve as an alternative to PDGF-BB.

The rapid radiation of Bomarea (Alstroemeriaceae: Liliales), driven by the rise of the Andes.

Geological events such as mountain uplift affect how, when, and where species diversify, but measuring those effects is a longstanding challenge. Andean orogeny impacted the evolution of regional biota by creating barriers to gene flow, opening new habitats, and changing local climate. B⁢o⁢m⁢a⁢r⁢e⁢a (Alstroemeriaceae) are tropical plants with (often) small, isolated ranges; in total, B⁢o⁢m⁢a⁢r⁢e⁢a species occur from central Mexico to central Chile. This genus appears to have evolved rapidly and quite recently, and rapid radiations are often challenging to resolve with traditional phylogenetic inference. In this study, we apply phylogenomics-with hundreds of loci, gene-tree-based data curation, and a multispecies-coalescent approach-to infer the phylogeny of B⁢o⁢m⁢a⁢r⁢e⁢a. We use this phylogeny to untangle the potential drivers of diversification and biogeographic history. In particular, we test if Andean orogeny contributed to the diversification of B⁢o⁢m⁢a⁢r⁢e⁢a. We find that B⁢o⁢m⁢a⁢r⁢e⁢a originated in the central Andes during the mid-Miocene, then spread north, following the trajectory of mountain uplift. Furthermore, Andean lineages diversified faster than non-Andean relatives. B⁢o⁢m⁢a⁢r⁢e⁢a thus demonstrates that-at least in some cases-geological change rather than environmental stability has driven high species diversity in a tropical biodiversity hotspot. These results also demonstrate the utility (and danger) of genome-scale data for making macroevolutionary inferences.

Non-ECG-gated cardiac CT angiography in acute stroke is feasible and detects sources of embolism.

BACKGROUND: A significant portion of cryptogenic stroke is hypothesized to be secondary to cardiac embolism. However, transthoracic echocardiogram is usually delayed after stroke, and more detailed cardiac imaging is not routinely done. AIMS: This study aimed to determine whether non-ECG-gated cardiac CT angiography (cCTA) during hyperacute stroke would provide diagnostic quality images and act as an adjunct modality of cardiac imaging to detect sources of emboli. METHODS: In this single-center prospective cohort study, modified Code Stroke imaging was implemented with a 64-slice CT scanner, where the longitudinal axis of CT angiography was extended from the carina to the diaphragm. The primary outcomes of image quality, recruitment feasibility, impact on hyperacute time metrics, and additional radiation dose were assessed. Secondary outcomes consisted of detection of high-risk cardiac sources of embolism, mediastinal or lung pathology, and impact on etiologic classification. RESULTS: One hundred and twenty eligible patients were enrolled, of which 105 (87.5%) had good/moderate quality images for motion artifact and 119 (99.2%) for contrast opacification. Total CT time, door-to-needle time, and door-to-groin puncture time were unchanged with the addition of cCTA. Eighty-nine patients received a final diagnosis of ischemic stroke, of which 12/89 (13.5%) had high-risk cardioembolic findings on cCTA. Incidental findings, such as pulmonary embolism (PE) (7/89, 7.9%) and malignancy (6/89, 6.7%), were observed. cCTA led to changes in management for 19/120 (15.8%) of all patients, and reclassification of stroke etiology for 8/89 (9%) of patients. CONCLUSIONS: Non-ECG-gated cCTA can be feasibly incorporated into Code Stroke and provide diagnostic quality images without delays in hyperacute time metrics. It can detect high-risk cardiac sources, and other findings impacting patient care. This may help reclassify a subset of cryptogenic stroke cases and improve secondary prevention.