Survival rate and peri-implant evaluation of immediately loaded dental implants in individuals with type 2 diabetes mellitus: a systematic review and meta-analysis.

OBJECTIVES: To evaluate the survival rate, success rate, and peri-implant biological changes of immediately loaded dental implants (ILs) placed in type 2 diabetic patients (DM2). MATERIALS AND METHODS: The present study was registered on PROSPERO and followed the PRISMA checklist. The search was performed by the first reviewer in January 2021. The electronic databases used were MEDLINE via PubMed, Cochrane, BVS, Web of Science, Scopus, LIVIVO, and gray literature. The risk of bias analysis was performed using an instrument from the Joanna Briggs Institute. RESULTS: A total of 3566 titles and abstracts were obtained. The qualitative synthesis included 7 studies, while the quantitative synthesis included 5 studies. The meta-analysis of IL in individuals with DM2 compared to nondiabetic individuals showed no significant difference among the groups regarding the survival rate of dental implants (RR = 1.00, 95% CI 0.96-1.04; p = 0.91; I2 = 0%), even if the patient had poor glycemic control (RR = 1.08, 95% CI 0.87-1.33; p = 0.48; I2 = 70%). Meta-analysis of marginal bone loss in IL compared to conventional loading in DM2 patients also showed no significant difference (mean difference = - 0.08, 95% CI - 0.25-0.08; p = 0.33; I2 = 83%). CONCLUSIONS: Type 2 diabetes mellitus does not seem to be a risk factor for immediately loaded implants if the glycemic level is controlled, the oral hygiene is satisfactory, and the technical steps are strictly followed. Clinical relevance Rehabilitation in diabetic individuals is more common due to the highest prevalence of edentulism in this population. It is essential to establish appropriate protocols for loading dental implants.

Photobiomodulation and Mandibular Advancement Modulates Cartilage Thickness and Matrix Deposition in the Mandibular Condyle.

Objective: We evaluated the effects of photobiomodulation (PBM), mandibular advancement (MA), and the combination of both treatments (PBM+MA) on condylar growth, by the analysis of cartilage and bone formation, fibrillar collagen deposition, proteoglycan content, cell proliferation, and clastic cell index (CCI). Methods: Forty male Wistar rats were randomly assigned to CONTROL, PBM, positive control-MA, and PBM+MA groups. The appliance was worn 10 h/day. Laser was irradiated bilaterally on mandibular condyles in 8 alternate days (1 irradiation point per condyle) using the following parameters: 780 nm, 10 J/cm2, 40 mW, 1 W/cm2, 10 sec/point, 0.4 J/point, and cumulative dose per point: 3.2 J. PBM+MA received both treatments simultaneously. After 15 days, the animals were euthanized and the condyles dissected and embedded in paraffin. Histological sections from the intermediate portion of the condyle were used for morphometric analysis. The relative frequency (%) of fibrillar collagens was determined in sections stained with picrosirius red-hematoxylin under polarized light or Gömöri's method for reticular fibers. Proteoglycan content was evaluated by computerized photocolorimetric analysis. CCI was determined by tartrate-resistant acid phosphatase (TRAP), and proliferating cell nuclear antigen (PCNA) was detected by immunohistochemistry. Results: PBM and MA influenced condylar cartilage thickeness and matrix deposition, but none of the treatments affected significantly the area of the condyle. CCI were not influenced by the treatments, but clastic cells distribution was influenced by MA and PBM+MA treatments. There was no significant difference in proliferating cells among the groups. Conclusions: This study demonstrated that PBM and MA stimulates matrix deposition and cartilage thickening in the mandibular condyle, but was not able to demonstrate a synergistic effect between the treatments. Additional studies should be conducted to evaluate the possible synergistic effect between PBM and MA.

Technical note: Intra-alveolar morphology assessed in empty dental sockets of teeth missing post-mortem.

Dental human identification relies on distinctive traits detected and compared between ante-mortem (AM) and post-mortem (PM) data. Several distinctive traits may be found in dental roots, such as dilacerations and bifurcations. However, teeth are often dislodged during the manipulation of skeletal remains, charred bodies and bodies retrieved from water. In these situations the identification process is hampered. The present study aims to retrieve information of teeth missing PM through the investigation of intra-alveolar morphology in empty dental sockets using different dental impression materials. This study was conducted using a dry human skull and 6 techniques for intra-alveolar impression, namely: (1) alginate using a dental tray; (2) heavy-body condensation silicone (HBCS) using manual compression; (3) HBSC using a blunt tip probe; (4) HBCS using a dental tray; (5) light- and HBCS using a syringe and a dental tray; and (6) polyether using a syringe and a dental tray. These techniques were evaluated based on 5 criteria: (I) intra-alveolar flow; (II) registration of apical morphology; (III) tensile strength; (IV) complexity; and (V) cost. The best outcomes considering the cost and benefit relation of each technique were observed in the following order: techniques #3>#2>#5>#6. Techniques #1 and #4 did not reach satisfactory outcomes for application in the forensic routine. Forensic dentists must be aware of the possibility of retrieving PM dental information even in the absence of teeth. The impression of intra-alveolar morphology may contribute significantly as source of PM dental information for human identifications.

The clinicopathologic significance of the expression of HLA-G in oral squamous cell carcinoma.

OBJECTIVE: This study aimed to evaluate HLA-G expression in primary oral cavity squamous cell carcinoma (OCSCC) and potentially malignant lesions and to evaluate its relationship with clinicopathologic parameters. STUDY DESIGN: HLA-G expression in samples from patients with metastatic and nonmetastatic OCSCC (n = 60), potentially malignant lesions (n = 15), and clinically and histologically normal oral mucosa (n = 10) was characterized by immunohistochemistry. The density of CD8, CD83, and CD68 cells and Ki-67(+) and bcl-2(+) neoplastic cells were analyzed. RESULTS: HLA-G expression by neoplastic cells was significantly higher in metastatic OCSCC compared with nonmetastatic OCSCC (P = .01). Higher HLA-G expression was observed in OCSCC than in potentially malignant lesions (P = .006). Moreover, patients with lower HLA-G expression exhibited a tendency toward longer survival (22 months) compared with those with higher HLA-G expression (16 months). CONCLUSIONS: Our findings suggest that increased HLA-G expression in metastatic OCSCC may represent a tumor escape mechanism, which portends an unfavorable clinical prognosis.