Surgical Drainage and Simultaneous Sinus Floor Augmentation in Patients with Chronic Maxillary Sinusitis.

Chronic maxillary sinusitis accompanied by severe thickening of the sinus mucosa, blockage of the ostium, and patient-reported symptoms requires preoperative assessment and treatment by an otolaryngologist before maxillary sinus floor augmentation (MSFA). Prescription of antibiotics and nasal saline irrigation are the first choice of treatment; however, endoscopic sinus surgery is considered when the treatment's effect is limited and drug resistance is observed. Nevertheless, MSFA performed in the presence of sinus pathologies have been reported to have favorable results when the lesions are managed properly. This report presents cases of two patients who required MSFA but were diagnosed with chronic maxillary sinusitis (case 1 with nasal sinusitis and case 2 with dental sinusitis). After 2 weeks of antibiotic therapy, endoscopic surgery was recommended due to minimal changes in the size of the sinus lesion; however, the patients refused because of improved self-reported symptoms. Therefore, intraoral surgical drainage was planned as an alternative treatment. A large bony window was prepared at the lateral wall of the maxillary sinus, and a long intentional incision was made to improve access for the suction tip in various directions and depths into the sinus cavity. Thorough suction of the purulent exudate and saline irrigation were performed through this access. The size of the perforated area was reduced along with the elevation of the Schneiderian membrane from the sinus floor, and simultaneous bone grafting with implant placement was performed. Prosthesis was delivered after 6-8 months. At 1-year follow-up after loading, favorable outcomes of implant survival and maintenance of augmented bone height were observed, with no recurrence of postoperative sinusitis. Within the limitations of the present case report, thorough sinus drainage and saline irrigation during maxillary sinus floor augmentation resolved sinus infection in patients with chronic maxillary sinusitis with short-term clinical outcomes.

Large Peripheral Osteomas and Dental Implants: A Case Report.

Peripheral osteoma of the jaw is a rare, benign, slow-growing lesion, which usually appears as a unilateral, pedunculated, radiopaque mass protruding from the periphery and is generally solitary. Multiple osteomas without any syndromic involvement are rare. In the present case, a 75-year-old male patient underwent implant placement in the edentulous posterior ridges of the maxilla and mandible. Over 7 years, multiple masses gradually proliferated in the buccal bone of the implant in three different sextants of the posterior region, reaching a size of 2.0 cm. Clinically and radiologically, these lesions were presumed to be peripheral osteomas and were surgically removed because the large mass made self-performed oral hygiene and maintenance of peri-implant health difficult. The histopathological evaluation confirmed that peripheral osteomas were both compact and cancellous. The patient did not exhibit any other clinical manifestations of Gardner syndrome. Whether dental implant placement and loading are involved in the occurrence of peripheral osteomas is unclear, but they might have affected the consistent growth of the mass as a reactive mechanism. After resection, the functional abilities of chewing and self-cleansing significantly improved. No recurrence of peripheral osteoma was observed after 1 year of follow-up, and peri-implant health was well maintained. Within the limitations of the present case report, multiple peripheral osteomas can occur adjacent to dental implants without any syndromic issues, and a large mass of PO can harm peri-implant health which requires surgical removal. It is speculated that dental implants may be associated with the slow and consistent growth of PO.

A Clinical Approach for the Removal of a Large Antral Pseudocyst with Simultaneous Maxillary Sinus Augmentation: A Case Series.

For a large benign lesion within the maxillary sinus, such as an antral pseudocyst, maxillary sinus floor augmentation is more commonly performed using a two-stage approach. This involves first removing the lesion, and then, re-entry following several months of healing. In this case series, we described the "one-bony-window" approach, which is a technical surgical modification of the previous one-stage approach, for simultaneous cyst removal and maxillary sinus floor augmentation. Four patients with large maxillary antral pseudocysts were included. The "one-bony-window" approach involves the preparation of a large window opening of approximately 15 mm × 20 mm at the lateral wall. A mesiodistally extended intentional perforation was made in the upper part of the exposed membrane to enhance the access for instrumentation. The antral pseudocyst was removed in its entirety without being deformed to prevent rupture or leakage of the cystic contents. Subsequent detachment and elevation of the Schneiderian membrane at the sinus floor significantly reduced the perforation site, and bone grafting with implant placement was performed simultaneously. This alleviated the need to surgically repair the perforation. The lateral opening was either uncovered or repositioned using bony window lids. Healing abutments were connected after six months, and the final prosthesis was placed after two months. At the 1-year follow-up, the antral pseudocysts had resolved with no specific recurrence, and the stability of the augmented sinus was maintained with excellent implant survival. Within the limitations of our findings, the "one-bony-window" technique can be suggested for the simultaneous removal of large antral pseudocysts and maxillary sinus floor augmentation with favorable clinical outcomes.

Oral Lichenoid Lesion following Dental Implant Placement and Successful Management with Free Gingival Graft: A Case Report with 10-Year Follow-Up.

Titanium and metal alloys are widely used in implants, crowns, and bridges in implant dentistry owing to their biocompatibility. In this case report of a 45-year-old female patient, multiple implants were placed in five different sextants at different time points. Notably, oral lichenoid lesions (OLL) occurred in three sextants following implant placement, strongly suggesting that the dental implants or prostheses were the causative factors for OLL. The lesion was of the reticular type with erythematous surroundings and was symptomatic. Although several conservative treatments, including repeated topical application of corticosteroids, were repeatedly continued, no discernible improvement or alleviation of symptoms was observed. Consequently, surgical excision and replacement of the lesion with a free gingival graft (FGG) harvested from the palatal soft tissue were performed. No clinical symptoms or recurrence of lesions were observed during 10 years of follow-up post-FGG.

Late implant placement following ridge preservation versus early implant placement: A pilot randomized clinical trial for periodontally compromised non-molar extraction sites.

AIM: To compare late implant placement following alveolar ridge preservation (LP/ARP) and early implantation (EP) in periodontally compromised non-molar extraction sites with respect to soft tissue levels, aesthetics, and patient-reported outcomes. MATERIALS AND METHODS: Sixteen patients were randomly allocated to groups LP/ARP (n = 9) or EP (n = 7). Group LP/ARP received ARP using deproteinized bovine bone mineral containing 10% collagen and a native bilayer collagen membrane, and group EP received only extraction. Implant placement was performed 4-8 weeks post-extraction in group EP and 4 months post-alveolar ridge preservation in group LP/ARP. The soft tissue levels, pink/white esthetic scores, and periodontal parameters were evaluated at 1 year post-loading. Patient's discomfort level was evaluated in terms of extraction/ARP and implant placement. RESULTS: No implant failure or biologic complications occurred. There was no statistically significant difference in the median change of the midfacial mucosal margin (0.03 for group LP/ARP, -0.19 mm for group EP) and the mesial/distal papilla (0.62/0.25 mm for group LP/ARP, 0.29/-0.5 mm for group EP), pink/white esthetic scores, periodontal parameters, and patient's discomfort between the two groups. CONCLUSION: Both implant placement protocols led to comparable outcomes in soft tissue levels, periodontal parameters, and patient's discomfort level.

Label-free quantitative proteomic analysis of human periodontal ligament stem cells by high-resolution mass spectrometry.

BACKGROUND AND OBJECTIVES: Proteome analysis of periodontal ligament stem cells (PDLSCs) could be used to study the function of PDL tissue. We used a label-free quantitative proteomic technique to investigate differentially expressed proteins (DEPs) in human PDLSCs (hPDLSCs) compared to human bone marrow mesenchymal stem cells (hBMSCs) and identify proteins specific to hPDLSCs. MATERIAL AND METHODS: hPDLSCs (n = 3) and hBMSCs (n = 3) were cultured and harvested for protein extraction and trypsin digestion. The proteomes of both cell types were analyzed by nano-liquid chromatography/tandem mass spectrometry. DEPs in hPDLSCs compared to hBMSCs were detected by label-free quantification and evaluated through signal transduction pathway and gene ontology (GO) analysis. RESULTS: In total, 690 and 771 proteins were identified from hPDLSCs and hBMSCs, of which 561 proteins were in common and 124 DEPs were found between hPDLSCs and hBMSCs. Fifty-eight proteins were expressed at significantly higher levels in hPDLSCs, whereas 66 proteins were expressed at lower levels compared to hBMSCs. The more highly expressed proteins were associated with translation and initiating protein synthesis, and lower expressed proteins were related to cell aging and metabolic processes. Proteins unique to hPDLSCs and hBMSCs were associated with translation and metabolic processes, respectively. CONCLUSION: Our results demonstrate evidence of distinct differences in protein expression between hPDLSCs and hBMSCs by using label-free quantitative proteomic analysis which was the first attempt in this field. DEPs included previously reported hPDLSC marker proteins and novel marker candidates, such as microtubule-associated protein, CTP synthase 1 and stathmin, which could be the markers for developing periodontal disease diagnostics and therapies.

A randomized, double-blind, placebo-controlled multicenter study for evaluating the effects of fixed-dose combinations of vitamin C, vitamin E, lysozyme, and carbazochrome on gingival inflammation in chronic periodontitis patients.

BACKGROUND: To evaluate gingival inflammation from fixed-dose combinations of vitamin C, vitamin E, lysozyme and carbazochrome (CELC) in the treatment of chronic periodontitis following scaling and root planing. METHODS: One hundred patients were randomly assigned to receive CELC (test) or placebo (control) for the first 4 weeks at a 1:1 ratio, and both groups received CELC for the remaining 4 weeks. Primary outcome was the mean change in the gingival index (GI) after 4 weeks. Secondary outcomes included mean change in GI after 8 weeks and plaque index, probing depth, clinical attachment level, and VAS at 4 weeks and 8 weeks. RESULTS: Ninety-three patients completed the study. The GI in the test group significantly decreased after 4 weeks (p < 0.001) and 8 weeks (p < 0.001). The mean change from baseline in GI significantly decreased in the test group compared to the control group after 4 weeks (p = 0.015). In the GEE model adjusting for age, gender and visits, the test group showed 2.5 times GI improvement compared to the control group (p = 0.022). CONCLUSIONS: Within the study, CELC showed a significant reduction in gingival inflammation compared with a placebo. Other parameters, however, were similar between groups. TRIAL REGISTRATION: KCT0001366 (Clinical Research Information Service, Republic of Korea) and 29 Jan 2015, retrospectively registered.

Sinus floor elevation in sites with a perforated schneiderian membrane: What is the effect of placing a collagen membrane in a rabbit model?

OBJECTIVE: To investigate the healing following sinus grafting in sites with a perforated schneiderian membrane repaired using a collagen membrane, compared to control sites without membrane perforation. MATERIALS & METHODS: Following elevation of the sinus membrane in 16 rabbits, each sinus was assigned to one of the following groups: (a) intentional schneiderian membrane perforation, followed by the placement of a collagen membrane and bone grafting (group SMP) and (b) bone grafting without a perforation of the schneiderian membrane and without a collagen membrane placement (control group). At 2 and 4 weeks (n = 8 for each time-point), microcomputed tomographic (micro-CT) and histomorphometric analyses were performed. RESULTS: Overall new bone formation in group SMP was significantly delayed compared to the control group at 2 and 4 weeks (1.58 ± 1.25% vs. 9.23 ± 2.69% at 2 weeks, 10.43 ± 3.55 vs. 17.86 ± 4.11% at 4 weeks, p < 0.05). At 2 weeks, new bone formation for the areas close to lateral (1.19 ± 2.02%) and medial sinus bone walls (3.17 ± 1.98%) was markedly delayed in group SMP compared to the control group (13.08 ± 6.13% and 12.75 ± 5.63%, respectively, p < 0.05), but there was no statistical difference in those areas at 4 weeks (p > 0.05). The augmented volumes at 2 and 4 weeks were not statistically significantly different in both groups. CONCLUSION: The perforation of the schneiderian membrane and the repair using a collagen membrane delayed new bone formation in the augmented sinuses. However, the extension of the collagen membrane on the sinus bone walls was also attributable to this delayed bone formation.

Effects of static magnetic fields on bone regeneration of implants in the rabbit: micro-CT, histologic, microarray, and real-time PCR analyses.

OBJECTIVES: The aim of this study was to investigate the effects of static magnetic fields (SMFs) on bone regeneration around titanium implants by µCT, histologic analysis, microarrays, and quantitative real-time PCR (qRT-PCR). MATERIALS AND METHODS: Neodymium magnets provided the source of SMFs, the specimens were grade 5 titanium implants, and the animals were twenty-seven adult male New Zealand white rabbits. These implants were divided into six groups according to the presence of a magnet and predetermined healing period (1, 4, and 8 weeks). Each group comprised six specimens for µCT (n = 6) and histologic examination, and three specimens (n = 3) for microarrays and qRT-PCR, yielding a total of 54 specimens. RESULTS: The µCT data showed that SMFs increased bone volume fraction (bone volume/total volume, BV/TV), trabecular number (Tb.N), and trabecular thickness (Tb.Th). Histologic observation indicated that SMFs promoted new bone formation and direct bony contact with implants. Microarray analysis identified 293 genes upregulated (>twofold) in response to SMFs. The upregulated genes included extracellular matrix (ECM)-related genes (COL10A1, COL9A1, and COL12A1) and growth factor (GF)-related genes (CTGF and PDGFD), and the upregulation was confirmed by qRT-PCR. Gene Ontology (GO) and pathway analysis revealed the involvement of the mitogen-activated protein kinase (MAPK), Wnt, and PPAR-gamma signaling pathways in implant healing. CONCLUSIONS: µCT, histology, microarrays, and real-time PCR indicate that SMFs could be an effective approach to improving bone regeneration around dental implants.

Long-term evaluation of sinus floor elevation using a modified lateral approach in the posterior maxilla.

OBJECTIVES: The aim of this study was to evaluate the hybrid technique, which was modified from the lateral approach in sinus elevation by combining transalveolar access. MATERIALS AND METHODS: Sixty patients (mean age of 53.3 ± 11.6 years) with 105 implants placed in the posterior maxilla with the average remaining bone height (RBH) of 4.3 ± 1.8 mm (range of 1.2-9.2 mm) were enrolled in the hybrid group and followed up for 96 months. The control group included 36 patients with 44 implants placed in the corresponding site with sufficient RBH. Cumulative survival rate (CSR), radiographic measurements in RBH, augmented bone height (ABH), and marginal bone loss (MBL) were analyzed during the follow-up period. RESULTS: Cumulative survival rate in the hybrid group was 98.1%, which was comparable to the control group (97.7%). MBL of the mesial and distal aspects in the hybrid group (0.28 ± 0.66 mm and 0.41 ± 0.93 mm, respectively) was comparable to the control group (0.84 ± 1.11 mm and 0.76 ± 0.88 mm, respectively). In the hybrid group, the membrane perforation rate during the surgery was 4.5%. ABH was 8.3 ± 1.8 mm after the surgery and maintained consistently during the follow-up period (7.4 ± 1.9 mm after 4 years). CONCLUSION: The hybrid technique is a simple and predictable surgical method for simultaneous placement of a dental implant with sinus floor elevation regardless of the RBH.

Validity of Collagen Plugs for Ridge Preservation in a Canine Model.

PURPOSE: The purpose of the present study was to evaluate healing outcomes after collagen plug insertion in extraction-related defects. MATERIALS AND METHODS: The third and fourth mandibular premolars in canines were extracted, and the septal bone was removed. The following treatments were performed for the defects: porcine atelo-collagen plug, bovine atelo-collagen plug, and no intervention (control). The experimental animals were killed after 6, 12, or 24 weeks (n = 4, respectively). Histologic and histomorphometric analyses were performed. RESULTS: Clinical healing was uneventful, and no difference was detected among the 3 groups. Histologically, similar healing patterns were observed in all groups. Gingival healing was complete at 6 weeks, but discontinuity in the buccal crestal bone was observed. At 12 weeks, various degrees of buccal bone depression and increase in bone marrow were observed. At 24 weeks, no further healing was observed. Histomorphometrically, the ridge width at 1, 3 and 5 mm levels below the crest and the ridge dimensions 1, 3, and 5 mm above the level were not statistically different among groups or healing periods. CONCLUSION: The healing following the use of collagen plug in the extraction socket may correspond to the natural healing after extraction.

A high concentration of recombinant human bone morphogenetic protein-2 induces low-efficacy bone regeneration in sinus augmentation: a histomorphometric analysis in rabbits.

OBJECTIVES: The aim of the study was to elucidate the efficacy of bone regeneration at the early stage of healing in rabbit sinuses grafted with a biphasic calcium phosphate (BCP) carrier soaked in a high concentration of recombinant human bone morphogenetic protein-2 (rhBMP-2). MATERIALS AND METHODS: Both maxillary sinuses of eight male rabbits were used. The sinus on one side (assigned randomly) was grafted with BCP loaded with rhBMP-2 (1.5 mg/ml; test group) using a soaking method, while the other was grafted with saline-soaked BCP (control group). After a 2-week healing period, the sinuses were analyzed by micro-computed tomography and histomorphometry. RESULTS: The total augmented area and soft tissue space were significantly larger in the test group than in the control group, whereas the opposite was true for the area of residual material and newly formed bone. Most of the new bone in the test group was localized to the Schneiderian membrane (SM), while very little bone formation was observed in the window and center regions of the sinus. New bone was distributed evenly in the control group sinuses. CONCLUSION: Within the limitations of this study, it appeared that application of a high concentration of rhBMP-2 soaked onto a BCP carrier inhibited bone regeneration from the pristine bone and increased soft tissue swelling and inflammatory response at the early healing stage of sinus augmentation, although osteoinductive potential was found along the SM.

Layered approach with autogenous bone and bone substitute for ridge augmentation on implant dehiscence defects in dogs.

OBJECTIVES: This study compared the efficacies of different layered approaches using autogenous bone and synthetic bone substitute for ridge augmentation on implant dehiscence defects in dogs. MATERIALS AND METHODS: Right mandibular second, third, and fourth premolars and the first molar were extracted, followed by standardized one-wall defect preparation in five dogs. After a healing period of 12 weeks, three implants (Implantium(®) ) were installed. Each of the three implant dehiscence defects was grafted with a different material as follows: (i) synthetic bone substitute combined with collagen (SBC; SBC group), (ii) inner autogenous bone layer and outer SBC layer (IAB group), and (iii) inner SBC layer and outer autogenous bone layer (OAB group). The grafted sites were covered with a resorbable collagen membrane. Quantitative and qualitative analyses of the subsequent bone regeneration were performed at 12 weeks postoperatively. RESULTS: The dome-like augmented shape was relatively well maintained in the IAB and OAB groups, while the graft particles in the SBC group were dispersed. The bone-to-implant contact values tended to be significantly higher in the OAB group (49.51%) than in the SBC (36.58%) group. The amounts of newly formed bone within an area designated as 1 × 3 mm (width × height) from the implant platform in the IAB, OAB, and SBC groups were 35.59%, 28.10%, and 16.71%, respectively. CONCLUSION: Application of the layered approach using autogenous bone and synthetic biomaterial resulted in substantial new bone formation and volume maintenance on implant dehiscence defects, irrespective of the position of the autogenous bone layer.

Bone regenerative efficacy of biphasic calcium phosphate collagen composite as a carrier of rhBMP-2.

OBJECTIVES: This study compared the bone regenerative effects of a recombinant human bone morphogenetic protein 2 (rhBMP-2)-loaded collagen-based biphasic calcium phosphate composite (BCPC) and rhBMP-2-loaded biphasic calcium phosphate (BCP). MATERIAL AND METHODS: The in vitro release profiles of rhBMP-2-loaded BCP and BCPC were measured. The animal surgery was performed on ten rabbits. Four 8-mm-diameter circular calvarial defects were made and filled with BCP, BCPC, rhBMP-2-loaded BCP (BMP + BCP) and rhBMP-2-loaded BCPC (BMP + BCPC). The animals were euthanized either 2 or 8 weeks after surgery. RESULTS: The initial burst release of rhBMP-2 was greater for BCP than for BCPC, and both presented a slow release pattern thereafter. In rabbit calvarial defects, the space maintaining capability and graft resorption of all experimental groups did not show statistical differences at 2 and 8 weeks. New bone formation in the rhBMP-2-loaded groups was greater than in the non-loaded groups at both weeks, but the amount of new bone was comparable between both rhBMP-2-loaded groups at both weeks. There was a distinct histologic difference between the BMP + BCP and BMP + BCPC groups at 2 weeks; the new bone formation occurred more in the intergranular spaces and the BCP-to-bone contact was greater in the BMP + BCPC group, but these differences were no longer discernible at 8 weeks. CONCLUSIONS: BCP- and BCPC-loaded rhBMP-2 significantly improved bone regeneration and BCPC led to a dense network of new bone and bone particles during the early healing period. BCPC can therefore be considered as a promising candidate for carrying rhBMP-2.

Pre-clinical evaluation of the osteogenic potential of bone morphogenetic protein-2 loaded onto a particulate porcine bone biomaterial.

AIM: The objective of study was to determine the osteogenic potential of bone morphogenetic protein-2 (BMP-2) loaded onto a particulate porcine bone mineral (PBM) biomaterial using a sinus augmentation model. METHODS: Release kinetics of BMP-2/PBM was determined in vitro. Eight rabbits received BMP-2/PBM or PBM alone into contra-lateral sinus sites. The animals were killed following a 2-week healing interval for micro-CT and histometrical analysis. RESULTS: Approximately 40% of the BMP-2 was released from PBM over the first 3 days in vitro; release maintained at a reduced level through day 21. In vivo, total augmented implant volume did not differ significantly between treatments. However, local bone formation was enhanced in the BMP-2/PBM group compared with PBM control (10.5% versus 6.6%; p = 0.03), specifically in the central aspect of the PBM implant (14.2% versus 5.5%; p < 0.01) and adjoining the Schneiderian membrane (11.9% versus 5.0%; p < 0.05). There were no significant overall differences in residual biomaterial and fibrovascular tissue. CONCLUSION: Bone morphogenetic protein-2 enhanced local bone formation in the rabbit maxillary sinus model following implantation using a PBM carrier.

Impact of different synthetic bone fillers on healing of extraction sockets: an experimental study in dogs.

OBJECTIVES: The objective of this study was to elucidate the socket healing process and biodegradation of incorporating synthetic bone fillers followed by grafting of the fresh extraction socket. MATERIALS AND METHODS: Third premolars in four quadrants of eight beagle dogs were extracted and randomly treated with either one of hydroxyapatite (HA), biphasic calcium phosphate (BCP), ß-tricalcium phosphate (ß-TCP), or no graft (C). Histologic observations and histomorphometric analysis at three zones (apical, middle, and coronal) of the socket were performed. Socket area (S) and the proportions of newly formed bone (%NB), residual biomaterials (%RB), and fibrovascular connective tissue (%FCT) at 2, 4, and 8 weeks were measured. The numbers of osteoclast-like multinucleated cells (No.OC) were also determined at the three zones. RESULTS: %NB was significantly higher in control group compared with the grafted groups at all healing periods. %NB of HA and BCP increased with time, whereas %RB showed different patterns that decreased in BCP, unlike the minimal change observed in HA. %NB of ß-TCP showed smallest portion compared with other grafted groups at 2 and 4 weeks, however, significantly increased at 8 weeks. %RB of ß-TCP was less than HA and BCP at all healing periods. Numbers of multinucleated cells were greater in BCP and ß-TCP, followed by HA and smallest in control group. CONCLUSIONS: Within the limit of this study, bone formation of the extraction socket was delayed in the sockets grafted with synthetic bone fillers and showed different healing process according to the biodegradation patterns.

Anatomical topography of the mandibular symphysis in the Korean population: a computed tomography analysis.

The objective of this study was to reveal the topography of the mandibular symphysis according to gender and age in the Korean population using computed tomography (CT) to provide a mean anatomical database for the safety zone during block bone harvesting. The following parameters were measured in CT images taken from Korean subjects: interforaminal distance (ID), vertical distance between the inferior mandibular border and the apices of the anterior teeth (VD), and horizontal distance between the labial cortical bone and the apices of the anterior teeth (HD). Differences between genders and among age groups, and the correlations among measurements were analyzed. A total of 973 images (411 males and 562 females; mean age = 41.2 years) were selected. The overall mean ID, VD, and HD were 55.38 ± 5.13, 22.16 ± 3.84 and 5.21 ± 1.70 mm, respectively. The ID and VD were significantly larger in males than in females (P < 0.001), and ID was significantly smaller in the youngest age group than in other age groups (P < 0.001), while HD differed significantly only between the youngest and oldest groups (P < 0.05). There was a weak positive correlation between ID and HD (γ > 0.10). This study provides information on the topography of the mandibular symphysis in the Korean population based on a large number of CT images. In general, gender seemed to influence the symphyseal dimensions strongly, whereas the influence of age was limited.

Soft-tissue volume augmentation using a connective tissue graft and a volume-stable collagen matrix with polydeoxyribonucleotide for immediate implant placement: a pilot study in a dog model.

PURPOSE: The aims of this study were 1) to investigate the effects of a subepithelial connective tissue graft (SCTG) and a volume-stable collagen matrix (VCMX) on soft-tissue volume gain in the immediate implant placement protocol, and 2) to determine whether polydeoxyribonucleotide (PDRN) can enhance the effects of a VCMX. METHODS: Dental implants were placed in 4 mongrel dogs immediately after extracting the distal roots of their third and fourth mandibular premolars. The gap between the implant and the buccal bone plate was filled with synthetic bone substitute particles. The following soft-tissue augmentation modalities were applied buccally: 1) control (no augmentation), 2) SCTG, 3) VCMX, and 4) VCMX/PDRN. After 4 months, histomorphometric analysis was performed. Tissue changes were evaluated using superimposed standard tessellation language (STL) files. RESULTS: Wound dehiscence was found in more than half of the test groups, but secondary wound healing was successfully achieved in all groups. Histomorphometrically, tissue thickness was favored in group SCTG at or above the implant platform level (IP), and group SCTG and the groups with VCMX presented similar tissue thickness below the IP. However, the differences in such thickness among the groups were minor. The keratinized tissue height was greater in group VCMX/PDRN than in groups SCTG and VCMX. Superimposing the STL files revealed a decrease in soft-tissue volume in all groups. CONCLUSIONS: Wound dehiscence after soft-tissue volume augmentation might be detrimental to obtaining the expected outcomes. PDRN appears not to have a positive effect on the soft-tissue volume gain.

Prediction model of browning inhibitor concentration and its optimal composition for mass processing of ready-to-eat fresh-cut 'Fuji' apple (Malus domestica Borkh.) strains.

In this study, we optimized the composition of the browning inhibitor for apples and established a prediction model for the browning inhibitor concentration in mass-processed fresh-cut apples based on electrical conductivity measurements. The "Fuji" apples that were harvested in Chungju, Korea, were used for this study. Vitamin C mixture (VCM) and trehalose (Tre) were used as browning inhibitors at a 4% ratio. The browning reaction under Δ3 of BI (browning index) for 5 days was defined as the target shelf-life of the apple flesh. The ΔBI of VCM and Tre was lower than that of VCM by 4%. It is revealed that the electrical conductivity of the browning inhibitor was highly correlated with its concentration and the number of soaked apples. Finally, the regression of the conductivity was fitted as Y = -0.0024 (number of soaked apples) + 0.5111 (R2 = 0.9931). In the validation test, the conductivity must be maintained at 0.4373 S/m or higher to maintain the target anti-browning level of Δ3 or less, which corresponded to ∼80% of the initial qualitative level after manufacture. The conductivity measurement of the browning inhibitor is suitable for monitoring and predicting its concentration in the mass processing of fresh-cut apple production due to the convenience of this method. PRACTICAL APPLICATION: The conductivity measurement of browning inhibitors can be applied not only to the mass processing of apple production but also to the anti-browning treatment of other fruits and vegetables, due to the convenience of this method. From these research results, it is expected to derive a formula that can predict the concentration of browning inhibitors through simple experiments for other fruits or vegetables.

Investigation of periodontitis, halitosis, xerostomia, and serological characteristics of patients with osteoarthritis and rheumatoid arthritis and identification of new biomarkers.

Rheumatoid arthritis (RA) and osteoarthritis (OA) are two different types of arthritis. Within RA, the subsets between seronegative RA (snRA) and seropositive RA (spRA) represent distinct disease entities; however, identifying clear distinguishing markers between them remains a challenge. This study investigated and compared the oral health conditions in patients with RA and OA to clarify the differences from healthy controls. In addition, we investigated the serological characteristics of the patients, the factors that distinguished patients with RA from those with OA, and the main factors that differentiated between snRA and spRA patients. A total of 161 participants (mean age: 52.52 ± 14.57 years, 32 males and 129 females) were enrolled in this study and categorized as: normal (n = 33), OA (n = 31), and RA (n = 97). Patients with RA were divided into the following two subtypes: snRA (n = 18) and spRA (n = 79). Demographics, oral health, and serological characteristics of these patients were compared. The prevalence of periodontal diseases was significantly higher in patients with OA (100%) and RA (92.8%) than in healthy controls (0.0%). However, the presence of periodontal diseases was not utilized as a distinguishing factor between OA and RA. Xerostomia occurred more frequently in patients with RA (84.5%) than in patients with OA (3.2%) and healthy controls (0.0%) (all p < 0.001). ROC analysis revealed that periodontal disease was a very strong predictor in the diagnosis of OA compared to healthy controls, with an AUC value of 1.00 (p < 0.001). Additionally, halitosis (AUC = 0.746, 95% CI 0.621-0.871, p < 0.001) and female sex (AUC = 0.663, 95% CI 0.529-0.797, p < 0.05) were also significant predictors of OA. The strongest predictors of RA diagnosis compared to healthy controls were periodontal diseases (AUC = 0.964), followed by xerostomia (AUC = 0.923), age (AUC = 0.923), female sex (AUC = 0.660), and halitosis (AUC = 0.615) (all p < 0.05). Significant serological predictors of RA were anti-CCP Ab (AUC = 0.808), and RF (AUC = 0.746) (all p < 0.05). In multiple logistic regression analysis, xerostomia (odds ratio, OR: 8124.88, 95% CI 10.37-6368261.97, p-value = 0.008) and Anti-CCP Ab (OR: 671.33, 95% CI 2.18-207,074.02, p = 0.026) were significant predictors for RA compared to OA. When diagnosing spRA compared to snRA, anti-CCP Ab (AUC = 1.000, p < 0.001) and RF (AUC = 0.910, 95%CI 0.854-0.967, p < 0.001) had outstanding predictive performances. Therefore, clinicians and researchers should thoroughly evaluate the oral status of both OA and RA patients, alongside serological factors, and consider these elements as potential predictors.