Effect of temperature on presepsin pre-analytical stability in biological fluids of preterm and term newborns.

OBJECTIVES: Thermostability is one of the pre-requisites for the reliability of analytes in clinical practice and biomedical research. Although presepsin represents a promising new biomarker for the early diagnosis of sepsis in newborns, data on its stability under different storage conditions are lacking. We aimed to investigate presepsin thermostability in blood, urine and saliva samples after thawing at 4 predetermined monitoring time-points in a cohort of preterm and term infants. METHODS: We conducted an observational study, where each case served as its own control, in 24 preterm and term infants. Blood, urine and saliva samples were stored at -80 °C for 18 months, and presepsin measured in different biological fluids at thawing (T0), 24 (T1), 48 (T2) and at 72 (T3) hours after thawing. RESULTS: No significant differences (p>0.05, for all) in presepsin levels were observed at T0-T3 in the different biological fluids. Furthermore, no differences at T0-T3 were observed in presepsin levels between blood and saliva fluids, whilst urine levels were significantly higher (p<0.05, for all) than blood and saliva at T0-T3. CONCLUSIONS: Results on presepsin pre-analytical thermo-stability in different biological fluids after long-term refrigeration support the reliability of this biomarker in the diagnosis and monitoring of perinatal sepsis.

Biological Effects of PMMA and Composite Resins on Human Gingival Fibroblasts: An In Vitro Comparative Study.

The use of temporary resin for provisional restorations is a fundamental step to maintain the position of prepared teeth, to protect the pulpal vitality and the periodontal health as well as the occlusion. The present study aimed at evaluating the biological effects of two resins used in dentistry for temporary restorations, Coldpac (Yates Motloid) and ProTemp 4™ (3M ESPE ™), and their eluates, in an in vitro model of human gingival fibroblasts (hGFs). The activation of the inflammatory pathway NFκB p65/NLRP3/IL-1ß induced by the self-curing resin disks was evaluated by real-time PCR, Western blotting and immunofluorescence analysis. The hGFs adhesion on resin disks was investigated by means of inverted light microscopy and scanning electron microscopy (SEM). Our results suggest that hGF cells cultured in adhesion and with eluate derived from ProTemp 4™ (3M ESPE ™) resin evidenced a downregulation in the expression of the inflammatory mediators such as NFκB p65, NLRP3 and IL-1ß compared to the cells cultured with Coldpac (Yates Motloid) after 24 h and 1 week of culture. Furthermore, the cells cultured with ProTemp 4™ (3M ESPE ™) after 24 h and 1 week of culture reported a higher cell viability compared to the cells cultured with Coldpac (Yates Motloid), established by MTS cell analysis. Similar results were obtained when hGFs were placed in culture with the eluate derived from ProTemp 4™ (3M ESPE ™) resin which showed a higher cell viability compared to the cells cultured with eluate derived from Coldpac (Yates Motloid). These results highlighted the lower pro-inflammatory action and improved cell biocompatibility of ProTemp 4™ (3M ESPE ™), suggesting a better performance in terms of cells-material interaction.

Collagen Fibres Orientation in the Bone Matrix around Dental Implants: Does the Implant's Thread Design Play a Role?

The aim of this study was to analyse the influence of different thread shapes of titanium dental implant on the bone collagen fibre orientation (BCFO) around loaded implants. Twenty titanium dental implants, divided for thread shapes in six groups (A-F) were analysed in the present study. All implants were immediately loaded and left in function for 6 months before retrieval. The parameters evaluated under scanning electron microscope were the thread width, thread depth, top radius of curvature, flank angle, and the inter-thread straight section. Two undecalcified histological sections were prepared from each implant. Birefringence analysis using circularly polarized light microscopy was used to quantitively measure BCFO. For groups A-F, respectively, transverse BCFO was 32.7%, 24.1%, 22.3%, 18.2%, 32.4%, and 21.2%, longitudinal BCFO was 28.2%, 14.5%, 44.9%, 33.1%, 37.7%, and 40.2%. The percentage differences between transverse and longitudinal orientation were 4.50% (A), 9.60% (B), -22.60% (C), -14.90% (D), -5.30% (E), and -19.00% (F). Following loading, the amount of transverse and longitudinal BCFO were significantly influenced by the thread shape. The greater flank angles and narrower inter-thread sections of the "V" shaped and "concave" shaped implant threads of groups A and B, respectively, promoted the predominance of transverse BCFO, compared to groups C-F (p < 0.05). A narrow inter-thread straight section promotes transverse BCFO, as do "V" shaped and "concave" shaped threads, which can thus be considered desirable design for implant threads.

Gingival Response to Dental Implant: Comparison Study on the Effects of New Nanopored Laser-Treated vs. Traditional Healing Abutments.

The health of peri-implant soft tissues is important for the long-term success rate of dental implants and the surface topography is pivotal in influencing it. Thus, the aim of this study was to evaluate, in human patients, the inflammatory mucosal microenvironment in the tissue surrounding a new, nanoscale, laser-treated healing abutment characterized by engineered nanopores versus a standard machined-surface. Analyses of anti- and pro-inflammatory markers, cytokeratins, desmosomal proteins and scanning electron microscopy were performed in 30 soft-tissue biopsies retrieved during second-stage surgery. The results demonstrate that the soft tissue surrounding the laser-treated surface was characterized by a lower grade of inflammation than the one facing the machined-surface, which, in turn, showed a disrupted epithelium and altered desmosomes. Moreover, higher adhesion of the epithelial cells on the laser-treated surface was detected compared to the machined one. In conclusion, the laser-treated surface topography seems to play an important role not only in cell adhesion, but also on the inflammatory makers' expression of the soft tissue microenvironment. Thus, from a clinical point of view, the use of this kind of topography may be of crucial importance not only on healing abutments but also on prosthetic ones.

The Antibiofilm Effect of a Medical Device Containing TIAB on Microorganisms Associated with Surgical Site Infection.

Surgical site infections (SSIs) represent the most common nosocomial infections, and surgical sutures are optimal surfaces for bacterial adhesion and biofilm formation. Staphylococcus spp., Enterococcus spp., and Escherichia coli are the most commonly isolated microorganisms. The aim of this research was to evaluate the antibiofilm activity of a medical device (MD) containing TIAB, which is a silver-nanotech patented product. The antibacterial effect was evaluated against Staphylococcus aureus ATCC 29213, Enterococcus faecalis ATCC 29212, and E. coli ATCC 25922 by assessing the minimum inhibitory concentration (MIC) by the Alamar Blue® (AB) assay. The antibiofilm effect was determined by evaluation of the minimum biofilm inhibitory concentration (MBIC) and colony-forming unit (CFU) count. Subsequently, the MD was applied on sutures exposed to the bacterial species. The antimicrobial and antibiofilm effects were evaluated by the agar diffusion test method, confocal laser scanning microscopy (CLSM), and scanning electron microscopy (SEM). The MIC was determined for S. aureus and E. faecalis at 2 mg/mL, while the MBIC was 1.5 mg/mL for S. aureus and 1 mg/mL for E. faecalis. The formation of an inhibition zone around three different treated sutures confirmed the antimicrobial activity, while the SEM and CLSM analysis performed on the MD-treated sutures underlined the presence of a few adhesive cells, which were for the most part dead. The MD showed antimicrobial and antibiofilm activities versus S. aureus and E. faecalis, but a lower efficacy against E. coli. Surgical sutures coated with the MD have the potential to reduce SSIs as well as the risk of biofilm formation post-surgery.

New bone formation after transcrestal sinus floor elevation was influenced by sinus cavity dimensions: A prospective histologic and histomorphometric study.

OBJECTIVE: The aim of this multicenter prospective study was to analyze clinically and histologically the influence of sinus cavity dimensions on new bone formation after transcrestal sinus floor elevation (tSFE). MATERIAL AND METHODS: Patients needing maxillary sinus augmentation (residual crest height <5 mm) were treated with tSFE using xenogeneic granules. Six months later, bone-core biopsies were retrieved for histological analysis in implant insertion sites. Bucco-palatal sinus width (SW) and contact between graft and bone walls (WGC) were evaluated on cone beam computed tomography, and correlations between histomorphometric and anatomical parameters were quantified by means of forward multiple linear regression analysis. RESULTS: Fifty consecutive patients were enrolled and underwent tSFE procedures, and forty-four were included in the final analysis. Mean percentage of newly formed bone (NFB) at 6 months was 21.2 ± 16.9%. Multivariate analysis showed a strong negative correlation between SW and NFB (R2  = .793) and a strong positive correlation between WGC and NFB (R2  = .781). Furthermore, when SW was stratified into three groups (<12 mm, 12 to 15 mm, and >15 mm), NFB percentages (36%, 13% and 3%, respectively) resulted significantly different. CONCLUSIONS: This study represented the first confirmation based on histomorphometric data that NFB after tSFE was strongly influenced by sinus width and occurred consistently only in narrow sinus cavities (SW <12 mm, measured between buccal and palatal walls at 10-mm level, comprising the residual alveolar crest).

Evaluation of Fibrin Clot Attachment on Titanium Laser-Conditioned Surface Using Scanning Electron Microscopy.

OBJECTIVES: The study aimed to evaluate the effects of different titanium surface treatments on blood clot extension (bce). METHODS: A total of 54 titanium disks with machined surface (M), laser-conditioned surface (L), and grit-blasted surface (S) were used in the present study. The surface characteristics such as contact angles and the microroughness were determined on each group (n = 4). To evaluate the bce, 0.1 mL of human blood was dropped onto the surface of each specimen and left for 7 minutes at room temperature. After fixation, dehydration, and gold sputtering treatments, the specimens were observed under scanning electron microscope. The bce values were expressed as percentage of specimen surface covered by blood clot. RESULTS: The surface roughness (Ra ±â€Šstandard deviation [SD]) was 0.75 ±â€Š0.02 µm for M, 0.25 ±â€Š0.02 µm for L, and 1.30 ±â€Š0.03 µm for S. The contact angles measured in static conditions (WCA ±â€ŠSD) were 71 ±â€Š5.4° for M, 107 ±â€Š6.6° for L, and 91 ±â€Š7.2° for S. Regarding the bce (bce ±â€ŠSD) of M samples (65.5 ±â€Š4.3%) was statistically lower compared with both L (83.4 ±â€Š5.1%) and S samples (72.4 ±â€Š4.7%) (P < 0.05). Meanwhile, the L group showed the higher bce value. CONCLUSION: The present results suggest that the laser-conditioned surface may increase the wettability and bce.

Three-Dimensional Architecture and Mechanical Properties of Bovine Bone Mixed with Autologous Platelet Liquid, Blood, or Physiological Water: An In Vitro Study.

In recent years, several techniques and material options have been investigated and developed for bone defect repair and regeneration. The progress in studies of composite graft materials and autologous platelet-derived growth factors for bone regeneration in dentistry and their biological and biomechanical properties has improved clinical strategies and results. The aim of this study was to evaluate the three-dimensional architecture and mechanical properties of three different combinations of composite bovine graft, adding autologous platelet liquid (APL), blood, or physiological water. One experimental group for each combination of biomaterials was created. In particular, in Group I, the bovine graft was mixed with APL; in Group II, it was mixed with blood, and in Group III, the biomaterial graft was combined with physiological water. Then, the composite biomaterials were evaluated by scanning electron microscopy (SEM), and a compression-loading test was conducted. The evaluation showed a statistical significance (p < 0.01) of the elastic regime of deformation resistance, in which the combination of APL with bone graft resulted in an 875% increase in the mechanical resistance. The protocol of APL mixed with bovine bone graft produced a composite sticky graft block that was capable of increasing the mechanical properties in order to improve its clinical use in the treatment of the maxillary bone defects.

Candida species isolated from different body sites and their antifungal susceptibility pattern: Cross-analysis of Candida albicans and Candida glabrata biofilms.

Candida species are regular commensal in humans, but-especially in immunocompromised patients-they represent opportunistic pathogens giving rise to systemic infection. The aim of the present work was to isolate and characterize for their antifungal profile Candida species from different body sites and to analyze the biofilms produced by C. albicans and C. glabrata isolates. Eighty-one strains of Candida species from 77 patients were identified. Epidemiological study showed that the most isolated species were C. albicans (44), C. glabrata (13) and C. parapsilosis (13) mainly from Hematology, Infectious Diseases, Medicine, Neonatology and Oncology Divisions, the majority of the biological samples were swabs (44) and blood cultures (16). The analysis of the biofilm formation was performed at 24 and 48-hours comparing resistant and susceptible strains of C. albicans to resistant and susceptible strains of C. glabrata. Candida albicans has a greater ability to form biofilm compared to C. glabrata, both in the susceptible and resistant strains reaching maturity after 24 hours with a complex structure composed of blastospores, pseudohyphae, and hyphae embedded in a matrix. On the contrary, C. glabrata biofilm was composed exclusively of blastospores that in the resistant strain, after 24 hours, were organized in a compact multilayer different to the discontinuous structure observed in the susceptible analyzed strains. In conclusion, the increasing of the incidence of Candida species infection together with their emerging drug resistance also related to the biofilm forming capability underline the need to monitor their distribution and susceptibility patterns for improving the surveillance and for a correct management of the infection.

Influence of Maxillary Sinus Width on New Bone Formation After Transcrestal Sinus Floor Elevation: A Proof-of-Concept Prospective Cohort Study.

PURPOSE: Graft maturation in the maxillary sinus requires adequate angiogenesis and osteoprogenitor cells migration from the surrounding bony walls: the aim of this study was to analyze the correlation between sinus cavity dimensions and new bone formation after transcrestal sinus floor elevation (tSFE). METHODS: Patients needing maxillary sinus augmentation (residual crest height ≤ 4 mm) were treated with tSFE using xenogeneic granules. Six months later, bone-core biopsies were retrieved for histological analysis in the implant insertion sites. Buccopalatal sinus width (SW) was evaluated on cone beam computed tomography, and correlations between histomorphometric and anatomical parameters were quantified by means of linear regression analysis. RESULTS: Eight consecutive patients underwent tSFE procedures: at 6 months, average percentage of newly formed bone resulted 24.2% ± 7.9%. Statistical analysis showed a strong inverse correlation between SW and new bone formation (R = 0.88), and a strong direct correlation between the number of exposed bone walls and new bone formation (R = 0.82). CONCLUSION: Within the limitations of this proof-of-concept study, in which a restricted number of patients were analyzed, tSFE showed more predictable results in narrow than in large sinuses, in terms of new bone formation.

Impact of Second Stage Surgery on Bone Remodeling Around New Hybrid Titanium Implants: A Prospective Clinical Study in Humans.

OBJECTIVE: The present prospective study aimed to more precisely identify the time points of bone changes around hybrid titanium implants up to 30 months of follow-up. MATERIALS AND METHODS: Twelve hybrid T3 implants (Biomet 3i) were placed in 9 healthy patients with the 2-stage surgical approach. Standardized digital Rx were taken at implant insertion (T0); healing-abutment connection after 3.1 ± 0.2 weeks (TX); loading stage after 7.5 ± 0.6 weeks (T1); after 12 months (T2); and after 30 months (T3) of functional loading. The marginal bone loss was digitally measured. RESULTS: The mean marginal bone loss was 0.76 ± 0.37 mm after 30 months. More than 60% (0.42 ± 0.29 mm) of the bone loss took place at healing-abutment connection (TX-T1). No statistically significant bone loss was found between T1-T2 and T2-T3, after 12 and 30 months, respectively. Approximately 40% of bone loss (0.34 mm) was noted between T1 and T3 (P < 0.05), which corresponds to the loading period. CONCLUSIONS: The implant-oral environment connection represents a critical step point in crestal bone loss. The amount of marginal bone loss, measured after 30 months of loading (T1-T3), was much less than that reported in the literature, showing that correct loading has a minor impact on the periimplant bone remodeling as compared to surgical implant reopening.

Porphyromonas gingivalis biofilm formation in different titanium surfaces, an in vitro study.

OBJECTIVE: The aim of this work was to evaluate the biofilm formation of Porphyromonas gingivalis on disks of titanium (Ti) grade 4 (G4) and Ti-6Al-4V alloy grade 5 (G5) with different surface topographies. MATERIALS AND METHODS: Porphyromonas gingivalis ATCC 33277 was used to develop an in vitro mature biofilm on a total of 96 disk-shaped specimens of laser-treated (L), sandblasted (S), and machined (M) surfaces of Ti G4 and Ti G5. Surface roughness (Ra) and the wettability contact angle (WCA) were measured to characterize the surface of the specimens. The bacterial biofilm was evaluated by biomass quantification, bacterial viability, visualization of the biofilm extracellular matrix, and bacterial cell count. Data were analyzed using one-way ANOVA and Holm-Sidak tests and expressed as mean ± standard deviation. RESULTS: The Ra for the L group was 0.10 (±0.07) µm inside the craters and 0.40 (±0.08) µm in the area surrounding the craters resulting the smoothest (P < 0.05) in respect to the S group (1.30 ± 0.61 µm) and the M group (0.75 ± 0.23 µm). The L group showed a higher WCA than S and M groups for both G4 (109.9° ± 6.6) and G5 (104.2° ± 5.9) materials (P < 0.05). The L group displayed both the less P. gingivalis bacterial biomass (0.38 ± 0.01 for G4; 0.62 ± 0.02 for G5) that was significant in respect to G4-S (P < 0.001), G4-M (P < 0.001), and G5-M (P = 0.001) and the less total cell number (215 ± 18 for G4 and 244 ± 9 for G5) than S and M groups for both G4 and G5 materials (P < 0.01). CONCLUSION: Within the limits of the present study, the results showed that G4-L appears to be significantly efficient in the reduction of the P. gingivalis biofilm formation.

Adhesion of human gingival fibroblasts/Streptococcus mitis co-culture on the nanocomposite system Chitlac-nAg.

Composite materials are increasingly used as dental restoration. In the field of biomaterials, infections remain the main reason of dental devices failure. Silver, in the form of nanoparticles (AgNPs), ions and salt, well known for its antimicrobial properties, is used in several medical applications in order to avoid bacterial infection. To reduce both bacterial adhesion to dental devices and cytotoxicity against eukaryotic cells, we coated BisGMA/TEGDMA methacrylic thermosets with a new material, Chitlac-nAg, formed by stabilized AgNPs with a polyelectrolyte solution containing Chitlac. Here we analyzed the proliferative and adhesive ability of human gingival fibroblasts (HGFs) on BisGMA/TEGDMA thermosets uncoated and coated with AgNPs in a coculture model system with Streptococcus mitis. After 48 h, HGFs well adhered onto both surfaces, while S. mitis cytotoxic response was higher in the presence of AgNPs coated thermosets. After 24 h thermosets coated with Chitlac as well as those coated with Chitlac-nAg exerted a minimal cytotoxic effect on HGFs, while after 48 h LDH release raised up to 20 %. Moreover the presence of S. mitis reduced this release mainly when HGFs adhered to Chitlac-nAg coated thermosets. The reduced secretion of collagen type I was significant in the presence of both surfaces with the co-culture system even more when saliva is added. Integrin ß1 localized closely to cell membranes onto Chitlac-nAg thermosets and PKCα translocated into nuclei. These data confirm that Chitlac-nAg have a promising utilization in the field of restorative dentistry exerting their antimicrobial activity due to AgNPs without cytotoxicity for eukaryotic cells.

Fracture Strength of Zirconia and Alumina Ceramic Crowns Supported by Implants.

Due to the brittleness and limited tensile strength of the veneering glass-ceramic materials, the methods that combine strong core material (as zirconia or alumina) are still under debate. The present study aims to evaluate the fracture strength and the mechanism of failure through fractographic analysis of single all-ceramic crowns supported by implants. Forty premolar cores were fabricated with CAD/CAM technology using alumina (n = 20) and zirconia (n = 20). The specimens were veneered with glass-ceramic, cemented on titanium abutments, and subjected to loading test until fracture. SEM fractographic analysis was also performed. The fracture load was 1165 (±509) N for alumina and 1638 (±662) N for zirconia with a statistically significant difference between the two groups (P = 0.026). Fractographic analysis of alumina-glass-ceramic crowns, showed the presence of catastrophic cracks through the entire thickness of the alumina core; for the zirconia-glass-ceramic crowns, the cracks involved mainly the thickness of the ceramic veneering layer. The sandblast procedure of the zirconia core influenced crack path deflection. Few samples (n = 3) showed limited microcracks of the zirconia core. Zirconia showed a significantly higher fracture strength value in implant-supported restorations, indicating the role played by the high resistant cores for premolar crowns.

Fracture toughness and hardness of a Y-TZP dental ceramic after mechanical surface treatments.

OBJECTIVES: The aim of the investigation was to evaluate the effects of surface mechanical treatments of all-Y-TZP restorations. In order to do that, surface roughness (Rs), fractal dimension (Df), fracture toughness (Ft), Vickers hardness (Hv), crack length (Cl), and opening (Co) were determined. MATERIALS AND METHODS: Y-TZP bar-shaped specimens (n = 30) were subdivided into three groups: as received by milling center (M), after coarse polishing (CP), and after fine polishing (FP). The specimens were examined under both confocal laser and electron scanning microscopes. One-way ANOVA and post hoc tests were used to analyze the data (α = 0.05). RESULTS: The FP group showed a significantly lesser amount of Rs (P < 0.05). The Df analysis confirmed the significantly lesser amount of surface complexity within the FP group (P < 0.05). The Hv values were not significantly different among the groups. The Ft was significantly lesser within the FP group (P < 0.05). At the same time, both Cl and Co were significantly higher within the FP group (P < 0.05). Likewise, the FP treatment showed a significant decrease in roughness and surface complexity associated to a decrease of fracture toughness with a significant microcrack increase. CONCLUSIONS: The present study suggests that the fine polishing procedure in all-YTZP restorations produces surface embrittlement. CLINICAL RELEVANCE: Because of the surface embrittlement, mechanical surface polishing of all-zirconia restorations should be avoided.

Bone-to-Implant Contact in Implants with Plasma-Treated Nanostructured Calcium-Incorporated Surface (XPEEDActive) Compared to Non-Plasma-Treated Implants (XPEED): A Human Histologic Study at 4 Weeks.

Titanium implants undergo an aging process through surface hydrocarbon deposition, resulting in decreased wettability and bioactivity. Plasma treatment was shown to significantly reduce surface hydrocarbons, thus improving implant hydrophilicity and enhancing the osseointegration process. This study investigates the effect of plasma surface treatment on bone-to-implant contact (BIC) of implants presenting a nanostructured calcium-incorporated surface (XPEED®). Following a Randomized Controlled Trial (RCT) design, patients undergoing implant surgery in the posterior maxilla received additional plasma-treated (n = 7) or -untreated (n = 5) 3.5 × 8 mm implants that were retrieved after a 4-week healing period for histological examination. Histomorphometric analysis showed that plasma-treated implants exhibited a 38.7% BIC rate compared to 22.4% of untreated implants (p = 0.002), indicating enhanced osseointegration potential. Histological images also revealed increased bone formation and active osteoblastic activity around plasma-treated implants when compared to untreated specimens. The findings suggest that plasma treatment improves surface hydrophilicity and biological response, facilitating early bone formation around titanium implants. This study underscores the importance of surface modifications in optimizing implant integration and supports the use of plasma treatment to enhance osseointegration, thereby improving clinical outcomes in implant dentistry and offering benefits for immediate and early loading protocols, particularly in soft bone conditions.

The Mineral Apposition Rate on Implants with Either a Sandblasted Acid-Etched Implant Surface (SLA) or a Nanostructured Calcium-Incorporated Surface (XPEED®): A Histological Split-Mouth, Randomized Case/Control Human Study.

This study aimed to histologically evaluate the effects of XPEED® and SLA surface on the mineral apposition rate (MAR) at 3 and 5 weeks in titanium dental implants placed in human bone. In total, 17 titanium dental implants with XPEED® surface (n = 9) used as test and SLA surface (n = 8) used as control were included in this study. Each patient received four doses of tetracycline 500 mg at 12 h intervals 2 weeks prior to biopsy retrieval. Implant retrieval was performed, and retrieved biopsies were carefully treated for histomorphometric evaluation under epifluorescence microscopy. At 3 and 5 weeks, newly formed bone appeared in direct contact with both types of tested surfaces. At 3 weeks, the MAR value was, respectively, 2.0 (±0.18) µm/day for XPEED® implants and 1.5 (±0.10) µm/day for SLA implants (p = 0.017). At 5 weeks, lower MAR values for both XPEED® and SLA implants were noted, with 1.2 (±0.10) µm/day and 1.1 (±0.10) µm/day, respectively (p = 0.046). The overall evaluation by linear regression analysis for both time and implant surfaces showed a decreased osteoblast activity at 5 weeks compared to 3 weeks (p < 0.005). The results of the present study show that the bone apposition rate occurs faster around implants with XPEED® surface at 3 weeks and 5 weeks of healing. MAR values may support the use of implants with XPEED® surfaces in early loading protocols.

Alveolar Ridge Preservation Using the One-Piece Autologous Tuberosity Graft: A Clinical, Radiological, and Histological Pilot Study.

This prospective study investigated clinically and radiologically the effectiveness of the use of a combined hard and soft tissue graft retrieved from the maxillary tuberosity and designed for alveolar ridge preservation following tooth extraction. Seven patients scheduled for a single mono-rooted tooth extraction were included in the study. After atraumatic extraction, sockets were filled with a "one-piece" dual tissue graft harvested from the tuberosity using an adjusted trephine. CBCTs were performed before the extraction and 4 months after ridge preservation, to analyze the vertical and horizontal alterations of the ridge, using ITK-Snap software. Clinical measurements of both soft and hard tissues were also assessed during the extraction and implant placement. All sites healed uneventfully. After 4 months, the 3D super-imposition of both CBCTs showed a mean bone volume resorption of 65 ± 76.7 mm3 (10.2 ± 10%). The mean horizontal reduction at 2, 4, and 6 mm from the top of the crest was respectively 1.5 ± 1.3 mm, 0.47 ± 1.4 mm and 0.57 ± 0.7 mm, while the mean vertical loss was 0.026 mm ± 2 mm. The mean soft tissue horizontal gain was 1.73 ± 1.12 mm. The "one-piece" autologous tuberosity graft was proven to be a safe and effective alveolar ridge preservation technique and may represent a feasible, user-friendly, time saving, low-cost solution for minimizing dimensional loss following tooth extraction.

Surfactant hydrogels for the dispersion of carbon-nanotube-based catalysts.

Novel hydrogel phases based on positively charged and zwitterionic surfactants, namely, N-[p-(n-dodecyloxybenzyl)]-N,N,N-trimethylammonium bromide (pDOTABr) and p-dodecyloxybenzyldimethylamine oxide (pDOAO), which combine pristine carbon nanotubes (CNTs), were obtained, thus leading to stable dispersions and enhanced cross-linked networks. The composite hydrogel featuring a well-defined nanostructured morphology and an overall positively charged surface was shown to efficiently immobilise a polyanionic and redox-active tetraruthenium-substituted polyoxometalate (Ru4POM) by complementary charge interactions. The resulting hybrid gel has been characterised by electron microscopy techniques, whereas the electrostatic-directed assembly has been monitored by means of fluorescence spectroscopy and ζ-potential tests. This protocol offers a straightforward supramolecular strategy for the design of novel aqueous-based electrocatalytic soft materials, thereby improving the processability of CNTs while tuning their interfacial decoration with multiple catalytic domains. Electrochemical evidence confirms that the activity of the catalyst is preserved within the gel media.

Finite element analysis in implant dentistry: State of the art and future directions.

OBJECTIVE: To discuss the state of the art of Finite Element (FE) modeling in implant dentistry, to highlight the principal features and the current limitations, and giving recommendations to pave the way for future studies. METHODS: The articles' search was performed through PubMed, Web of Science, Scopus, Science Direct, and Google Scholar using specific keywords. The articles were selected based on the inclusion and exclusion criteria, after title, abstract and full-text evaluation. A total of 147 studies were included in this review. RESULTS: To date, the FE analysis of the bone-dental implant system has been investigated by analyzing several types of implants; modeling only a portion of bone considered as isotropic material, despite its anisotropic behavior; assuming in most cases complete osseointegration; considering compressive or oblique forces acting on the implant; neglecting muscle forces and the bone remodeling process. Finally, there is no standardized approach for FE modeling in the dentistry field. SIGNIFICANCE: FE modeling is an effective computational tool to investigate the long-term stability of implants. The ultimate aim is to transfer such technology into clinical practice to help dentists in the diagnostic and therapeutic phases. To do this, future research should deeply investigate the loading influence on the bone-implant complex at a microscale level. This is a key factor still not adequately studied. Thus, a multiscale model could be useful, allowing to account for this information through multiple length scales. It could help to obtain information about the relationship among implant design, distribution of bone stress, and bone growth. Finally, the adoption of a standardized approach will be necessary, in order to make FE modeling highly predictive of the implant's long-term stability.