Porphyromonas gingivalis amount in the tongue biofilm is associated with erosive arthritis in systemic lupus erythematosus.

BACKGROUND: Several data have demonstrated the occurrence of erosive arthritis in Systemic Lupus Erythematosus (SLE) patients. However, a few studies have focused on the pathogenic mechanisms involved in this feature. The implication of oral pathogens has been proved in Rheumatoid Arthritis: in particular, Porphyromonas gingivalis (Pg), by inducing citrullination, could trigger autoimmune response. Here, we evaluated amount of Pg on the tongue in a cohort of SLE patients with arthritis, focusing on the association with the erosive phenotype. METHODS: SLE patients with arthritis were enrolled. DAS28 was applied to assess activity. Erosive damage was evaluated by ultrasound at level of MCP (metacarpophalangeal) and PIP (proximal interphalangeals) joints. All subjects underwent a tongue cytologic swab in order to quantify the amount of Pg (real-time PCR). The bacterium expression was obtained from the ratio between the patient's DNA amount and that obtained from healthy subjects. RESULTS: 33 patients were enrolled (M/F 3/30; median age 47 years, IQR 17; median disease duration 216 months, IQR 180): 12 of them (36.4%) showed erosive damage, significantly associated with ACPA positivity (p = 0.03) and higher values of DAS28 (p = 0.01). A mean ratio of 19.7 ± 31.1 was found for Pg amount. Therefore, we used Pg mean values as threshold, identifying two groups of patients, namely, highPg and lowPg. Erosive damage was significantly more frequent in highPg patients in comparison with lowPg (60.0% vs 26.0%, p = 0.001). Furthermore, highPg patients showed higher prevalence of skin manifestations, serositis, and neurological involvement (p = 0.005, p = 0.03, p = 0.0001, respectively). CONCLUSION: The possible contribution of oral microbiota in SLE erosive arthritis was here evaluated for the first time, finding a significant association between erosive damage and higher expression of Pg at tongue level.

Proximal femoral replacement for non-neoplastic conditions: a systematic review on current outcomes.

Proximal femoral replacement (PFR) is a well-established treatment for neoplasia of the proximal femur. The use of this surgical technique for non-neoplastic conditions has increased over the years. We carried out a systematic review of the literature to study the indications, complications, and functional results when PFR is used for non-neoplastic conditions. Twenty-seven studies were included in the review with a total of 828 PFRs with a mean follow-up of 50 months (range 1-225 months). The main indications were infection (28%), periprosthetic fracture (27%), aseptic loosening (22%), and fracture (16%). The rate of reoperation was 20.3% overall. The overall revision rate was 15.4%. The main complications were dislocation (10.2%) and infection (7.3%). After 2010, the rates of reoperation (25.5% versus 18.2%), loosening (9.4% versus 3.2%), and dislocation (15.7% versus 7.9%) were lower than before 2010. The 30-day mortality ranged from 0% to 9%. The hip function scores improved post-surgery. In conclusion, the use of PFR in non-neoplastic conditions remains a marginal tool, associated with low direct mortality and high complication rates, but we expect its use to increase in the near future.

A community detection analysis of malocclusion classes from orthodontics and upper airway data.

OBJECTIVE: The interaction between skeletal class and upper airway has been extensively studied. Nevertheless, this relationship has not been clearly elucidated, with the heterogeneity of results suggesting the existence of different patterns for patients' classification, which has been elusive so far, probably due to oversimplified approaches. Hence, a network analysis was applied to test whether different patterns in patients' grouping exist. SETTINGS AND SAMPLE POPULATION: Ninety young adult patients with no obvious signs of respiratory diseases and no previous adeno-tonsillectomy procedures, with thirty patients characterized as Class I (0 < ANB < 4); 30 Class II (ANB > 4); and 30 as Class III (ANB < 0). MATERIALS AND METHODS: A community detection approach was applied on a graph obtained from a previously analysed sample: thirty-two measurements (nineteen cephalometric and thirteen upper airways data) were considered. RESULTS: An airway-orthodontic complex network has been obtained by cross-correlating patients. Before entering the correlation, data were controlled for age and gender using linear regression and standardized. By including or not the upper airway measurements as independent variables, two different community structures were obtained. Each contained five modules, though with different patients' assignments. CONCLUSION: The community detection algorithm found the existence of more than the three classical skeletal classifications. These results support the development of alternative tools to classify subjects according to their craniofacial morphology. This approach could offer a powerful tool for implementing novel strategies for clinical and research in orthodontics.

Complexity and data mining in dental research: A network medicine perspective on interceptive orthodontics.

Procedures and models of computerized data analysis are becoming researchers' and practitioners' thinking partners by transforming the reasoning underlying biomedicine. Complexity theory, Network analysis and Artificial Intelligence are already approaching this discipline, intending to provide support for patient's diagnosis, prognosis and treatments. At the same time, due to the sparsity, noisiness and time-dependency of medical data, such procedures are raising many unprecedented problems related to the mismatch between the human mind's reasoning and the outputs of computational models. Thanks to these computational, non-anthropocentric models, a patient's clinical situation can be elucidated in the orthodontic discipline, and the growth outcome can be approximated. However, to have confidence in these procedures, orthodontists should be warned of the related benefits and risks. Here we want to present how these innovative approaches can derive better patients' characterization, also offering a different point of view about patient's classification, prognosis and treatment.

Electric-Field-Induced Second Harmonic Generation Nonlinear Optic Response of A4 ß-Pyrrolic-Substituted ZnII Porphyrins: When Cubic Contributions Cannot Be Neglected.

In this work, we have prepared a series of A4 ZnII porphyrins, carrying in the ß-pyrrolic-position one or two π-delocalized ethynylphenyl moieties with a -NO2 acceptor or a -NMe2 donor pendant, and measured their second-order NLO response in CHCl3 solution at 1907 nm via the electric-field-induced second harmonic generation (EFISH) technique. For some of these compounds, we have recorded an unexpected sign and/or absolute value of µß1907. Since their sterically hindered A4 structure should ensure the lack of significant aggregation processes in solution, we explain such anomalous EFISH results by invoking a non-negligible contribution of the electronic cubic term γ(-2ω; ω, ω, 0) to γEFISH, as supported by a qualitative evaluation of the third-order response through the measure of the cubic hyperpolarizability (γTHG) and by computational evidence.

Three-dimensional analyses of short- and long-term effects of rapid maxillary expansion on nasal cavity and upper airway: A systematic review and meta-analysis.

INTRODUCTION: The purpose of this systematic review was to evaluate the three-dimensional (3D) changes occurring at short- and long-term follow-up after rapid maxillary expansion (RME) in nasal cavity (NC) and upper airway (UA) in growing patients. METHODS: A literature search up to 1 July 2019 was performed. Randomized and non-randomized clinical trials and cohort studies comparing the effects of RME in a paediatric population using 3D analyses based on computed tomography (CT), cone-beam CT and MRI were included. The risks of bias of the included studies were assessed using the Cochrane Collaboration's risk of bias tool, the GRADE approach and a customized tool. The random-effects meta-analyses of the mean differences and 95% confidence intervals of NC and UA volume changes were carried out, followed by subgroup analyses. RESULTS: Twenty-seven studies were included, with 18 selected for quantitative synthesis. Immediately after expansion, the nasopharynx and oropharynx increased significantly. After 3 months of retention, only the NC and nasopharynx showed a significant volume increase. Two studies mentioned the use of a sleep-disordered breathing questionnaire, and one study reported the difference before and after RME. None of the 27 articles included assessed the correlation between the skeletal widening and NC or UA volume changes after RME. CONCLUSIONS: The existing evidence confirmed only the short-term positive effect of RME on expanding the volume of the NC and the upper part of the UA. However, long-term stability could not be sustained.

Porphyromonas gingivalis and rheumatoid arthritis.

PURPOSE OF REVIEW: To explore the pathogenic association between periodontal disease and rheumatoid arthritis focusing on the role of Porphyromonas gingivalis. RECENT FINDINGS: In the last decades our knowledge about the pathogenesis of rheumatoid arthritis substantially changed. Several evidences demonstrated that the initial production of autoantibodies is not localized in the joint, rather in other immunological-active sites. A central role seems to be played by periodontal disease, in particular because of the ability of P. gingivalis to induce citrullination, the posttranslational modification leading to the production of anticitrullinated protein/peptide antibodies, the most sensitive and specific rheumatoid arthritis biomarker. SUMMARY: The pathogenic role of P. gingivalis has been demonstrated in mouse models in which arthritis was either triggered or worsened in infected animals. P. gingivalis showed its detrimental role not only by inducing citrullination but also by means of other key mechanisms including induction of NETosis, osteoclastogenesis, and Th17 proinflammatory response leading to bone damage and systemic inflammation.

Dental Cone Beam Computed Tomography in Children: Clinical Effectiveness and Cancer Risk due to Radiation Exposure.

Firstly used in the early 90s to generate 3-dimensional projections of X-ray images, cone beam computed tomography (CBCT) has resulted in a large application in dentomaxillofacial imaging, even in children. CBCT uses ionizing radiation that may cause damage to the DNA, and children are at the greatest carcinogenesis risk due to their higher tissue radiosensitivity and their longer life expectancy compared to adults. The questions of whether the cancer risk is really increased after repeated dental CBCT in childhood and of what the underlying biological basis is have become hot topics in the field of dentistry and radiobiology. We performed an overview of the current literature to assess an acceptable role of CBCT in pediatric dentistry.

Periodontitis and Rheumatoid Arthritis: The Same Inflammatory Mediators?

The strict link between periodontitis (PD) and rheumatoid arthritis (RA) has been widely demonstrated by several studies. PD is significantly more frequent in RA patients in comparison with healthy subjects: this prevalence is higher in individuals at the earliest stages of disease and in seropositive patients. This is probably related to the role of P. gingivalis in inducing citrullination and leading to the development of the new antigens. Despite the many studies conducted on this topic, there is very little data available concerning the possibility to use the same biomarkers to evaluate both RA and PD patients. The aim of the review is to summarize this issue. Starting from genetic factors, data from literature demonstrated the association between HLA-DRB1 alleles and PD susceptibility, similar to RA patients; moreover, SE-positive patients showed simultaneously structural damage to the wrist and periodontal sites. Contrasting results are available concerning other genetic polymorphisms. Moreover, the possible role of proinflammatory cytokines, such as TNF and IL6 and autoantibodies, specifically anticyclic citrullinated peptide antibodies, has been examined, suggesting the need to perform further studies to better define this issue.

Two-Year Postoperative Upper Airway Cone-Beam Computed Tomographic Outcomes Based on a Verified Upper Airway Analysis Following Bimaxillary Orthognathic Surgery.

PURPOSE: Upper airway (UA) assessment after orthognathic surgery should rely on a verified method of UA analysis. Therefore, the authors applied a new validated UA evaluation method to determine the effect of bimaxillary surgery (BMS) on UA parameters and hyoid bone and epiglottis displacement evaluated immediately and 2 years after surgery. MATERIALS AND METHODS: A retrospective cohort study was implemented of patients without obstructive sleep apnea who had undergone BMS for maxillomandibular deficiencies. A new validated UA cone-beam computed tomographic (CBCT) analysis, based on stable anatomic landmarks, was applied to CBCT scans acquired before initiation of treatment (T0), immediately after surgery (T1), and 2 years postoperatively (T2). A quality assessment was performed before analysis. The primary predictor variable consisted of time points during treatment (T0, T1 and T2), and UA volumes, cross-sectional area (CSA), and hyoid bone and epiglottis displacement were the outcome variables. Descriptive statistics and t test were performed and the P value was set at .05. RESULTS: Fifty patients (16 men and 34 women) with a mean age of 25.7 ± 8.2 years at time of surgery were included. CBCT scans were acquired at T0 (20 ± 9 months before surgery), T1 (14 ± 2 days after surgery), and T2 (30 ± 6 months after surgery). Immediately after surgery (T1 vs T0), BMS resulted in a statistically relevant UA volume increase of 26%. At 2-year follow-up (T2 vs T0), UA volume showed a statistically relevant increase by 20%. CSA increased by approximately 26 and 19% (P < .001) at T1 versus T0 and T2 versus T0, respectively. Two years after surgery, epiglottis displacement was 2 mm (P < .001) and hyoid bone displacement was 3 mm (P < .001) in a cranial direction and hyoid bone anterior displacement measured 3 mm (P < .001). CONCLUSIONS: Based on an objective, standardized, and validated CBCT UA analysis, BMS was associated with increased UA volume and CSA measures evaluated immediately and 2 years after surgery.

Intriguing Influence of -COOH-Driven Intermolecular Aggregation and Acid-Base Interactions with N,N-Dimethylformamide on the Second-Order Nonlinear-Optical Response of 5,15 Push-Pull Diarylzinc(II) Porphyrinates.

A series of 5,15 push-pull meso-diarylzinc(II) porphyrinates, carrying one or two -COOH or -COOCH3 acceptor groups and a -OCH3 or a -N(CH3)2 donor group, show in N,N-dimethylformamide and CHCl3 solutions a negative and solvent-dependent second-order nonlinear-optical (NLO) response measured by the electric-field-induced second-harmonic generation (EFISH) technique, different from the structurally related zinc(II) porphyrinate carrying a -N(CH3)2 donor group and a -NO2 acceptor group, where a still solvent-dependent but positive EFISH second-order response was previously reported. Moreover, when a -N(CH3)2 donor group and a -COOH acceptor group are part of a sterically hindered 2,12 push-pull ß-pyrrolic-substituted tetraarylzinc(II) porphyrinate, the EFISH response is positive and solvent-independent. In order to rationalize these rather intriguing series of observations, EFISH measurements have been integrated by electronic absorption and IR spectroscopic investigations and by density functional theory (DFT) and coupled-perturbed DFT theoretical and 1H pulsed-gradient spin-echo NMR investigations, which prompt that the significant concentration effects and the strong influence of the solvent nature on the NLO response are originated by a complex whole of different aggregation processes induced by the -COOH group.

Optically Multiresponsive Heteroleptic Platinum Dithiolene Complex with Proton-Switchable Properties.

Both linear- and nonlinear-optical properties of Bu4N[Pt(L1)(L2)] (1; L1 = [4',5':5,6][1,4]dithiino[2,3-b]quinoxaline-1',3'dithiolato; L2 = (R)-α-MBAdto dithiooxamidate, where (R)-α-MBA = (R)-(+)-α-methylbenzyl) upon HCl addition at room temperature change dramatically: the color turns from deep blue to green; the luminescence switches from deep red to green; the nonlinear-optical response (first hyperpolarizability) increases by a factor of 12. Thus, 1 behaves as a unique multiresponsive optical switch whose properties can be followed by the naked eye.

Coupling of Zinc Porphyrin Dyes and Copper Electrolytes: A Springboard for Novel Sustainable Dye-Sensitized Solar Cells.

The combination of ß-substituted Zn2+ porphyrin dyes and copper-based electrolytes represents a sustainable route for economic and environmentally friendly dye-sensitized solar cells. Remarkably, a new copper electrolyte, [Cu(2-mesityl-1,10-phenanthroline)2]+/2+, exceeds the performance reached by Co2+/3+ and I-/I3- reference electrolytes.

Light-harvesting antennae based on photoactive silicon nanocrystals functionalized with porphyrin chromophores.

Silicon nanocrystals functionalized with tetraphenylporphyrin Zn(II) chromophores at the periphery perform as light harvesting antennae: excitation of the porphyrin units in the visible spectral region yields sensitized emission of the silicon nanocrystal core in the near infrared with a long lifetime (λ(max) = 905 nm, τ = 130 µs). This result demonstrates that this hybrid material has a potential application as a luminescent probe for bioimaging.

Light-Induced Regiospecific Bromination of meso-Tetra(3,5-di-tert-butylphenyl)Porphyrin on 2,12 ß-Pyrrolic Positions.

The antipodal introduction of two bromine atoms on the 2,12 ß-pyrrolic position of 5,10,15,20-tetra(3,5-di-tert-butylphenyl)porphyrin was successfully achieved by a light-induced reaction of the substrate with excess NBS. Complexation with Ni(II) of the major regioisomer led to good quality crystals, suitable for X-ray structure determination with unprecedented probability levels. The regiospecific character of the synthetic procedure and the exactness of the bromine atom position assignment were thus confirmed, suggesting an unexpected electrophilic aromatic substitution pathway rather than a free-radical halogenation process. A QTAIM topological analysis on the DFT-optimized wave function of the monosubstituted free-base porphyrin intermediate carrying a bromine atom in C2 ß-pyrrolic position confirmed the largest negative charge for the C12 carbon atom in antipodal position, in agreement with the proposed electrophilic aromatic substitution mechanism.

Fast and Early Mandibular Osteodistraction: The Long-Term Follow-Up of Mandibular Distraction Osteogenesis on Teeth Position.

Pierre Robin Sequence is a congenital pathology defined by the triad micrognathia, glossoptosis and often a U-shaped cleft of soft palate. Newborns affected by airways obstruction may necessitate more invasive options: tongue-lip adhesion, tracheostomy and mandibular distraction osteogenesis. The authors analyzed the effect of fast and early mandibular osteodistraction on deciduous dental development in patients affected by Pierre Robin Sequence. Analysis of the patients treated for severe form was performed by a team composed by maxillofacial surgeons and dentists. Five patients were included for the analysis: before and long term clinical and radiological assessments were considered. All patients underwent fast and early mandibular osteodistraction; two years follow up computed tomography and panorex reconstructions showed bone consolidation, 33 of 35 teeth analyzed before ostedistraction are present after distraction protocol; no positional changes were detected at the follow up analysis either deciduous teeth and molar permanent buds. No deformities regarding molar buds were detected. In conclusion external mandibular distractor devices have been associated with dental injuries and facial scaring. Even though, the dental complications identified can not be unambiguously connected to the external distractor devices.

Survival of dental implants in patients with oral cancer treated by surgery and radiotherapy: a retrospective study.

BACKGROUND: The aim of this retrospective study was to evaluate the survival of dental implants placed after ablative surgery, in patients affected by oral cancer treated with or without radiotherapy. METHODS: We collected data for 34 subjects (22 females, 12 males; mean age: 51 ± 19) with malignant oral tumors who had been treated with ablative surgery and received dental implant rehabilitation between 2007 and 2012. Postoperative radiation therapy (less than 50 Gy) was delivered before implant placement in 12 patients. A total of 144 titanium implants were placed, at a minimum interval of 12 months, in irradiated and non-irradiated residual bone. RESULTS: Implant loss was dependent on the position and location of the implants (P = 0.05-0.1). Moreover, implant survival was dependent on whether the patient had received radiotherapy. This result was highly statistically significant (P < 0.01). Whether the implant was loaded is another highly significant (P < 0.01) factor determining survival. We observed significantly better outcomes when the implant was not loaded until at least 6 months after placement. CONCLUSIONS: Although the retrospective design of this study could be affected by selection and information biases, we conclude that a delayed loading protocol will give the best chance of implant osseointegration, stability and, ultimately, effective dental rehabilitation.

Analysis of human alveolar osteoblast behavior on a nano-hydroxyapatite substrate: an in vitro study.

BACKGROUND: Nano-hydroxyapatite (nHA) is a potential ideal biomaterial for bone regeneration. However, studies have yet to characterize the behavior of human osteoblasts derived from alveolar bone on nHA. Thus, the aim of the present study was to evaluate the influence of nHA on the adhesion, proliferation and differentiation of these alveolar bone-derived cells. METHODS: Primary human alveolar osteoblasts were collected from the alveolar ridge of a male periodontal patient during osseous resective surgery and grown on culture plates coated with either polylysine or polylysine with nano-hydroxyapatite (POL/nHA) composite. The cells were grown and observed for 14 days, and then assessed for potential modifications to osteoblasts homeostasis as evaluated by quantitative reverse transcriptase-polymerase chain reaction (real time RT-PCR), scanning electron microscopy and atomic force microscopy. RESULTS: Real time PCR revealed a significant increase in the expression of the selected markers of osteoblast differentiation (bone morphogenetic protein (BMP)-2,-5,-7, ALP, COLL-1A2, OC, ON) in cells grown on the POL/nHA substrate. In addition, as compared with the POL surface, cells grown on the POL/nHA substrate demonstrated better osteoconductive properties, as demonstrated by the increase in adhesion and spreading, likely as a result of the increased surface roughness of the composite. CONCLUSIONS: The increased expression of BMPs and osteoinductive biomarkers suggest that nano-hydroxyapatite may stimulate the proliferation and differentiation of local alveolar osteoblasts and thus encourage bone regeneration at sites of alveolar bone regeneration.

Biomechanical Multipurpose Miniscrew Strategy for Simultaneous Distalization in Class II Patients-The BiGa System.

An efficient treatment plan using a temporary anchorage device should be built following the principle of reducing the number of tads to obtain a multiple biomechanical advantage. The following case report concerns the Biga system, a strategy that supports orthodontists during class II corrections and vertical control through treatment. A 12-year-old girl with a high angle of skeletal class II was selected. A novel biomechanical strategy was effectively applied using two tads on the upper arch to obtain sequential distalization of the upper teeth and to correct the lower arch spee curve using third-class elastics. Eventually, on the same tads, a double cantilever was applied to control the overbite and intrusion during incisors' retraction. The Biga system is an easy biomechanical strategy that ensures the three-dimensional control of treatment mechanics in class II patients.

Perfluorinated Zinc Porphyrin Sensitized Photoelectrosynthetic Cells for Enhanced TEMPO-Mediated Benzyl Alcohol Oxidation.

This research introduces a novel series of perfluorinated Zn(II) porphyrins with positive oxidation potentials designed as sensitizers for photoelectrosynthetic cells, with a focus on promoting the oxidation of benzyl alcohol (BzOH) mediated by the 2,2,6,6-tetramethyl-1-piperidine N-oxyl (TEMPO) organocatalyst. Three dyes, CLICK-3, CLICK-4, and BETA-4, are meticulously designed to explore the impact of substituents and their positions on the perfluorinated porphyrin ring in terms of redox potentials and energy level alignment when coupled with SnO2/TiO2-based photoanodes and TEMPO mediator. A comprehensive analysis utilizing spectroscopy, electrochemistry, photophysics, and computational techniques of the dyes in solution and sensitized thin films unveils an enhanced charge-separation character in the 4D-π-1A type BETA-4. Incorporating four dimethylamino donor groups at the periphery of the porphyrin ring and a BTD-accepting linker at the ß-pyrrolic position equips the structure with a more efficient donor-acceptor system. This enhancement ensures improved light-harvesting capacity, resulting in a doubled incident photon-to-current conversion efficiency (IPCE% ≃30%) in the presence of LiI compared to meso-substituted dyes CLICK-3 and CLICK-4. Sensitizing SnO2/TiO2 thin films with BETA-4 successfully promotes the photooxidation of benzyl alcohol (BzOH) in the presence of the rapid TEMPO radical catalyst, yielding photocurrents of approximately 125 µA/cm2 in an optimized TBPy/LiClO4/ACN electrolyte. Notably, when lithium bis(trifluoromethanesulfonyl)imide (LiTFSI) replaces TBPy as the base for TEMPO-catalyzed BzOH oxidation, a remarkable photocurrent of around 800 µA/cm2 is achieved, marking one of the highest values reported for this photoelectrochemical reaction to date. This study underscores that the proper functionalization of perfluorinated zinc porphyrins positions these dyes as ideal candidates for sensitizing SnO2/TiO2 in the photodriven oxidation of BzOH. It also highlights the crucial role of carefully tuning electrolyte composition based on the electronic properties of molecular sensitizers.