Titanium-Based Nanoarchitectures for Sonodynamic Therapy-Involved Multimodal Treatments.

Sonodynamic therapy (SDT) has considerably revolutionized the healthcare sector as a viable noninvasive therapeutic procedure. It employs a combination of low-intensity ultrasound and chemical entities, known as a sonosensitizer, to produce cytotoxic reactive oxygen species (ROS) for cancer and antimicrobial therapies. With nanotechnology, several unique nanoplatforms are introduced as a sonosensitizers, including, titanium-based nanomaterials, thanks to their high biocompatibility, catalytic efficiency, and customizable physicochemical features. Additionally, developing titanium-based sonosensitizers facilitates the integration of SDT with other treatment modalities (for example, chemotherapy, chemodynamic therapy, photodynamic therapy, photothermal therapy, and immunotherapy), hence increasing overall therapeutic results. This review summarizes the most recent developments in cancer therapy and tissue engineering using titanium nanoplatforms mediated SDT. The synthesis strategies and biosafety aspects of Titanium-based nanoplatforms for SDT are also discussed. Finally, various challenges and prospects for its further development and potential clinical translation are highlighted.

Tumor Microenvironment Responsive Single-Atom Nanozymes for Enhanced Antitumor Therapy.

Single-atom nanozymes (SAzymes) with specific response to the unique tumor microenvironment (TME) feature providing 100 % metal atoms utilization for high-efficient enzyme-catalyzed therapy and accurate template for the study of therapeutic mechanisms. In this review, we first introduce the various synthetic strategies of SAzymes, and the TME-responsive SAzymes activities. Next, the TME-responsive enhanced antitumor therapeutic approaches based on the enzymatic activities of SAzymes are summarized, and the corresponding therapy mechanisms are elaborated. Subsequently, a concise but concentrated summary, and the challenges and opportunities for the future design and engineering of SAzyme are outlined. As a new discipline, SAzymes have vast space for development in enhanced antitumor therapy. This timely review provides guidance and constructive suggestions for the future of SAzymes.

Chloro-aluminum phthalocyanine-mediated photodynamic therapy in the treatment of stage-II chronic periodontitis among smokers.

PURPOSE: To assess the clinical periodontal, bacterial, and immunological outcomes of chloro-aluminum phthalocyanine-mediated photodynamic therapy (PDT) as an adjunct to dental scaling (DS) versus DS alone among cigarette smokers (CS) and never-smokers (NS). METHODS: A total of 26 patients (13 CS and 13 NS) with clinical and radiographic diagnosis of stage-II chronic periodontitis were recruited. Each patient from both groups were subjected with two parallel therapies (split-mouth): PDT + DS (test side) and DS alone (control side). Periodontal parameters were investigated by evaluating plaque scores (PS), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), and alveolar bone loss (ABL). Subgingival plaque was collected to detect and quantify Porphyromonas gingivalis and Tannerella forsythia using real-time quantitative polymerase chain reaction (RT-qPCR) assay. Gingival crevicular fluid was sampled for the quantification of interleukin (IL)-1ß and tumor necrosis factor-alpha (TNF-α) using enzyme linked immunosorbent assay. All assessments were performed at baseline, 3 months, and 6 months. RESULTS: Bleeding on probing was significantly reduced at 6 months after PDT + DS in CS groups (p < .05). Mean PD and CAL significantly reduced after both PDT + DS and DS subgroups and among NS and CS groups (p < .05). At 6 months follow-up, the copy number of both P. gingivalis and T. forsythia remained significantly high in CS group (p < .01). Only PDT + DS subgroup in CS significantly reduced the counts of P. gingivalis and T. forsythia at 3 months and 6 months (p < .05). Only at 6 months did PDT + DS showed statistically significantly reduced IL-1ß levels in the NS group (p < .01). TNF-α levels significantly reduced in CS group with PDT + DS and DS alone at both 3 months and 6 months follow-up (p < .01). CONCLUSION: Chloro-aluminum phthalocyanine-mediated PDT helped to improve the non-surgical periodontal therapy outcomes among stage-II chronic periodontitis patients among smokers and never-smokers.

Antimicrobial photodynamic therapy using chloro-aluminum phthalocyanine for treating advanced stage-III periodontitis in smoking patients.

PURPOSE: To evaluate the bacterial, clinical, and cytokine profile of adjunctive photodynamic therapy using chloro-aluminum phthalocyanine (CAP/aPDT) with root surface debridement (RSD) versus RSD alone in cigarette smokers (CS) and never-smokers (NS) during the period of 6 months. METHODS: Twenty-nine patients [CS - 14 and NS - 15] were recruited for the trial having stage-III periodontitis. All candidates from the study groups were subjected to a split-mouth treatment technique receiving CAP/aPDT + RSD and RSD alone. Periodontal parameters including plaque levels (PL), bleeding on probing (BP), probing depth (PD), clinical attachment loss (CAL), and marginal bone loss (MBL) were assessed. Polymerase chain reaction (qPCR) assay was used to analyze the copy numbers of Porphyromonas gingivalis (Pg) and Tannerella forsythia (Tf). Levels of tumor necrosis factor-alpha (TNF-α) interleukin (IL)-6 in the crevicular fluid were evaluated by enzyme-linked immunosorbent assay (ELISA). RESULTS: CAP/aPDT+RSD decreased BP in smokers after 6 months (p < .05). Probing depth and CAL reported statistically significant reductions within both CAP/aPDT+RSD and RSD groups and also within the NS and CS (p < .05). Pg and Tf stayed elevated in smokers at the 6-month evaluation period (p < .01). Only CAP/aPDT+RSD significantly decreased Pg and Tf at 3- and 6-month follow-up in smokers (p < .05). CAP/aPDT+RSD showed decreased IL-6 levels in the NS during the 6-month follow-up (p < .01). TNF-α levels were significantly reduced in the CS group with CAP/aPDT+RSD and RSD alone until 6 months (p < .01). CONCLUSION: CAP-mediated aPDT along with nonsurgical periodontal therapy helped to improve the bacteriological outcomes among smokers and never-smokers with stage-III CP patients.

Effect of tongue piercing on periodontal and peri-implant health: A cross-sectional case-control study in adults.

OBJECTIVES: The authors hypothesize that periodontal and peri-implant inflammatory parameters are poorer in adult patients with tongue piercing compared with controls. The aim was to assess the influence of tongue piercing on periodontal and peri-implant health status in adults. METHODS: Test and control groups comprised of individuals with and without tongue piercing, respectively. A questionnaire was used to collect information about gender, age, duration of tongue piercing and implants in function, jaw location of the implant, reasoning for wearing the tongue ornament, and oral hygiene and ornament cleaning habits. Full-mouth and peri-implant plaque index (PI), gingival index (GI), clinical attachment loss (CAL), probing depth (PD) and marginal/crestal bone loss (MBL and CBL, respectively) on mesial and distal surfaces of teeth/implants were recorded. The material (plastic or metal) from which, the bar and ball-ends of the ornament were fabricated was also recorded. A p < 0.01 was considered statistically significant. RESULTS: Forty-eight and 49 individuals were included in the test and control groups, respectively. There was no difference in PI, GI, PD, CAL and MBL (mesial and distal) among individuals in the test and control groups. In the test group, peri-implant PI (p < 0.01), GI (p < 0.01), PD (p < 0.01) and mesial (p < 0.01) and distal (p < 0.01) CBL were significantly higher in the anterior mandible compared with implants in other jaw locations. In the control group, there was no difference in peri-implant PI, GI, PD and CBL around implants placed in both jaws. CONCLUSION: Wearing tongue piercings could increase the risks of periodontal and peri-implant diseases particularly in the mandibular anterior segment.

Biogenic Synthesis of NiO Nanoparticles Using Areca catechu Leaf Extract and Their Antidiabetic and Cytotoxic Effects.

Nanoworld is an attractive sphere with the potential to explore novel nanomaterials with valuable applications in medicinal science. Herein, we report an efficient and ecofriendly approach for the synthesis of Nickel oxide nanoparticles (NiO NPs) via a solution combustion method using Areca catechu leaf extract. As-prepared NiO NPs were characterized using various analytical tools such as powder X-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM), and UV-Visible spectroscopy (UV-Vis). XRD analysis illustrates that synthesized NiO NPs are hexagonal structured crystallites with an average size of 5.46 nm and a hexagonal-shaped morphology with slight agglomeration. The morphology, size, and shape of the obtained material was further confirmed using SEM and TEM analysis. In addition, as-prepared NiO NPs have shown potential antidiabetic and anticancer properties. Our results suggest that the inhibition of α-amylase enzyme with IC 50 value 268.13 µg/mL may be one of the feasible ways through which the NiO NPs exert their hypoglycemic effect. Furthermore, cytotoxic activity performed using NiO NPs exhibited against human lung cancer cell line (A549) proved that the prepared NiO NPs have significant anticancer activity with 93.349 µg/mL at 50% inhibition concentration. The biological assay results revealed that NiO NPs exhibited significant cytotoxicity against human lung cancer cell line (A549) in a dose-dependent manner from 0-100 µg/mL, showing considerable cell viability. Further, the systematic approach deliberates the NiO NPs as a function of phenolic extracts of A. catechu with vast potential for many biological and biomedical applications.

Investigation of Antifungal Properties of Synthetic Dimethyl-4-Bromo-1-(Substituted Benzoyl) Pyrrolo[1,2-a] Quinoline-2,3-Dicarboxylates Analogues: Molecular Docking Studies and Conceptual DFT-Based Chemical Reactivity Descriptors and Pharmacokinetics Evaluation.

Candida albicans, an opportunistic fungal pathogen, frequently colonizes immune-compromised patients and causes mild to severe systemic reactions. Only few antifungal drugs are currently in use for therapeutic treatment. However, evolution of a drug-resistant C. albicans fungal pathogen is of major concern in the treatment of patients, hence the clinical need for novel drug design and development. In this study, in vitro screening of novel putative pyrrolo[1,2-a]quinoline derivatives as the lead drug targets and in silico prediction of the binding potential of these lead molecules against C. albicans pathogenic proteins, such as secreted aspartic protease 3 (SAP3; 2H6T), surface protein ß-glucanase (3N9K) and sterol 14-alpha demethylase (5TZ1), were carried out by molecular docking analyses. Further, biological activity-based QSAR and theoretical pharmacokinetic analysis were analyzed. Here, in vitro screening of novel analogue derivatives as drug targets against C. albicans showed inhibitory potential in the concentration of 0.4 µg for BQ-06, 07 and 08, 0.8 µg for BQ-01, 03, and 05, 1.6 µg for BQ-04 and 12.5 µg for BQ-02 in comparison to the standard antifungal drug fluconazole in the concentration of 30 µg. Further, in silico analysis of BQ-01, 03, 05 and 07 analogues docked on chimeric 2H6T, 3N9K and 5TZ1 revealed that these analogues show potential binding affinity, which is different from the therapeutic antifungal drug fluconazole. In addition, these molecules possess good drug-like properties based on the determination of conceptual Density Functional Theory (DFT)-based descriptors, QSAR and pharmacokinetics. Thus, the study offers significant insight into employing pyrrolo[1,2-a]quinoline analogues as novel antifungal agents against C. albicans that warrants further investigation.

Cu2 MoS4 /Au Heterostructures with Enhanced Catalase-Like Activity and Photoconversion Efficiency for Primary/Metastatic Tumors Eradication by Phototherapy-Induced Immunotherapy.

Photoimmunotherapy can not only effectively ablate the primary tumor but also trigger strong antitumor immune responses against metastatic tumors by inducing immunogenic cell death. Herein, Cu2 MoS4 (CMS)/Au heterostructures are constructed by depositing plasmonic Au nanoparticles onto CMS nanosheets, which exhibit enhanced absorption in near-infrared (NIR) region due to the newly formed mid-gap state across the Fermi level based on the hybridization between Au 5d orbitals and S 3p orbitals, thus resulting in more excellent photothermal therapy and photodynamic therapy (PDT) effect than single CMS upon NIR laser irradiation. The CMS and CMS/Au can also serve as catalase to effectively relieve tumor hypoxia, which can enhance the therapeutic effect of O2 -dependent PDT. Notably, the NIR laser-irradiated CMS/Au can elicit strong immune responses via promoting dendritic cells maturation, cytokine secretion, and activating antitumor effector T-cell responses for both primary and metastatic tumors eradication. Moreover, CMS/Au exhibits outstanding photoacoustic and computed tomography imaging performance owing to its excellent photothermal conversion and X-ray attenuation ability. Overall, the work provides an imaging-guided and phototherapy-induced immunotherapy based on constructing CMS/Au heterostructures for effectively tumor ablation and cancer metastasis inhibition.

Efficacy of Nonsurgical Mechanical Debridement With and Without Adjunct Low-Level Laser Therapy in the Treatment of Peri-Implantitis: A Randomized Controlled Trial.

We hypothesized that in the long term (6-month follow-up), nonsurgical mechanical debridement (NSMD) with adjunct low-level laser therapy (LLLT) is more effective for the treatment of peri-implantitis than NSMD alone. The aim of the present 6-month follow-up convenience-sample cohort study was to assess the efficacy of LLLT as an adjunct to NSMD in the treatment of peri-implantitis. A questionnaire was used to collect demographic information. Patients with peri-implantitis in the test and control groups underwent NSMD with and without adjunct LLLT, respectively. Randomization was done by tossing a coin. In the test group, the laser was applied perpendicular to the periodontal pocket for 20 seconds at a constant distance of 15 mm and with a continuous wavelength (3.41 J/cm2 delivery with a 1.76 cm2 spot and average output of 0.3 W). In both groups, peri-implant probing depth, bleeding upon probing, and crestal bone resorption were assessed at baseline and at the 3-month and 6-month follow-up. Group comparisons were performed, and P < .05 was considered statistically significant. Sixty-seven individuals with peri-implantitis were included. The mean age of participants who underwent NSMD with adjunct LLLT and NSMD alone was 46.5 ± 3.4 and 45.3 ± 1.1 years, respectively. At the 3- and 6-month follow-up, peri-implant (P < .05), bleeding upon probing (P < .05), and probing depth (P < .05) were significantly higher among patients who underwent NSMD alone compared with patients who underwent NSMD with adjunct LLLT. There was no significant difference in crestal bone resorption in all patients up to the 6-month follow-up. In the short term, NSMD with adjunct LLLT was a useful treatment protocol for the treatment of peri-implant soft-tissue inflammation.

Oral Candida carriage among cigarette- and waterpipe-smokers, and electronic cigarette users.

OBJECTIVE: The aim of this cross-sectional study was to compare oral Candida carriage among cigarette- and waterpipe-smokers, electronic cigarette (E-Cig) users, and never-smokers. METHODS: Demographic data and information regarding smoking and vaping were collected using a questionnaire. Number of missing teeth and unstimulated whole salivary flow rate (UWSFR) were recorded. Oral Candida samples were collected and identified using concentrated oral rinse culture technique and PCR, respectively. Level of significance was set at p < 0.05. RESULTS: Thirty-four cigarette-smokers (Group-1), 33 waterpipe-smokers (Group-2), 30 E-Cig users (Group-3), and 32 never-smokers (Group-4) were included. All were male participants with comparable mean ages. In groups 1, 2, 3, and 4, oral Candida carriage rate was 100%, 100%, 83.3% and 50%, respectively. The most commonly isolated oral yeast species in all groups was C. albicans. C. albicans carriage was significantly higher in groups 1 (p < 0.05), 2 (p < 0.05), and 3 (p < 0.05) than Group-4. Data stratification for age, missing teeth, and UWSFR showed no significant difference in oral yeasts carriage in groups 1, 2, and 3. CONCLUSIONS: Oral C. albicans carriage was significantly higher among cigarette- and waterpipe-smokers and E-Cig users than never-smokers. No significant differences were identified among groups in the oral carriage of other Candida species.

Full Color Luminescence Tuning in Bi3+/Eu3+-Doped LiCa3MgV3O12 Garnet Phosphors Based on Local Lattice Distortion and Multiple Energy Transfers.

In the pursuit of high-quality W-LED lighting, the precise control of emission color of phosphor materials is indispensable. Herein we report a series of single-composition Bi3+-doped LiCa3MgV3O12 garnet-structure phosphors, whose emission colors under n-UV excitation could be tuned from bluish green (480 nm) to yellow (562 nm) on the basis of local lattice distortion and VO43- → Bi3+ energy transfer. Furthermore, full-color luminescence tuning from bluish green to orangish red across the warm white light region was successfully achieved by designing VO43- → Bi3+ → Eu3+ energy transfers. More interestingly, the thermal stabilities of as-prepared samples were gradually enhanced through designing VO43-/Bi3+ → Eu3+ energy transfers. This work provides a new perspective for color tuning originating from simultaneous local lattice distortion and multiple energy transfers.

Analyzing Relationship between Patient and Doctor in Public Dental Health using Particle Memetic Multivariable Logistic Regression Analysis Approach (MLRA2).

In the developing technology managing patient and doctor relationship and communication process is one of the critical factors because the patient may take high risk surgery, treatment and diagnosis. Due to the importance of the patient-doctor relationship, in this paper investigate the various aspects of relation between the doctor and dental problem related patients. During the analyzing process, data has been collected from adults who are facing dental problems and other dental injuries in which data has been gathered from 423 individuals by conducting interviews. The gathered data is investigated with the help of particle-memetic multivariable logistic regression analysis method which examines the patient income, dental surgical details, injuries and other factors relationship has been investigated. From the analyzed data, how the patients are treated by doctors examined for improving the relationship between patient and doctor in public dental health aspects.

Comparison of clinical and radiographic status around dental implants placed in patients with and without prediabetes: 1-year follow-up outcomes.

OBJECTIVE: We hypothesized that peri-implant soft tissue inflammation is worse and peri-implant marginal bone loss (MBL) is higher around dental implants placed in patients with prediabetes compared to healthy subjects. The aim of the present 12-month follow-up study was to compare the clinical and radiographic status around dental implants placed in patients with and without prediabetes. MATERIAL AND METHODS: Twelve patients with medically diagnosed prediabetes (Group-1) and 12 controls (Group-2) were included. All patients were indicated for single tooth maxillary or mandibular premolar replacement with the adjacent teeth intact. Success of the restored implants was assessed by comparing clinical (peri-implant bleeding on probing [BOP], and probing pocket depth [PPD]) and radiographic (peri-implant MBL) parameters at baseline and at 12-months follow-up. Statistical analysis was performed using one-way analysis of variance, and P-values <0.05 were considered statistically significant. RESULTS: At 12 months of follow-up, there was no clinical evidence for the presence of plaque, BOP and peri-implant pockets with PPD ≥ 4 mm in both groups. At 12-month follow-up, the mean MBL among implants placed in groups 1 and 2 were 0.2 ± 0.1 mm and 0.1 ± 0.01 mm, respectively. Overall, the periodontal status (PI, BOP and PPD ≥ 4 mm) at 12-month follow-up was comparable among patients in both groups. CONCLUSION: Within the limitations of this study, it is concluded that dental implants inserted in prediabetic and healthy patients have similar success rates and remain clinically and radiographically stable after 1-year follow-up.

Comparison of clinical and radiographic parameters around short (6 to 8 mm in length) and long (11 mm in length) dental implants placed in patients with and without type 2 diabetes mellitus: 3-year follow-up results.

OBJECTIVE: To compare the clinical and radiographic parameters around short (6 to 8 mm in length) and long (11 mm in length) dental implants placed in patients with and without type 2 diabetes mellitus (T2DM). MATERIAL AND METHODS: Forty-five male patients with T2DM (Group-1) and 42 male non-diabetic controls (Group-2) who had undergone implant therapy in the posterior mandible were included. Depending upon the length of the implant, patients were divided into two subgroups: (a) patients with short implants (6-8 mm long) and (b) patients with long implants (11 mm long). Peri-implant plaque index (PI), bleeding on probing (BOP), probing depth (PD) and crestal bone loss (CBL) were measured at 18 and 36 months of follow-up in both groups. Hemoglobin A1c (HbA1c) levels were measured at baseline and after 18 and 36 months of follow-up in both groups. P-values less than 0.05 were considered statistically significant. RESULTS: The mean age of patients in groups 1 and 2 was 42.5 and 40.6 years, respectively. The mean HbA1c levels at baseline among patients in groups 1 and 2 were 7.7% and 4.5%, respectively. At 18 and 36 months of follow-up, the mean HbA1c levels among patients in groups 1 and 2 were 6.6% and 4.5% and 6.5% and 4.4%, respectively. The mean duration of T2DM among patients that received short and long implants was 4.3 years and 4.1 years, respectively. There was no significant difference in PI, BOP, PD and CBL around implants placed in both groups at 18 and 36 months of follow-up. Success rate of short and long dental implants was 100% in both groups. CONCLUSION: Short implants can demonstrate clinical and radiographic stability in a manner similar to conventional long implants in patients with and without T2DM. The role of oral hygiene and glycemic maintenance in this scenario cannot be disregarded.

Soft tissue changes and crestal bone loss around platform-switched implants placed at crestal and subcrestal levels: 36-month results from a prospective split-mouth clinical trial.

OBJECTIVE: The aim of the present 36-month prospective split-mouth clinical trial was to investigate the peri-implant soft tissue changes and crestal bone loss (CBL) around delayed loaded platform-switched implants placed at crestal and subcrestal levels. MATERIAL AND METHODS: Twenty-three individuals with bilaterally missing either mandibular first or second molars were included. The test and control sites were defined as follows: (i) test sites: implants placed 2 mm below the alveolar crest (subcrestal); (ii) control sites: implants placed at bone level (crestal). Forty-six implants (23 implants in test sites and 23 in control sites) were placed in the center of the healed alveolar ridge in the posterior mandible. Peri-implant bleeding on probing (BOP), probing depth (PD ≥ 4 mm), and CBL was compared at 6, 18, and 36 months of follow-up. P < 0.05 was considered statistically significant. RESULTS: Sixteen males and seven females with a mean age of 43.5 years (29-50) were included. In the control group (n = 23), the highest mean percentage of sites that showed BOP and PD ≥ 4 mm were at 6 months (7.4% and 1.4%, respectively). In the test group (n = 23), the highest mean percentage of sites that showed BOP and PD ≥ 4 mm were at 6 months (2.4% and 1.2%, respectively). The total amount of CBL around crestal and subcrestal implants after 36 months of loading was 0.45 ± 0.2 and 0.3 ± 0.2 mm, respectively. At all follow-up intervals, all intragroup and intergroup comparisons showed no significant differences in BOP, PD ≥ 4 mm, and CBL around implants placed at crestal and subcrestal levels. CONCLUSION: Up to 36 months of follow-up, soft tissue parameters and crestal bone levels can remain equally stable around dental implants placed at crestal and subcrestal levels. The need for long-term follow-up clinical trials is also emphasized.

Cytokine profile in the synovial fluid of patients with temporomandibular joint disorders: A systematic review.

The aim of this study was to review the cytokine profiles in the synovial fluid (SF) of patients with temporomandibular joint disorders (TMJD). Databases were searched from 1965 till September 2015 using different combinations of the following key words: "Temporomandibular joint"; "Cytokine"; "disorder"; and "synovial fluid" and "inflammation". Titles and abstracts of studies identified using the above-described protocol were screened and checked for agreement. Full-texts of articles judged by title and abstract to be relevant were read and independently evaluated. Hand-searching of the reference lists of potentially relevant original and review articles was also performed. The pattern of the present systematic review was customized to mainly summarize the relevant data. Fifteen studies were included. In 12 studies, cytokine profile of patients with TMJD was assessed using enzyme linked immunosorbent assay; and in 2 studies, histological analysis was performed to assess the cytokine profile of patients with TMJD. Patients with TMJD presented raised levels of interleukin (IL)-6 in 8 studies, IL-1beta (1ß) in 5 studies and tumor necrosis factor-alpha (TNF-α) in 5 studies. Two studies showed no significant difference in TNF-α levels in patients with and without TMJD; and IL-1ß levels were comparable in patients with and without TMJD in 2 studies. Raised levels of IL-6, TNF-α, IL-1ß, IL-8, and IFN-γ in the SF have been associated with inflammation in patients with TMJD. Cytokines IL-10, osteoclastogenesis inhibitory factor/osteoprotegerin (OCIF/OPG), and VEGF found in the SF of TMJs could have an anti-inflammatory effect.

Effect of oral hygiene maintenance on HbA1c levels and peri-implant parameters around immediately-loaded dental implants placed in type-2 diabetic patients: 2 years follow-up.

OBJECTIVE: The aim of the present 2-year follow-up study was to assess the effect of oral hygiene maintenance on hemoglobin Alc (HbA1c) levels and peri-implant parameters around immediately-loaded dental implants placed in type-2 diabetic patients with varying glycemic levels. MATERIAL AND METHODS: Ninety-one individuals were divided into three groups. In group 1, 30 systemically healthy individuals were included (HbA1c < 6%). Patients in group 2 and 3, comprised of 30 patients with T2DM (HbA1c 6.1-8%); and 31 patients with T2DM (HbA1c 8.1-10%) respectively. In all groups, patients received immediately loaded bone level implants. All participants were enrolled in a 6 monthly periodontal/peri-implant maintenance program. Peri-implant bleeding on probing (BOP), probing depth (PD), and marginal bone loss (MBL) were measured at 6, 12, and 24 months of follow-up. RESULTS: Mean preoperative HbA1c levels in patients in groups 1, 2, and 3 were 4.5%, 6.8%, and 8.7% respectively. In group-1, there was no significant difference in HbA1c levels at all follow-up durations. Among patients in groups 2 and 3, there was a significant decrease in HbA1c levels at 24-months follow-up than 6-months follow-up. At 6 months follow-up, BOP, PD, and MBL were significantly higher among patients in group-3 than group-1. At 12 and 24 months follow-up, there was no significant difference in BOP, PD, and MBL in all groups. CONCLUSIONS: Oral hygiene maintenance reduces hyperglycemia and peri-implant inflammatory parameters around immediately loaded dental implants placed in type 2 diabetic patients.

Effect of Nd:YAG laser-assisted non-surgical periodontal therapy on clinical periodontal and serum biomarkers in patients with and without coronary artery disease: A short-term pilot study.

BACKGROUND/OBJECTIVE: We hypothesized that nonsurgical-periodontal-therapy (NSPT) with adjunct Nd:YAG laser therapy is more effective in reducing periodontal inflammatory parameters (plaque index [PI], bleeding-on-probing [BOP], and probing-pocket-depth [PPD]) and serum interleukin-1beta (IL-1ß) and matrix metalloproteinase-9 (MMP-9) levels in patients with and without coronary artery disease (CAD) than NSPT alone. The aim of this short-term pilot study was to assess the effect of NSPT + Nd:YAG laser therapy on periodontal parameters and serum IL-1ß and MMP-9 levels in patients with and without CAD. STUDY DESIGN: A prospective randomized clinical study was conducted on 87 patients who were divided into two groups: Group-1: 44 patients with CAD and periodontal disease (PD) and Group-2: 43 patients with PD alone. Treatment-wise, these individuals were randomly divided into two subgroups: (i) NSPT alone and (ii) NSPT + Nd:YAG laser therapy. Demographic information was collected using a self-completed questionnaire. Periodontal parameters (PI, BOP, and PPD) and serum IL-1ß and MMP-9 levels were measured at baseline and after 3 months of treatment. P-values <0.05 were considered statistically significant. RESULTS: At 3 months follow-up, PI (P < 0.01), BOP (P < 0.01), PPD ≥ 4 mm (P < 0.01), and serum IL-1ß (P < 0.01) and MMP-9 (P < 0.01) levels were significantly higher in patients treated with NSPT alone than those treated with NSPT + Nd:YAG laser therapy. Among patients that underwent NSPT + laser therapy in both groups, periodontal parameters and serum IL-1ß, and MMP-9 levels were comparable at 3-months follow-up. CONCLUSION: NSPT + Nd:YAG laser therapy may be more effective in reducing periodontal inflammation and serum IL-1ß and MMP-9 levels in patients with and without CAD than NSPT alone. Lasers Surg. Med. 48:929-935, 2016. © 2016 Wiley Periodicals, Inc.

Efficacy of parathyroid hormone supplementation on the osseointegration of implants: a systematic review.

OBJECTIVE: The aim of the present systematic review was to assess the efficacy of parathyroid hormone supplementation on the osseointegration of implants. METHODS: The addressed focused question was Does parathyroid hormone supplementation affect osseointegration around implants? Indexed databases were searched from 1965 up to and including April 2015 using various key words including: Bone to implant contact; implant; parathyroid hormone; and osseointegration. Letters to the Editor, case-reports/case-series, historic reviews, commentaries and articles published in languages other than English were excluded. The pattern of the present systematic review was customized to primarily summarize the pertinent data. RESULTS: Eighteen studies fulfilled the eligibility criteria. Evidence was limited to preclinical animal studies only (11 studies in rodents, 4 in dogs and 3 in rabbits). Number of titanium implants placed ranged between 20 and 80 implants. Results from 16 studies showed that PTH supplementation enhanced new bone formation and/or BIC around implants. One study suggests that PTH-coated implants improve BIC and BA. One study showed no significant difference in BIC and new bone formation around implants with PTH hydrogel placement. CONCLUSION: Efficacy of PTH supplementation on osseointegration of implants shows promising results in animal models, however further investigation is necessary to assess the effectiveness in humans.

Efficacy of Vitamin D3 Supplementation on Osseointegration of Implants.

PURPOSE: The aim was to systematically review the efficacy of vitamin D3 (VD3) supplementation on the osseointegration of implants. METHODS: The addressed focused question was "does VD3 supplementation affect osseointegration around implants?" Indexed databases were searched from 1969 up to and including March 2015 using various key words including: "Bone to implant contact"; "implant"; "vitamin D"; and "osseointegration." Letters to the editor, case reports/case series, reviews, and articles published in languages other than English were excluded. The pattern of the present systematic review was customized to primarily summarize the pertinent data. RESULTS: Six experimental studies (4 in rodents and 2 in rabbits) were included. Number of titanium implants placed ranged between 28 and 100 implants. Results from 5 studies showed that VD3 supplementation enhanced new bone formation and/or bone to implant contact (BIC) around implants. One study showed no significant difference in BIC and new bone formation around VD3 coated and noncoated implants. One study reported that insulin therapy with adjunct VD3 supplementation enhances new bone formation around implants in diabetic rats than when insulin replacement therapy is used alone. CONCLUSION: Efficacy of VD3 supplementation on osseointegration of implants remains controversial and requires further investigations.