Influence of Human Telomerase Reverse Transcriptase Mutation on the Aggressiveness and Recurrence in Meningiomas.

BACKGROUND:  Over 200 human telomerase reverse transcriptase (hTERT) polymorphism combinations have been implicated in the development of cancer. This study aimed to evaluate hTERT mutations in meningioma tissue and its association with meningioma. MATERIAL AND METHODS: A total of 90 patients who underwent surgery between 2006 and 2015 and were histopathologically diagnosed with meningioma (WHO 2016) were included. RESULTS: Among the 90 participants included herein, 50 (55.5%) and 40 (44.5%) were female and male, respectively, with an average age of 56.2 ± 14 years. Mean Ki-67 values were 10.56% (SD 12.41, range 0-60), while the mean follow-up duration was 39.1 months (SD 26.3). Low- and high-grade patients had a mean Ki-67 score of 4.31% (SD 3.58, range 0-16) and 19.92% (SD 14.91, range 2-60) (p = 0.0001). Our results showed a moderate positive correlation between Ki-67 score and the presence of hTERT mutation (Pearson correlation test, r = 0.5161; p = 0.0001). Patients with an hTERT mutation > 30% had significantly higher risk for reoperation than those with lower levels of mutation (p = 0.016, chi square test). None of the patients requiring reoperation had an hTERT mutation < 10%. Moreover, high-grade patients had a 7.2 times higher risk of reoperation than those with an hTERT mutation > 30%. CONCLUSION: The presence of hTERT mutation, in addition to high Ki-67, indicated a more aggressive meningioma disease course and potentially increased risk of recurrence.

Analysis and Differences of the Neurosurgical Complications During COVID-19 Pandemic.

Objectives: The objective of the study was to analyze the complications of neurosurgical operations during the COVID-19 pandemic by comparing them with the complications observed in the pre-pandemic period. Methods: Two groups were formed: (1) Patients who were operated in the 5-month period of the pandemic (March-July 2020) and (2) those who were operated the same operations in the same period 1 year before (March-July 2019). Demographics, characteristics, medical follow-up data, complications, and outcome compared between the groups. Results: Similar demographics were observed between the groups. The number of all neurosurgical cases and neurotrauma cases decreased by 79% and 68% in pandemic period, respectively. The rate of emergency surgeries was significantly higher in pandemic group (p<0.001). The operation time was significantly longer in pandemic group (p=0.014). Total complication rate was significantly higher in pandemic group (p=0.002). Specifically, the rate of pulmonary complications was significantly higher during pandemic period (p<0.001). The infection rate (p<0.001), antibiotic use (p<0.001), and intensive care unit stay (p=0.023) were significantly higher in pandemic group. Conclusion: During pandemic period complication rates increased and a higher risk than expected was encountered. Treatment should be performed by taking the precautions and informing the patients about additional risks.

Mutagenic potentials of dental cements as detected by the Salmonella/microsome test.

The potential mutagenicity of a zinc phosphate (Poscal), a polycarboxylate (Aqualox) and glass ionomer cements with (Argion) and without (Meron) silver reinforcement were characterized by employing the Ames Salmonella/microsome test. The materials were eluted in dimethyl sulphoxide or physiologic saline and the aliquots were used either immediately or after an incubation period of 24h at 37 degrees C. Mutagenic effects of the materials were tested on Salmonella typhimurium strains TA 98, TA 100, TA 102 and TA 1535 using the standard plate incorporation assay, and in the presence or absence of S9 fraction from rat liver. Poscal and Aqualox elicited mutagenic effects on S. typhimurium TA 98 and TA 1535, whereas Meron exhibited mutagenic effects on S. typhimurium TA 98. No mutagenic effects were detected for Argion. The type of solvent, dose of the material and incubation as well as the interactions between these factors exhibited varying degrees of influences on the mutagenic activities of the cements (P<0.05 and P<0.1). We conclude that zinc phosphate, polycarboxylate, and glass ionomer cements may have possible mutagenic activities.

Effects of machined/turned, TiO2-blasted and sandblasted/acid-etched titanium oral implant surfaces on nerve conduction: a study on isolated rat sciatic nerves.

The purpose of this study was to explore the clinical relevance of the effects of machined/turned, TiO(2)-blasted and sandblasted/acid-etched titanium oral implant surfaces on nerve conduction. Isolated rat sciatic nerves were placed between two suction electrodes in a pyrex bath containing a tyrode solution. Evoked compound action potentials (cAPs) of the nerves were recorded before and after contact with the implants. The mandibular incisors of randomly selected animals were extracted and changes in cAP amplitudes were used as controls. The differences in final cAP values of Astra Tech implants and rat natural teeth were insignificant (P < 0.05), whereas the differences between other groups were significant (P < 0.05). Machined/turned-surface implants did not cause any change in cAPs. A slight decrease in cAPs was observed for TiO(2)-blasted and sandblasted/acid-etched implants, and the natural teeth. The reductions of cAPs in latter groups were not 50% after an application time of 300 min. The cAP changes of nerves contacting TiO(2)-blasted and sandblasted/acid-etched oral implants fall within physiologic limits in vitro. Machined/turned, TiO(2)-blasted, and sandblasted/acid-etched titanium implant surfaces do not lead to irreversible neurotoxic effects.

Vascular response to titanium dioxide: a study on the rat carotid artery.

The purpose of this study was to explore the effects of titanium dioxide (TiO(2)) on vascular smooth muscle contractility with the use of the rat carotid-artery model. TiO(2) powder was implanted on right carotid arteries of five albino rats, the left arteries of which were left intact and served as controls. Fourteen days after placement, bilateral carotid arteries were removed and contraction/relaxation of isolated vessel rings were measured for dose-dependent epinephrine and acetylcholine administrations by a force displacement transducer. The data of each tissue specimen were collected with the use of a computerized system and corresponding software at a sample rate of 1000 kHz, and were expressed as contraction force. Contraction forces of control and TiO(2)-implanted vessel rings were similar (P > 0.05). TiO(2) does not appear to have adverse effects on vascular contractility.

Role of mechanical environment and implant design on bone tissue differentiation: current knowledge and future contexts.

OBJECTIVES: To evaluate published evidence related to bone reactions to varying loading regimens and the impact of implant design on bone tissue differentiation. DATA AND SOURCES: The literature was searched for original research articles relating effect of mechanical environment on bone tissue and effects of implant design on bone biomechanics and marginal bone reactions using MEDLINE and manual tracing of references cited in key papers otherwise not elicited. STUDY SELECTION: Current literature on biomechanics of bone and dental implants as main focus and pertinent to key aspects of the review. CONCLUSIONS: Implant design influences force transmission characteristics in peri-implant bone, but not the time-dependent marginal bone reactions. Mechanical signals affect bone tissue differentiation. Therefore, it is essential to control biomechanical loads on implants to maintain osseointegration and/or to promote early bone-implant interface healing.

The influence of functional forces on the biomechanics of implant-supported prostheses--a review.

OBJECTIVES: To evaluate published evidence related to the influence of functional forces on the biomechanics of implant-supported prostheses. DATA AND SOURCES: The literature was searched for original research articles relating control of loads on dental implants, effects of early and late occlusal loads, the influence of bone quality, prosthesis type, prosthesis material, number of supporting implants, and engineering techniques employed for evaluating mechanical and biomechanical behavior of implants using MEDLINE and manual tracing of references cited in key papers otherwise not elicited. STUDY SELECTION: Current literature on implant biomechanics as main focus and pertinent to key aspects of the review. CONCLUSIONS: The outcome of implant treatment is often maximized when implants are placed in dense bone, number of supporting implants are increased, implant placement configuration reduces the effects of bending moments, and when a fixed prosthesis is delivered to the patient.

Cytotoxicity of eluates from a gamma-ray-polymerized poly(methyl methacrylate).

The purpose of this study was to evaluate the cytotoxicity of gamma-ray-polymerized poly(methyl methacrylate) (PMMA). A total of 32 disk-shaped PMMA specimens were polymerized by gamma-irradiation with 1 Mrad for 4 h (Group 1), 2 Mrad for 8 h (Group 2), 3 Mrad for 12 h (Group 3), and thermally polymerized (Group 4). Four- and 6-day eluates of the specimens were prepared in Eagle's Minimal Essential Medium (EMEM) without Fetal Calf Serum (FCS). The eluates and EMEM supplemented by 20% FCS were placed into Vero (green African monkey kidney) cell cultures, and incubated at 37 degrees C for 24, 48, and 72 h. EMEM kept at 37 degrees C for 4 and 6 days was also tested up to 72 h, and served as controls. After each incubation period, the number of viable cells were counted and stained at the termination of the experiments for histological evaluation. The number of viable cells for Group 1 was slightly lower than that of other groups after 24 h. The time-dependent increase in cells exposed to Group 3 eluates was comparable with the control group. There was a dose-dependent effect on cell response for gamma-ray-polymerized specimens. The number of viable cells and the morphological appearance of cells in all groups were similar. Eluates from PMMA polymerized by low doses of gamma-ray with reduced polymerization periods have early inhibitory effects on cell response. Higher doses of gamma-irradiation lead to better cellular response, and therefore, may be future candidates for polymerization of PMMA.

Biological reactions to a poly(L-lactide)-hydroxyapatite composite: a study in canine mandible.

In this study, bone response, possible use and ultimate fate of a chemically-synthesized poly(L-lactide)-hydroxyapatite (PLLA-HA) composite was experimented in canine mandible. Bilateral mandibular second premolars were extracted in four dogs. The PLLA-HA composite was placed into left surgical sites, and right extraction sites were used as controls. After three months of healing, bone specimens were harvested from each animal and processed for histological evaluation. Bone uptake of methylene diphosphonate (99mTc-MDP) was calculated as indicators of osteoblastic activity in the surgical sites. Histological evaluation and the amount of 99mTc-MDP uptake showed that all surgical sites had similar levels of cellular activity and the material was biocompatible. The experimental PLLA-HA composite studied is safe to be used as a small-defect filler in applications such as repair of alveolar defects, ridge augmentations, and sinus lift procedures.

Effects of prosthesis design and impression techniques on human cortical bone strain around oral implants under load.

PURPOSE: The purpose of this study was to evaluate the effects of two different prosthetic designs (screw-retained versus cement-retained) and two impression techniques (open versus closed tray) on bone-level strains around implants. MATERIALS AND METHODS: Two Ø 4.1 mm x 10 mm Straumann implants were placed in the bilateral fibulas of six fresh cadavers; bone segments were removed en bloc. Twelve implant-level and six abutment-level (18 total) working casts were made to fabricate fixed partial dentures, resulting in three test groups: Group 1: closed-tray technique/implant-level model/screw-retained prostheses; Group 2: closed-tray technique/abutment-level model/cement-retained prostheses; Group 3: open-tray technique/implant-level model/screw-retained prostheses. Linear strain-gauges were bonded to the cortical bone between implants and the lateral wall of the fibula in close proximity to the implant necks in each bone fragment. Strain-gauge signals were digitized by a data acquisition system and corresponding software at a sample rate of 10 KHz, simultaneously monitored from the computer during application of an external static load of 150 N on the middle of the pontic, using a loading frame. RESULTS: The approximal and lateral strains were extremely similar in both prosthetic groups (p>0.05). Within-group comparisons for the indirect impression technique showed that approximal and lateral strains in screw- and cement-retained prostheses were similar (p>0.05). Neither the prostheses design nor the impression technique had any discernable effect on bone-level strain. CONCLUSION: Strains on the cortical bone around two implant supported, 3-unit screw- or cement-retained fixed prostheses, fabricated either by direct or indirect impression techniques on Straumann dental implants, are similar under a 150 N static load.

A dual-purpose guide for optimum placement of dental implants.

Correct placement of implants is a requirement for implant treatment. The use of computed tomography and precise surgical guides is required when inadequate bone support is anticipated. This article describes the fabrication and use of an acrylic resin dual-purpose guide for radiographic evaluation of recipient sites and implant placement, which uses internally stacked stainless steel surgical guide channels. The drill guides are machined to allow consecutive surgical drills to be used without changing the implant angulation during surgery.

Dynamic fatigue resistance of implant-abutment junction in an internally notched morse-taper oral implant: influence of abutment design.

PURPOSE: To compare dynamic fatigue resistance of one- and two-piece abutments connected to internally notched morse-taper oral implants. MATERIAL AND METHODS: Sixteen synOcta ITI implants were tightened into two metal models. SynOcta abutments for cement-retained restorations and solid abutments were divided into two equal groups and were torque-tightened into the implants. Each implant received a cement-retained crown. Cyclic dynamic axial and lateral peak loads of 75+/-5 N were applied on the implants for a duty of 500,000 cycles at 0.5 Hz, and at an angle of 20 degrees. Prior to the experiments and at each 100,000 cycles of loading, periotest values (PTVs) were measured. Removal torque values (RTVs) of the abutments were also measured with a custom-made torque device at the termination of the experiment. RESULTS: All abutments and implants were clinically immobile and without any signs of mechanical failure. The final PTVs for both abutments were similar and the difference between groups was insignificant (P>0.05). The RTVs of solid abutments were significantly higher than synOcta abutments (P<0.05). CONCLUSION: Predictable long-term clinical results can be achieved with solid abutments and synOcta abutments for cement-retained restorations. Solid abutments possess higher removal torque resistance than synOcta abutments when connected to synOcta ITI implants.

Effects of hydroxyapatite-coated and commercially pure titanium oral implant surfaces on compound nerve action potentials.

The aim of this study was to investigate the effects of hydroxyapatite-coated and commercially pure titanium oral implants on nerve conduction. Isolated rat sciatic nerves were placed between two suction electrodes in a bath containing a tyrode solution. The implants were brought into intimate contact with the nerves and evoked compound action potentials (cAPs) were recorded before and after contact with the implants. The commercially pure titanium implants did not cause any change in cAPs. A gradual reduction in cAPs was observed for hydroxyapatite-coated implants. However, this reduction was < 50% after an application time of 120 min. Recovery of the cAPs in this group was recorded after approximately 60 min. We conclude that, although intimate contact with hydroxyapatite-coated implants leads to a reduction in cAPs in nerves in vitro, neither this surface nor a commercially pure titanium surface leads to irreversible neurotoxic effects.

Morphologic, functional and behavioral effects of titanium dioxide exposure on nerves.

OBJECTIVES: The purpose of this study was to explore morphologic, functional, and behavioral effects of titanium dioxide (TiO(2)) on nerves. MATERIAL AND METHODS: A total of 17 albino rats were used for nerve conduction experiments, hot-plate tests, and histological evaluation. TiO(2) was implanted unilaterally on the sciatic nerves of five rats. Ten days after surgery, test and control nerves were dissected and their signal transduction speeds were quantified by suction electrodes in a bath containing a Tyrode solution. Twelve rats were divided into three equal groups resulting in equal number of nerves (n=8) for TiO(2) implantation, surgical exposure of the nerves, and for use as controls. One week after surgery, hot-plate tests were undertaken for 10 consecutive days to determine response latencies of the nerves. At the termination of the experiments, the nerves were harvested, processed, and examined under a microscope. RESULTS: The signal transduction speeds of TiO(2)-implanted nerves was similar to control specimens (P>0.05). The avoidance responses of TiO(2)-implanted, surgically exposed, and control nerves were comparable (P>0.05). At the cellular level, TiO(2) did not lead to any signs of adverse reactions on nerves. CONCLUSIONS: TiO(2), the main oxide surrounding endosseous titanium implants, does not alter the structure and the function of myelinated nerves.