Association between Periodontitis and Mild Cognitive Impairment: A Systematic Review and Meta-Analysis.

INTRODUCTION: The connection between periodontitis and mild cognitive impairment (MCI) continues to receive attention. However, whether periodontitis is a risk factor for MCI remains still uncertain. This study aims to systematically analyze the available literature regarding the relationship between periodontitis and the risk of developing MCI and whether the periodontal health of MCI patients is poorer. METHODS: A literature search of PubMed, Scopus, Embase, and Web of Science databases was conducted to include all studies on the relationship between periodontitis and MCI from inception to April 2023. The studies were independently screened by 2 researchers, and those meeting the inclusion criteria were extracted and cross-checked. Pooled odds ratio (OR) or mean difference (MD) with 95% confidence intervals (CI) was calculated using either a fixed-effects or random-effects model. RESULTS: Seven studies with a total of 3,973 participants were included. Meta-analysis results showed a statistically significant higher incidence of MCI in patients with periodontitis (OR, 1.70 (95% CI: 1.24-2.32, p < 0.001) compared to healthy participants. A subgroup meta-analysis showed that the pooled OR for the risk of MCI in patients with severe periodontitis was 2.09 (95% CI: 1.49-2.92, p < 0.001). In addition, attachment loss (MD = 0.44, 95% CI: 0.12-0.75, p < 0.001) and plaque index (MD = 0.72, 95% CI: 0.50-0.93, p < 0.001) were higher in MCI patients compared with the control group, but the pocket probing depth (MD = 0.21, 95% CI: -0.08 to 0.49, p = 0.15) was not significantly different between the two groups. CONCLUSIONS: Patients with periodontitis are at a higher risk of developing MCI, and the periodontal health of MCI patients is generally compromised. However, further well-designed studies should be conducted to confirm this relationship between MCI and periodontitis.

Effects of intermittent parathyroid hormone on cementoblast-mediated periodontal repair.

OBJECTIVES: To investigate the effects of intermittent parathyroid hormone on cementoblast-mediated periodontal repair in the context of orthodontic-induced root resorption. MATERIALS AND METHODS: The rat model of orthodontic-induced root resorption was established. Sixty rats were randomly allocated into the experiment group (n = 30) and the control group (n = 30), either receiving a daily subcutaneous injection of recombinant human PTH or placebo vehicle. Enzyme-linked immunosorbent assay, Micro-computed tomography, hematoxylin and eosin staining, and immunohistochemistry staining were performed to detect the periodontal repair. In vitro, OCCM-30 cells were exposed to intermittent PTH (incubated with PTH for the first 6 h in each 24-h cycle). After three cycles, flow cytometry assay, alkaline phosphatase staining, and Alizarin red staining were performed. Quantitative real-time polymerase chain reaction and Western blotting were employed to further determine the effects of intermittent PTH. RESULTS: Intermittent PTH-responsive repair enhancement was detected with the expression of bone sialoprotein, osteocalcin, collagen-1, and alkaline phosphatase significantly upregulated. Increased expressions of cementoblastic proteins were positively correlated to cycles of PTH administration. The proportion of cementoblasts in S and G2/M phases was increased; namely, intermittent PTH promoted cementoblast cell proliferation. CONCLUSIONS: Intermittent parathyroid hormone administration promotes cementoblast-mediated cementogenesis during periodontal repair in a time-dependent manner.

Gavage-administered lactoferrin promotes palatal expansion stability in a dose-dependent manner.

OBJECTIVE: To investigate the effects of different lactoferrin concentrations on mid-palatal suture bone remodeling during palatal expansion and relapse in rats. MATERIALS AND METHODS: Thirty-two 5-week-old male Wistar rats were randomly divided into four groups: EO (expansion only), E+LF1 (expansion plus 10 mg/kg/day daily LF), E+LF2 (expansion plus 100 mg/kg/day daily LF), and E+LF3 (expansion plus 1 g/kg/day daily LF). Thereafter, micro-computed tomography and micro-morphology of the mid-palatal suture were analyzed on day 7 and day 14, respectively. RESULTS: The arch widths were increased in all the four groups after expansion, and there was no significant difference among them on day 7. After relapse, however, the arch width in the E+LF3 group was significantly larger compared with EO group. In E+LF3 group and E+LF2 group, new bone formation and osteoblast number were enhanced with up-regulated expression of osteocalcin and collagen type I, while the expression of cathepsin K-positive cells was downregulated in E+LF3 group. CONCLUSION: Lactoferrin gavage administration might increase the stability of palatal expansion and reduce relapse in a concentration-dependent manner by enhancing bone formation and inhibiting resorption. LF administration may be promising for optimizing the maxillary expansion outcome.

The mechanism underlying the remodeling effect of lactoferrin on midpalatal sutures during maxillary expansion and relapse in rats.

INTRODUCTION: The remodeling effects of intragastric administration and intramaxillary injection of lactoferrin (LF) on midpalatal sutures (MPS) during maxillary expansion and relapse in rats were studied to explore the underlying bone remodeling mechanism. METHODS: Using a rat model of maxillary expansion and relapse, rats were treated with LF by intragastric administration (1 g·kg-1·d-1) or intramaxillary injection (5 mg·25 µl-1·d-1). The effects of LF on the osteogenic and osteoclast activities of MPS were observed by microcomputed tomography, histologic staining, and immunohistochemical staining, and the expressions of key factors in the extracellular regulated protein kinase 1/2 (ERK1/2) pathway and osteoprotegerin (OPG)-receptor activator of nuclear factor-KB ligand (RANKL)-receptor activator of nuclear factor-KB (RANK) axis were detected. RESULTS: Compared with the group with maxillary expansion alone, osteogenic activity was relatively enhanced, whereas osteoclast activity was relatively weakened in the groups administered LF, and the phosphorylated-ERK1/2: ERK1/2 and OPG: RANKL expression ratios increased significantly. The difference was more significant in the group administered LF intramaxillary. CONCLUSIONS: Administration of LF promoted osteogenic activity at MPS and inhibited osteoclast activity during maxillary expansion and relapse in rats, which may have occurred through regulation of the ERK1/2 pathway and the OPG-RANKL-RANK axis. The efficiency of intramaxillary LF injection was greater than that of intragastric LF administration.

Inkjet Bioprinting of Biomaterials.

The inkjet technique has the capability of generating droplets in the picoliter volume range, firing thousands of times in a few seconds and printing in the noncontact manner. Since its emergence, inkjet technology has been widely utilized in the publishing industry for printing of text and pictures. As the technology developed, its applications have been expanded from two-dimensional (2D) to three-dimensional (3D) and even used to fabricate components of electronic devices. At the end of the twentieth century, researchers were aware of the potential value of this technology in life sciences and tissue engineering because its picoliter-level printing unit is suitable for depositing biological components. Currently inkjet technology has been becoming a practical tool in modern medicine serving for drug development, scaffold building, and cell depositing. In this article, we first review the history, principles and different methods of developing this technology. Next, we focus on the recent achievements of inkjet printing in the biological field. Inkjet bioprinting of generic biomaterials, biomacromolecules, DNAs, and cells and their major applications are introduced in order of increasing complexity. The current limitations/challenges and corresponding solutions of this technology are also discussed. A new concept, biopixels, is put forward with a combination of the key characteristics of inkjet printing and basic biological units to bring a comprehensive view on inkjet-based bioprinting. Finally, a roadmap of the entire 3D bioprinting is depicted at the end of this review article, clearly demonstrating the past, present, and future of 3D bioprinting and our current progress in this field.

Palatal expansion and relapse in rats: A histologic and immunohistochemical study.

INTRODUCTION: Rapid palatal expansion is an effective intervention for correcting transverse maxillary deficiency in growing patients. However, relapse after treatment is often observed, and the mechanisms of tissue remodeling during expansion and relapse remain unclear. This study aimed to gain insight into such a mechanism. METHODS: A total of 24 5-week-old male Wistar rats were randomly divided into either the expansion or sham device (control) group. Each rat underwent 7 days of expansion and 7 days of relapse. The width of the dental arch, palatal bone, and suture, as well as the angle of the teeth, were measured. Tissue remodeling in the midpalatal suture was examined using microcomputed tomography and histologic and immunohistochemical analyses. RESULTS: The mechanical expansion force caused an increase in arch width, which relapsed after the removal of force. Bilateral tilting of the teeth and midpalatal suture expansion contributed to the widening of the maxillary arch, and only the relapse of the palatal bone width was observed. Histochemical staining showed that suture tissue remodeling was activated by mechanical force in the expansion group and reverted to the level of the control group after relapse. Immunohistochemistry staining revealed that the expression of cathepsin K, osteocalcin, and collagen type I was higher in the expansion group than that in the control group on day 7; however, the difference dissipated by day 14. CONCLUSIONS: The expansion force stimulated osteogenic activity in the midpalatal suture area. After removal of the expansion force, tissue remodeling went back to the normal level.

Biomaterials Based on Marine Resources for 3D Bioprinting Applications.

Three-dimensional (3D) bioprinting has become a flexible tool in regenerative medicine with potential for various applications. Further development of the new 3D bioprinting field lies in suitable bioink materials with satisfied printability, mechanical integrity, and biocompatibility. Natural polymers from marine resources have been attracting increasing attention in recent years, as they are biologically active and abundant when comparing to polymers from other resources. This review focuses on research and applications of marine biomaterials for 3D bioprinting. Special attention is paid to the mechanisms, material requirements, and applications of commonly used 3D bioprinting technologies based on marine-derived resources. Commonly used marine materials for 3D bioprinting including alginate, carrageenan, chitosan, hyaluronic acid, collagen, and gelatin are also discussed, especially in regards to their advantages and applications.

Enhancing osseointegration of titanium implants through large-grit sandblasting combined with micro-arc oxidation surface modification.

PURPOSE: The demand for titanium dental implants has risen sharply. However, the clinical success rate of implant surgery needs to be improved. In this paper, we report a novel surface modification strategy, large-grit sandblasting combined with micro-arc oxidation (SL-MAO), aiming to promote peri-implant bone formation and osseointegration of titanium implants. MATERIALS AND METHODS: Modified titanium samples were prepared by large-grit sandblasting and acid etching (SLA), micro-arc oxidation (MAO), and SL-MAO. The resulting topographical changes and chemical composition of the samples were examined by scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS), respectively, and the biocompatibility and bioactivity were analyzed by bone-marrow mesenchymal stem cells (BMMSC) adhesion tests. Modified titanium implants were also inserted into the femurs of beagle dogs, and their competence of osseointegration was appraised by quantitative histomorphometry and micro-computed-tomography (micro-CT) analyses. RESULTS: Compared to SLA and MAO techniques, SL-MAO surface modification further enhanced titanium surfaces by creating a topographic morphology characterized by both micron-sized craters and sub-micron-scale pits, and resulted in superior chemical composition, which promoted cell adhesion, proliferation, and osteogenic differentiation. SL-MAO-modified titanium implants osseointegrated more efficiently than SLA or MAO controls, with significantly higher bone-area (BA) ratio and bone-implant contact (BIC) in the peri-implant region. CONCLUSIONS: The SL-MAO surface modification technique optimized the surface properties of titanium implants and enhanced peri-implant bone formation and osseointegration.

Effects of lactoferrin on bone resorption of midpalatal suture during rapid expansion in rats.

INTRODUCTION: The aim of this study was to investigate the effect of lactoferrin (LF) on bone resorption of rats' midpalatal sutures during rapid palatal expansion. METHODS: Sixty male 5-week-old Wistar rats were randomly divided into 3 groups: expansion only (EO), expansion plus LF (E + LF), and sham device (control). RESULTS: Microcomputed tomography showed that the bone volume/tissue volume ratio and the relative bone mineral density of the suture bone were significantly increased in the E + LF group compared with the EO group. Histochemical staining suggested that the activity of osteoblast-like cells and the amount of new bone formation were stimulated in the E + LF group whereas the activity of osteoclasts showed no obvious difference between groups. On the other hand, the immunohistochemical and the real-time polymerase chain reaction results showed that the expressions of receptor activator of nuclear factor kappa B ligand and osteoprotegerin had no significant difference between the EO and E + LF groups. CONCLUSIONS: These findings demonstrated that LF could stimulate bone volume and bone density in midpalatal sutures during the suture remodeling process under tensile force. However, this enhancement effect was not caused by the reduction of bone resorption.

Screening the Expression Changes in MicroRNAs and Their Target Genes in Mature Cementoblasts Stimulated with Cyclic Tensile Stress.

Cementum is a thin layer of cementoblast-produced mineralized tissue covering the root surfaces of teeth. Mechanical forces, which are produced during masticatory activity, play a paramount role in stimulating cementoblastogenesis, which thereby facilitates the maintenance, remodeling and integrity of cementum. However, hitherto, the extent to which a post-transcriptional modulation mechanism is involved in this process has rarely been reported. In this study, a mature murine cementoblast cell line OCCM-30 cells (immortalized osteocalcin positive cementoblasts) was cultured and subjected to cyclic tensile stress (0.5 Hz, 2000 µstrain). We showed that the cyclic tensile stress could not only rearrange the cell alignment, but also influence the proliferation in an S-shaped manner. Furthermore, cyclic tensile stress could significantly promote cementoblastogenesis-related genes, proteins and mineralized nodules. From the miRNA array analyses, we found that 60 and 103 miRNAs were significantly altered 6 and 18 h after the stimulation using cyclic tensile stress, respectively. Based on a literature review and bioinformatics analyses, we found that miR-146b-5p and its target gene Smad4 play an important role in this procedure. The upregulation of miR-146b-5p and downregulation of Smad4 induced by the tensile stress were further confirmed by qRT-PCR. The direct binding of miR-146b-5p to the three prime untranslated region (3' UTR) of Smad4 was established using a dual-luciferase reporter assay. Taken together, these results suggest an important involvement of miR-146b-5p and its target gene Smad4 in the cementoblastogenesis of mature cementoblasts.

Precisely tunable engineering of sub-30 nm monodisperse oligonucleotide nanoparticles.

Advancement of RNAi therapies is mainly hindered by the development of efficient delivery vehicles. The ability to create small size (<30 nm) oligonucleotide nanoparticles is essential for many aspects of the delivery process but is often overlooked. In this report, we describe diblock star polymers that can reproducibly complex double-stranded oligonucleotides into monodisperse nanoparticles with 15, 23, or 30 nm in diameter. The polymer-nucleic acid nanoparticles have a core-shell architecture with dense PEG brush coating. We characterized these nanoparticles using ITC, DLS, FRET, FCS, TIRF, and TEM. In addition to small size, these nanoparticles have neutral zeta-potentials, making the presented polymer architecture a very attractive platform for investigation of yet poorly studied polyplex size range for siRNA and antisense oligonucleotide delivery applications.

Expert consensus on pediatric orthodontic therapies of malocclusions in children.

Malocclusion, identified by the World Health Organization (WHO) as one of three major oral diseases, profoundly impacts the dental-maxillofacial functions, facial esthetics, and long-term development of ~260 million children in China. Beyond its physical manifestations, malocclusion also significantly influences the psycho-social well-being of these children. Timely intervention in malocclusion can foster an environment conducive to dental-maxillofacial development and substantially decrease the incidence of malocclusion or reduce the severity and complexity of malocclusion in the permanent dentition, by mitigating the negative impact of abnormal environmental influences on the growth. Early orthodontic treatment encompasses accurate identification and treatment of dental and maxillofacial morphological and functional abnormalities during various stages of dental-maxillofacial development, ranging from fetal stages to the early permanent dentition phase. From an economic and societal standpoint, the urgency for effective early orthodontic treatments for malocclusions in childhood cannot be overstated, underlining its profound practical and social importance. This consensus paper discusses the characteristics and the detrimental effects of malocclusion in children, emphasizing critical need for early treatment. It elaborates on corresponding core principles and fundamental approaches in early orthodontics, proposing comprehensive guidance for preventive and interceptive orthodontic treatment, serving as a reference for clinicians engaged in early orthodontic treatment.

Tunable thioesters as "reduction" responsive functionality for traceless reversible protein PEGylation.

Disulfide has been the only widely used functionality to serve as a reduction responsive trigger in drug delivery. We introduce thioester as a novel thiol responsive chemistry for drug delivery, whose reactivity can be conveniently modulated by choosing the appropriate steric environment around the thioester. Compared with disulfides, thioesters are facile to synthesize and have an order of magnitude broader kinetic tunability. A novel traceless reversible protein PEGylation reagent is developed based on thioester chemistry.

Enamel etching for bonding fixed orthodontic braces.

BACKGROUND: Acid etching of tooth surfaces to promote the bonding of orthodontic attachments to the enamel has been a routine procedure in orthodontic treatment since the 1960s. Various types of orthodontic etchants and etching techniques have been introduced in the past five decades. Although a large amount of information on this topic has been published, there is a significant lack of consensus regarding the clinical effects of different dental etchants and etching techniques. OBJECTIVES: To compare the effects of different dental etchants and different etching techniques for the bonding of fixed orthodontic appliances. SEARCH METHODS: We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 8 March 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 2), MEDLINE via OVID (to 8 March 2013), EMBASE via OVID (to 8 March 2013), Chinese Biomedical Literature Database (to 12 March 2011), the WHO International Clinical Trials Registry Platform (to 8 March 2013) and the National Institutes of Health Clinical Trials Registry (to 8 March 2013). A handsearching group updated the handsearching of journals, carried out as part of the Cochrane Worldwide Handsearching Programme, to the most current issue. There were no restrictions regarding language or date of publication. SELECTION CRITERIA: Randomized controlled trials (RCTs) comparing different etching materials, or different etching techniques using the same etchants, for the bonding of fixed orthodontic brackets to incisors, canines and premolars in children and adults. DATA COLLECTION AND ANALYSIS: Two review authors extracted data and assessed the risk of bias of included studies independently and in duplicate. We resolved disagreements by discussion among the review team. We contacted the corresponding authors of the included studies to obtain additional information, if necessary. MAIN RESULTS: We included 13 studies randomizing 417 participants with 7184 teeth/brackets. We assessed two studies (15%) as being at low risk of bias, 10 studies (77%) as being at high risk of bias and one study (8%) as being at unclear risk of bias. Self etching primers (SEPs) versus conventional etchantsEleven studies compared the effects of SEPs with conventional etchants. Only five of these studies (three of split-mouth design and two of parallel design) reported data at the participant level, with the remaining studies reporting at the tooth level, thus ignoring clustering/the paired nature of the data. A meta-analysis of these five studies, with follow-up ranging from 5 to 37 months, provided low-quality evidence that was insufficient to determine whether or not there is a difference in bond failure rate between SEPs and convention etchants (risk ratio 1.14; 95% confidence interval (CI) 0.75 to 1.73; 221 participants). The uncertainty in the CI includes both no effect and appreciable benefit and harm. Subgroup analysis did not show a difference between split-mouth and parallel studies.There were no data available to allow assessment of the outcomes: decalcification, participant satisfaction and cost-effectiveness. One study reported decalcification, but only at the tooth level. SEPs versus SEPsTwo studies compared two different SEPs. Both studies reported bond failure rate, with one of the studies also reporting decalcification. However, as both studies reported outcomes only at the tooth level, there were no data available to evaluate the superiority of any of the SEPs over the others investigated with regards to any of the outcomes of this review.We did not find any eligible studies evaluating different etching materials (e.g. phosphoric acid, polyacrylic acid, maleic acid), concentrations or etching times. AUTHORS' CONCLUSIONS: We found low-quality evidence that was insufficient to conclude whether or not there is a difference in bond failure rate between SEPs and conventional etching systems when bonding fixed orthodontic appliances over a 5- to 37-month follow-up. Insufficient data were also available to allow any conclusions to be formed regarding the superiority of SEPs or conventional etching for the outcomes: decalcification, participant satisfaction and cost-effectiveness, or regarding the superiority of different etching materials, concentrations or etching times, or of any one SEP over another. Further well-designed RCTs on this topic are needed to provide more evidence in order to answer these clinical questions.

Effect of parathyroid hormone on experimental tooth movement in rats.

INTRODUCTION: The aim of this study was to investigate the effect of parathyroid hormone injection on experimental tooth movement in rats. METHODS: Sixty male Wistar rats were randomly divided into 2 groups. Their maxillary right first molars were moved mesially with nickel-titanium closed-coil springs. The experimental group received daily subcutaneous injections of parathyroid hormone at a dose of 4 µg per 100 g of body weight for 12 days, and the control group received vehicle injections. The results were evaluated by intraoral measurements and by hematoxylin and eosin, tartrate-resistant acid phosphatase, and immunohistochemistry staining. RESULTS: The tooth movement and osteoclast numbers were significantly increased in the parathyroid hormone group compared with the control group. The expressions of receptor activator of nuclear factor kappa B ligand and insulin-like growth factor-I were significantly stimulated in the parathyroid hormone group. CONCLUSIONS: The data suggest that short-term parathyroid hormone injection might be a potential method for accelerating orthodontic tooth movement by increasing the alveolar bone turnover rate.

Cyclic tensile force modifies calvarial osteoblast function via the interplay between ERK1/2 and STAT3.

BACKGROUND: Mechanical therapies, such as distraction osteogenesis, are widely used in dental clinics. During this process, the mechanisms by which tensile force triggers bone formation remain of interest. Herein, we investigated the influence of cyclic tensile stress on osteoblasts and identified the involvement of ERK1/2 and STAT3. MATERIALS AND METHODS: Rat clavarial osteoblasts were subjected to tensile loading (10% elongation, 0.5 Hz) for different time periods. RNA and protein levels of osteogenic markers were determined using qPCR and western blot after inhibition of ERK1/2 and STAT3. ALP activity and ARS staining revealed osteoblast mineralization capacity. The interaction between ERK1/2 and STAT3 was investigated by immunofluorescence, western blot, and Co-IP. RESULTS: The results showed that tensile loading significantly promoted osteogenesis-related genes, proteins and mineralized nodules. In loading-induced osteoblasts, inhibition of ERK1/2 or STAT3 decreased osteogenesis-related biomarkers significantly. Moreover, ERK1/2 inhibition suppressed STAT3 phosphorylation, and STAT3 inhibition disrupted the nuclear translocation of pERK1/2 induced by tensile loading. In the non-loading environment, inhibition of ERK1/2 hindered osteoblast differentiation and mineralization, while STAT3 phosphorylation was elevated after ERK1/2 inhibition. STAT3 inhibition also increased ERK1/2 phosphorylation, but did not significantly affect osteogenesis-related factors. CONCLUSION: Taken together, these data suggested that ERK1/2 and STAT3 interacted in osteoblasts. ERK1/2-STAT3 were sequentially activated by tensile force loading, and both affected osteogenesis during the process.

Suppressing STAT3 activation impairs bone formation during maxillary expansion and relapse.

OBJECTIVES: The mid-palatal expansion technique is commonly used to correct maxillary constriction in dental clinics. However, there is a tendency for it to relapse, and the key molecules responsible for modulating bone formation remain elusive. Thus, this study aimed to investigate whether signal transducer and activator of transcription 3 (STAT3) activation contributes to osteoblast-mediated bone formation during palatal expansion and relapse. METHODOLOGY: In total, 30 male Wistar rats were randomly allocated into Ctrl (control), E (expansion only), and E+Stattic (expansion plus STAT3-inhibitor, Stattic) groups. Micro-computed tomography, micromorphology staining, and immunohistochemistry of the mid-palatal suture were performed on days 7 and 14. In vitro cyclic tensile stress (10% magnitude, 0.5 Hz frequency, and 24 h duration) was applied to rat primary osteoblasts and Stattic was administered for STAT3 inhibition. The role of STAT3 in mechanical loading-induced osteoblasts was confirmed by alkaline phosphatase (ALP), alizarin red staining, and western blots. RESULTS: The E group showed greater arch width than the E+Stattic group after expansion. The differences between the two groups remained significant after relapse. We found active bone formation in the E group with increased expression of ALP, COL-I, and Runx2, although the expression of osteogenesis-related factors was downregulated in the E+stattic group. After STAT3 inhibition, expansive force-induced bone resorption was attenuated, as TRAP staining demonstrated. Furthermore, the administration of Stattic in vitro partially suppressed tensile stress-enhanced osteogenic markers in osteoblasts. CONCLUSIONS: STAT3 inactivation reduced osteoblast-mediated bone formation during palatal expansion and post-expansion relapse, thus it may be a potential therapeutic target to treat force-induced bone formation.

Distalization of the mandibular dentition of an adult with a skeletal Class III malocclusion.

This case report describes the orthodontic treatment of an 18-year-old woman with a skeletal Class III malocclusion and a midline deviation. The treatment plan consisted of distalizing the mandibular dentition asymmetrically and producing space for retraction of the mandibular anterior teeth. Short Class III elastics, an open-coil spring, and the mulitloop edgewise archwire technique were used, combining the entire maxillary dentition as integrated anchorage. The active treatment period was 26 months. Normal overbite and overjet were obtained, and facial balance was improved.

Computer-aided surgical workflow in a surgery - First orthognathic approach to correct anterior open bite in a young adult with temporomandibular disorders.

An 18-year-old female patient with temporomandibular disorders (TMD) history sought medical care in orthodontic-orthognathic interdisciplinary department with chief complaint of anterior open bite. After splint therapy to seat the condylar into the musculo-skeletally stable position, a surgery-first approach was formulated assisted by 3D virtual planning and transferred to the surgery by computer-aided manufacturing splint. No TMD symptom reoccurrence was reported or noted. Stable occlusion and satisfactory facial aesthetics were achieved. In the 18-month follow-up, no clinically significant open bite relapse occurred. This case report describes the remarkable role that computer-assisted surgical simulation could play throughout the surgical-orthodontic procedure to correct the skeletal open bite deformity.

The Emerging Role of Plant-Derived Exosomes-Like Nanoparticles in Immune Regulation and Periodontitis Treatment.

Periodontitis is an infectious oral disease, which leads to the destruction of periodontal tissues and tooth loss. Although the treatment of periodontitis has improved recently, the effective treatment of periodontitis and the periodontitis-affected periodontal tissues is still a challenge. Therefore, it is urgent to explore new therapeutic strategies for periodontitis. Natural products show anti-microbial, anti-inflammatory, anti-oxidant and bone protective effects to periodontitis and most of these natural products are safe and cost-effective. Among these, the plant-derived exosome-like nanoparticles (PELNs), a type of natural nanocarriers repleted with lipids, proteins, RNAs, and other active molecules, show the ability to enter mammalian cells and regulate cellular activities. Reports from the literature indicate the great potential of PELNs in the regulation of immune functions, inflammation, microbiome, and tissue regeneration. Moreover, PELNs can also be used as drug carriers to enhance drug stability and cellular uptake in vivo. Since regulation of immune function, inflammation, microbiome, and tissue regeneration are the key phenomena usually targeted during periodontitis treatment, the PELNs hold the promising potential for periodontitis treatment. This review summarizes the recent advances in PELNs-related research that are related to the treatment of periodontitis and regeneration of periodontitis-destructed tissues and the underlying mechanisms. We also discuss the existing challenges and prospects of the application of PELNs-based therapeutic approaches for periodontitis treatment.