Effectiveness of typodont, quail egg and virtual simulation for ultrasonic periodontal scaling teaching among pre-clinical students: a randomized trial.

BACKGROUND: This study aimed to compare the efficacy of three different techniques, namely virtual simulation technology (VS), traditional pathological typodont (TT), and quail egg (QE), in pre-clinical training of periodontal ultrasonic scaling. It also aimed to propose an integrated teaching approach for ultrasonic scaling teaching. METHODS: This single-blind randomized multi-arm trial enrolled 108 fourth-year students from Guanghua School of Stomatology at Sun Yat-sen University. The participants were randomly, evenly assigned to VS, TT, or QE group. First, the participants received theoretical review on ultrasonic scaling and demonstrative teaching. Then in the 90-minute operation training by group, students used traditional typodont equipped in head-simulators, raw quail eggs, or scaling module of the UniDental VS system respectively. Then all participants practiced on pathological models for 30 min. In the final operation examination, participants were instructed to remove the supra- and sub-gingival calculi pre-set on designated teeth by ultrasonic scalers within 30 min. Their performances were evaluated by residual calculus rate and a multi-perspective scoring scale. After the examination, questionnaires were provided to assess the teaching effects of each method and the fidelity of VS. Statistical analysis was carried out using one-way, two-way ANOVA, and multiple t-test. RESULTS: Students in VS group had significant higher total test scores than QE group (87.89 ± 6.81, 83.53 ± 8.14) and TT group (85.03 ± 6.81). VS group scored higher in several dimensional comparisons with the other two groups, especially in difficult situations. QE group had higher scores particularly in force application and supra-gingival scaling. TT group scored the highest in pivot stability practice and body position training. Students gave higher scores when assessing the fidelity of VS than experienced teachers. CONCLUSION: The study highlights the importance of specialized pre-clinical training on ultrasonic scaling for dental students. The methods adopted in current study (VS, TT and QE) each offered unique advantages in education, which can be combined to create an integrative teaching procedure. This procedure aims to provide an effective, advisable and normative pre-clinical training procedure for ultrasonic scaling. By utilizing the strengths of each method, dental educators can deliver high-quality training and ensure that students are well-prepared for clinical practice.

The effect of virtual simulation technology applied to undergraduate teaching of periodontal probing.

INTRODUCTION: The rise of virtual simulation technology and dental simulators has created a new pedagogical approach for undergraduate medical education. The purpose of this study is to evaluate the effect of virtual simulation (VS) technology on improving the students' comprehensive abilities in periodontal probing teaching in pre-practicum periodontology, such as increasing the accuracy of probing, tactile perception and performance on force control. MATERIALS AND METHODS: Twenty students were randomly selected among the fourth-year students and equally divided into VS technology teaching group (VS group) and traditional teaching group (TT group) by drawing half lots. One day later, students were required to probe the periodontal pathology model. The consistency rate between PD measurements and PD reference values, time consumption and final exam scores were recorded and statistically analysed using an unpaired Student's t test and p < .05 was considered statistical significance. Finally, questionnaires relating to teaching methods evaluation and the fidelity of the digital VS training system were distributed to students and teachers. RESULTS: VS group had a significantly higher consistency rate (72.976 ± 6.811%) than TT group (64.107 ± 4.988%, p = .004). To specify, the difference of consistency rates between the two groups in posterior teeth was larger than anterior teeth. Similarly, a larger difference was also found in proximal surfaces compared with buccal-lingual surfaces. As the pocket depth increased, the difference between the two groups increased too. These results indicated that VS is more efficient in complicated parts of periodontal probing teaching. In addition, students in VS group spent less time and gained a higher score than TT group (p < .05). The overall satisfaction rating in VS group was significantly higher than TT group. Lastly, teachers gave significant lower scores than students concerning the fidelity of VS system. CONCLUSION: Although there are much to improve, VS technology has obvious advantages in periodontal probing teaching in pre-practicum periodontology.

Combined Periodontal-Orthodontic Treatment with Periodontal Corticotomy Regenerative Surgery in an Adult Patient Suffering from Periodontitis and Skeletal Class II Malocclusion: A Case Report with 5-Year Longitudinal Observation.

A thick periodontal phenotype with thick gingiva and alveolar bone volume is required for safe orthodontic tooth movement and long-term stability. A high incidence of dehiscence and fenestration in the labial aspect of mandibular anterior teeth may limit the correction of deformity and orthodontic treatment, especially when the lower anterior teeth are needed to have a large range of movement. This study reports a combination of periodontal therapy and orthodontic therapy with periodontal corticotomy regenerative surgery (PCRS) in a 25-year-old patient suffering from skeletal Class II malocclusion and periodontitis. The patient received periodontal therapy 5 years ago and commenced orthodontic treatment 4.5 years ago. During the 4 years of follow-up for PCRS, the clinical and radiographic evaluations revealed significant improvements in the periodontal phenotype of the mandibular anterior region. The periodontal phenotypes in the mandibular incisors region were all modified from thin to thick. Supplementing orthodontic treatment with labial PCRS could be a promising treatment strategy to maintain long-term periodontal health in adult patients with alveolar deficiency and thin gingiva tissue.

Nisin a probiotic bacteriocin mitigates brain microbiome dysbiosis and Alzheimer's disease-like neuroinflammation triggered by periodontal disease.

INTRODUCTION: Periodontitis-related oral microbial dysbiosis is thought to contribute to Alzheimer's disease (AD) neuroinflammation and brain amyloid production. Since probiotics can modulate periodontitis/oral dysbiosis, this study examined the effects of a probiotic/lantibiotic, nisin, in modulating brain pathology triggered by periodontitis. METHODS: A polymicrobial mouse model of periodontal disease was used to evaluate the effects of this disease on brain microbiome dysbiosis, neuroinflammation, Alzheimer's-related changes, and nisin's therapeutic potential in this context. RESULTS: 16S sequencing and real-time PCR data revealed that Nisin treatment mitigated the changes in the brain microbiome composition, diversity, and community structure, and reduced the levels of periodontal pathogen DNA in the brain induced by periodontal disease. Nisin treatment significantly decreased the mRNA expression of pro-inflammatory cytokines (Interleukin-1ß/IL-1 ß, Interleukin 6/IL-6, and Tumor Necrosis Factor α/TNF-α) in the brain that were elevated by periodontal infection. In addition, the concentrations of amyloid-ß 42 (Aß42), total Tau, and Tau (pS199) (445.69 ± 120.03, 1420.85 ± 331.40, 137.20 ± 36.01) were significantly higher in the infection group compared to the control group (193.01 ± 31.82, 384.27 ± 363.93, 6.09 ± 10.85), respectively. Nisin treatment markedly reduced the Aß42 (261.80 ± 52.50), total Tau (865.37 ± 304.93), and phosphorylated Tau (82.53 ± 15.77) deposition in the brain of the infection group. DISCUSSION: Nisin abrogation of brain microbiome dysbiosis induces beneficial effects on AD-like pathogenic changes and neuroinflammation, and thereby may serve as a potential therapeutic for periodontal-dysbiosis-related AD.

PVA enema ameliorates DSS-induced acute colitis in mice.

BACKGROUND: Ulcerative colitis (UC) represents a clinically challenging condition characterized by persistent damage to the colonic epithelial mucosa as the principal pathological feature. Polyvinyl alcohol (PVA) solution, primarily composed of glue, is a biodegradable polymer material that has found utility in the medical field. This research endeavors to investigate the therapeutic potential of PVA water solution in ameliorating UC in mice. METHODS: UC was induced in 48 C57BL/6 mice by administering 2.5% DSS in their diet for 6 days. Mice were treated with different concentrations of PVA (0.1 mg/ml PVA, 0.3 mg/ml PVA, 1 mg/ml PVA, 3 mg/ml PVA, 10 mg/ml PVA) enemas (n = 6). Disease Activity Index (DAI) and histologic score were evaluated for inflammation degree. Furthermore, mouse colon organoids were cultured, which were used to assess the effects of PVA on expansion in vitro. RESULTS: PVA aqueous solutions (1 mg/ml and 3 mg/ml) were able to alleviate the DAI in mice. By DAY 6, there was a significant 3/5-fold decrease in DAI within the 1 mg/ml PVA group (p = 0.02). Histopathology scores demonstrated improvements, while the levels of inflammatory factors in the intestinal mucosal tissue were reduced. Additionally, it was confirmed that PVA could promote the expansion of colonic organoids in vitro. CONCLUSIONS: In summary, our investigation has yielded findings indicating that PVA holds the potential to ameliorate symptoms associated with colitis in murine subjects afflicted by DSS-induced colitis, primarily through its facilitation of intestinal stem cell expansion. This study might provide a new candidate for the clinical treatment of ulcerative colitis.

Enhanced antidepressant effects of BDNF-quercetin alginate nanogels for depression therapy.

BACKGROUND: Brain-derived neurotrophic factor (BDNF) with neuronic development and function is a promising therapeutic agent for treating depressive disorder, according to the neurotrophin hypothesis. However, the delivery of BDNF into the brain is not easy as these large protein molecules cannot efficiently cross the blood-brain barrier (BBB) and easily suffer oxidative damage in vivo. Therefore, the quercetin-based alginate nanogels (quercetin nanogels) loaded with BDNF have been developed, which could efficiently bypass the BBB via the nose-to-brain pathway and protect BDNF from oxidative damage, providing an effective route for the therapy of depressive disorders by intranasal delivery. RESULTS: Quercetin nanogels exhibited uniform size distribution, excellent biocompatibility, and potent antioxidant and anti-inflammatory activities. Quercetin nanogels in the thermosensitive gel achieved sustained and controlled release of BDNF with non-Fick's diffusion, exhibited rapid brain distribution, and achieved nearly 50-fold enhanced bioavailability compared to oral quercetin. Quercetin nanogels as a therapeutic drug delivery carrier exerted antidepressant effects on reserpine-induced rats, effectively delivered BDNF to reverse despair behavior in stress-induced mice, and exhibited antidepressant effects on chronic mild unpredictable stimulation (CUMS) rats. These antidepressant effects of BDNF-Quercetin nanogels for CUMS rats are associated with the regulation of the glutamatergic system, PI3K-Akt, and BDNF-TrkB signaling pathway. CONCLUSIONS: In this study, we provide a promising strategy for brain delivery of BDNF for treating depressive disorders, effectively achieved through combining quercetin nanogels and intranasal administration.

Establishment and evaluation of a three-dimensional quantitative analysis method of dental plaque based on intraoral scanner technique.

AIM: Quantitative dental plaque evaluation is necessary for clinical and scientific work. This study aimed to examine the reliability of this 3D image analysis method by digitally analysing the colour 3D images obtained from an intraoral scanner, and then detecting and quantifying the plaque information and comparing it with the clinical examination results. MATERIALS AND METHODS: A total of 140 teeth from 5 subjects with a standard dentition were enrolled in this study, and plaque examination was performed at two different stages: after 24 hours without oral hygiene (T1) and after habitual brushing (T2). At each time point, the Quigley-Hein plaque index of each tooth surface was recorded separately, followed by colour 3D images obtained using an intraoral scanner, and image analysis and calculation using Geomagic Wrap 2021. RESULTS: It was found that the percentage of plaque staining area calculated from the 3D image analysis correlated well with the plaque index recorded during the clinical examination: the Spearman correlation coefficients were 0.9136 and 0.9061 (p<0.001) for all tooth surfaces at T1 and T2, respectively. The measurements of the three investigators were in good agreement, with intraclass correlation coefficients of 0.989 and 0.992 (P<0.001) for the vestibular and lingual surfaces at T1, and 0.964 and 0.983 (P<0.001) for the vestibular and lingual surfaces at T2. CONCLUSION: In this study, we initially developed a digital 3D evaluation system of dental plaque suitable for research and clinical practice and demonstrated its reliability.

A non-randomized concurrent controlled trial of myofunctional treatment in the mixed dentition children with functional mouth breathing assessed by cephalometric radiographs and study models.

OBJECTIVES: This study aimed to examine the clinical effects of myofunctional treatment on children with functional mouth breathing by cephalometric radiographs and study models. METHODS: A total of 224 children (6-10 years old; 114 males and 110 females; SNA°: 82.24 ± 1.67°; ANB°: 2.79 ± 0.80°, 28° < SN-GoGn° < 37°) formed three groups: MB-M group (mouth breathers with myofunctional treatment,n = 75); MB-N group (mouth breathers with no treatment,n = 70); NB group (nasal breathers with no treatment, n = 79). A blind evaluation of cephalometric radiographs and study models was conducted at T1(pre-study) and T2 (post-study), respectively. RESULTS: Two hundred four children (MB-M:66, MB-N:68, NB:70) completed the present study. At T1, MB-M and MB-N groups, compared to their NB counterpart, had greater anterior lower facial height(P < 0.01) and overjet(P < 0.001) but shorter overbite and maxillary canines width (P < 0.001). At T2, the MB-N group exhibited a higher ANB angle, anterior lower facial height, and overjet, but shorter overbite and maxillary canines width (P < 0.001). From T1 to T2, the anterior lower facial height increased, overbite and the maxillary canines width further decreased in the MB-N group (P < 0.001). However, in the MB-M group, the incisors were retracted, overbite increased (P < 0.001), anterior lower facial height increased insignificantly (P > 0.05), and maxillary canines width increased slightly (P < 0.05). In the NB and MB-M groups, the mandible showed a normal tendency to grow forward, whereas, in the MB-N group, the mandible showed a tendency to grow downward (P < 0.001). CONCLUSIONS: Mouth breathers demonstrated increased anterior facial height and overjet but reduced overbite and maxillary arch width, which improved significantly following myofunctional treatment. TRIAL REGISTRATION: TCTR: TCTR20220401001 . Registered 1stApril 2022-Retrospectively registered.

Effect of surface treatments on bond durability of zirconia-reinforced lithium silicate ceramics: An in vitro study.

STATEMENT OF PROBLEM: The influence of surface treatments on the bond durability of zirconia-reinforced lithium silicate ceramics (ZLS) is unclear. PURPOSE: The purpose of this in vitro study was to evaluate the effect of different surface treatments on the bond durability of zirconia-reinforced lithium silicate ceramic after long-term thermocycling. MATERIAL AND METHODS: Five computer-aided design and computer-aided manufacturing (CAD-CAM) dental ceramic blocks, including 2 zirconia-reinforced lithium silicate ceramic materials (Vita Suprinity/VS and Cetra Duo/CD), 2 commonly used glass-ceramic materials (e.max CAD/EM and Empress CAD/EP), and 1 yttria-stabilized zirconia (Y-TZP, Zenostar/ZS) were tested. Rectangular ceramic blocks were divided into 6 groups and subjected to different surface treatments: group Control (no treatment), group Uni (universal adhesive), group HF (hydrofluoric acid), group CoJet, group HF+Uni (HF and universal adhesive), and group CoJet+Uni (CoJet and universal adhesive). Subsequently, the specimens were cemented to composite resin blocks, sectioned into rectangular microbars of approximately 2×2×12 mm in size, and assigned to 2 groups with and without 100 000 thermal cycles (n=15 per group). The microtensile bond strength (µTBS) test was performed using a universal testing machine. Failure modes were observed with a stereomicroscope and scanning electron microscope (SEM). Three-way analysis of variance (ANOVA) followed by post hoc pairwise comparisons was performed to evaluate the effects of surface treatments, ceramics, and thermocycling on µTBS (α=.05). RESULTS: The µTBS (MPa) was affected by the surface treatment (P<.001), ceramic type (P<.001), and thermocycling (P<.001). The bond strength after HF etching and universal adhesive treatment was highest in glass-ceramic groups (VS, CD, EP, and EM), while CoJet combined with universal adhesive indicated the highest bond strength in the ZS group before (34.3 ±4.2 MPa) and after thermocycling (16.0 ±2.9 MPa). No significant differences for µTBS were found among ZLS (VS and CD), lithium disilicate ceramic group (EM), and leucite-based ceramic group (EP, P>.05), but they demonstrated better bond strength than zirconia (ZS group, P<.01) after thermocycling. Adhesive failure increased in all groups, and the cohesive failure of glass-ceramic decreased after thermocycling. CONCLUSIONS: ZLS showed similar µTBS with traditional glass-ceramics, including lithium disilicate ceramic and leucite-based ceramic, and more durable bonding than zirconia to resist thermocycling. Moreover, the combination of HF and universal adhesive treatments was the most effective method for ZLS among all the different surface treatments in this study.

Durability of infiltrated resin application on white spot lesions after different challenges: An ex vivo study.

STATEMENT OF PROBLEM: Infiltrated resin has been widely used as a minimally invasive approach to masking white spot lesions and reinforcing demineralized enamel. Recent evidence confirms its satisfactory effect in the short term, but studies focusing on its long-term performance are lacking. PURPOSE: The purpose of this ex vivo study was to evaluate the durability of infiltrated resin on white spot lesions after pH cycling and long-term thermocycling, staining, and toothbrushing. MATERIAL AND METHODS: Four axial surfaces of 25 extracted human molars were sectioned and fabricated as specimens. The enamel surface of each specimen was prepared in 3 areas: sound enamel, demineralized enamel (white spot lesions), and demineralized enamel treated by infiltrated resin. Then, 4 specimens of each molar were allocated to different challenges simulating a 10-year follow-up: pH cycling, thermocycling, staining, and toothbrushing. The surface roughness, microhardness, and CIELab color values were measured before and after different treatments. A scanning electron microscope (SEM) was used to observe representative specimens. Linear mixed models were used to evaluate the effect of different treatments on microhardness, roughness, and color differences (ΔE) (α=.05). RESULTS: Resin infiltration reduced the surface roughness and increased the microhardness of demineralized lesions, (P<.001) but the values of sound enamel at baseline were not reached. The pH cycling led to the greatest roughness values (515.6 ±56.9 nm) on resin-infiltrated lesions, followed by thermocycling (450.7 ±64.7 nm), toothbrushing (291.2 ±43.5 nm), and staining (183.6 ±49.3 nm) (all P<.001). Only pH cycling significantly decreased the microhardness of resin-infiltrated lesions (81.6 ±14.8 HV 0.2) after progressive demineralization (P<.001). No clinically identified differences were found between resin-infiltrated white spot lesions and sound enamel (ΔE=3.4 ±2.0) at baseline. However, resin-infiltrated lesions demonstrated significantly greater discoloration after pH cycling (ΔE=8.0 ±4.5, P<.001), thermocycling (ΔE=5.4 ±2.0, P=.014), and staining treatments (ΔE=10.4 ±3.2, P<.001) than sound enamel. CONCLUSIONS: Infiltrated resin application reduced surface roughness, improved microhardness, and masked white spot lesions immediately. However, it could not reestablish the characteristics of sound enamel completely and resist chemical and mechanical challenges over time.

Different concentrations of C5a affect human dental pulp mesenchymal stem cells differentiation.

BACKGROUND: During the process of deep decay, when decay approaches the pulp, an immune response is triggered inside the pulp, which activates the complement cascade. The effect of complement component 5a (C5a) on the differentiation of dental pulp mesenchymal stem cells (DPSCs) is related to dentin reparation. The aim of the present study was to stimulate DPSCs with different concentrations of C5a and evaluate the differentiation of odontoblasts using dentin sialoprotein (DSP). METHODS: DPSCs were divided into the following six groups: (i) Control; (ii) DPSCs treated with 50 ng/ml C5a; (iii) DPSCs treated with 100 ng/ml C5a; (iv) DPSCs treated with 200 ng/ml C5a; (v) DPSCs treated with 300 ng/ml C5a; and (vi) DPSCs treated with 400 ng/ml C5a. Flow cytometry and multilineage differentiation potential were used to identify DPSCs. Mineralization induction, Real-time PCR and Western blot were conducted to evaluate the differentiation of odontoblast in the 6 groups. RESULT: DPSCs can express mesenchymal stem cell markers, including CD105, CD90, CD73 and, a less common marker, mesenchymal stromal cell antigen-1. In addition, DPSCs can differentiate into adipocytes, neurocytes, chondrocytes and odontoblasts. All six groups formed mineralized nodules after 28 days of culture. Reverse transcription-quantitative PCR and western blotting indicated that the high concentration C5a groups expressed higher DSP levels and promoted DPSC differentiation, whereas the low concentration C5a groups displayed an inhibitory effect. CONCLUSION: In this study, the increasing concentration of C5a, which accompanies the immune process in the dental pulp, has demonstrated an enhancing effect on odontoblast differentiation at higher C5a concentrations in vitro.

Research on the roles of genes coding ATP-binding cassette transporters in Porphyromonas gingivalis pathogenicity.

Porphyromonas gingivalis, as a major pathogen of periodontitis, could rapidly adhere to and invade host gingival epithelial cells (GECs) for the induction of infection. One ATP-binding cassette (ABC) transporter gene was found to be upregulated during this infection process, however, the molecular mechanisms remain unclear. In this study, we systemically investigated the messenger RNA level changes of all ABC transporter family genes in P. gingivalis while being internalized within GECs by real-time polymerase chain reaction. We identified that two ABC transporter genes, PG_RS04465 (PG1010) and PG_RS07320 (PG1665), were significantly increased in P. gingivalis after coculturing with GECs. Mutant strains with knockout (KO) of these two genes were generated by homogenous recombination. PG_RS04465 and PG_RS07320 KO mutants showed no change in the growth of bacteria per se. Knockdown of PG_RS07320, but not PG_RS04465, caused decreased endotoxin level in the bacteria. In contrast, both mutant strains showed decreased Arg- and Lys-gingipains activities, with significantly reduced adhesion and invasion capabilities. Secreted interleukin-1ß (IL-1ß) and IL-6 levels in GECs cocultured with PG_RS04465 or PG_RS07320 KO mutants were also decreased, whereas, only the cells cocultured with PG_RS07320 KO mutants showed significant decrease. In addition, virulence study using mouse revealed that both KO mutant strains infection caused less mouse death than wild-type strains, showing reduced virulence of two KO strains. These results indicated that ABC transporter genes PG_RS04465 and PG_RS07320 are positive regulators of the virulence of P. gingivalis.

Probiotics, including nisin-based probiotics, improve clinical and microbial outcomes relevant to oral and systemic diseases.

The effects of probiotic supplementation on systemic health and gastrointestinal diseases have been investigated in numerous studies. The aim of this review is to provide an overview of probiotics and their effects on periodontal health. Probiotics show beneficial effects as adjunctive therapeutics and as stand-alone agents in the treatment and prevention of gingivitis as well as specific clinical parameters of periodontitis. This review focuses on the clinical and microbiological aspects of probiotics in the context of health, gingivitis, and periodontitis. In addition, a special focus on nisin-producing probiotics and nisin itself showcase their significant potential for oral and systemic use.

Pegylated liposomal doxorubicin for myeloid neoplasms.

Pegylated liposomal doxorubicin (Peg-Dox) treatment resulted in a good outcome for patients with lymphoma and multiple myeloma, with reduced cardiotoxicity and an improved pharmacokinetic profile when compared to those of conventional doxorubicin. However, the use of Peg-Dox in myeloid neoplasms remains poorly studied. In this study, we first tested the role of Peg-Dox in the killing of myeloid cell lines and of primary myeloid leukemia cells. Then, a Peg-Dox-based protocol was used to treat patients with myeloid neoplasms. The results showed that the Peg-Dox and Peg-Dox-based protocols had a similar killing ability in myeloid cell lines and in primary myeloid leukemia cells compared to that of conventional doxorubicin. The complete remission rate was 87.5% and 100% for patients with refractory/relapsed acute myeloid leukemia and myelodysplastic syndrome with excess blasts, respectively, after treatment with Peg-Dox. All patients developed grade 3 or 4 hematological toxicity and recovered approximately 2 weeks after completing chemotherapy. No deaths or other severe complications were reported. Our results showed that Peg-Dox can be used in the treatment of myeloid neoplasms with high rates of complete remission and with mild complications.

Macrophage polarization in human gingival tissue in response to periodontal disease.

OBJECTIVE: Although accumulating evidence indicates that macrophages are central players in the destructive and reparative phases of periodontal disease, their polarization states at different stages of periodontal inflammation remain unclear. METHODS: We collected gingival biopsies from patients with chronic periodontitis (P group), gingivitis (G group), or periodontally healthy individuals (H group). Polarized macrophages were identified through immunofluorescence. M1- and M2-related cytokines were detected by immunohistochemistry. RESULTS: Compared with the H group, the P group had more M1 cells (higher M1/M2 ratio) and significantly higher TNF-α, IFN-γ, IL-6, and IL-12 levels. Although the G group also exhibited higher TNF-α and IL-12 levels than the H group, they had similar M1/M2 ratios. The M1/M2 ratio and IFN-γ and IL-6 levels were significantly higher in the P than the G group. Among M2-related cytokines, IL-4 levels were significantly higher in the G than the H group. The M1/M2 ratio was positively correlated with clinical probing depth (PD), and both were positively correlated with IFN-γ and IL-6. PD was negatively correlated with IL-4. CONCLUSION: Macrophage polarization in gingival tissue may be responsible for the development and progression of inflammation-induced tissue destruction, and modulating macrophage function may be a potential strategy for periodontal disease management.

The role of osteomodulin on osteo/odontogenic differentiation in human dental pulp stem cells.

BACKGROUND: Extracellular matrix secretion and odontoblastic differentiation in human dental pulp stem cells (hDPSCs) are the cellular bases for reparative dentinogenesis. Osteomodulin (OMD) is a member of the small leucine-rich proteoglycan family distributed in the extracellular matrix but little is known about its role in osteo/odontogenic differentiation. The objective of this study was to investigate the role of OMD during osteo/odontoblastic differentiation of hDPSCs. METHODS: hDPSCs were selected using immune-magnetic beads and their capability of multi-differentiation was identified. OMD knockdown was achieved using short hairpin RNA (shRNA) lentivirus and was confirmed by western blot. Gene expression was measured by real-time qPCR and osteo/odontoblastic differentiation of hDPSCs was determined by alizarin red S staining. RESULTS: Compared with uninduced cells, the transcription of OMD was up-regulated by 35-fold at the late stage of osteo/odontogenic differentiation. shRNA-mediated gene silencing of OMD decreased the expression of odontoblastic genes, such as alkaline phosphatase (ALP), dentin matrix acidic phosphoprotein 1 (DMP1) and dentin sialophosphoprotein (DSPP). Besides, knockdown of OMD attenuated the mineralized nodules formation induced by osteo/odontogenic medium. CONCLUSIONS: These results implied that OMD may play a pivotal role in modulating the osteo/odontoblastic differentiation of hDPSCs.

Nonimpacted Third Molars Affect the Periodontal Status of Adjacent Teeth: A Cross-Sectional Study.

PURPOSE: Most previous studies of the effect of third molars (M3s) on the health of adjacent second molars (A-M2s) have focused on impacted M3s (I-M3s). The purpose of this study was to investigate whether nonimpacted M3 (N-M3s) could affect the periodontal status of A-M2s. PATIENTS AND METHODS: In this cross-sectional study, patients (≥18 years) who had at least 1 quadrant with intact first and second molars and a nonimpacted or absent M3 were enrolled in this study. The periodontal measurements of M2 (6 sites) in the examined quadrants included the gingival index (GI), plaque index (PLI), probing pocket depth (PPD), clinical attachment level (CAL), gingival recession, and bleeding on probing (BOP). The mean GI, PLI, PPD, CAL, and BOP proportion and the proportion with at least 1 site with a PPD of at least 5 mm (PPD5+) were compared using the t test or χ2 test. The association of PPD5+ (percentage) or BOP (percentage) with the presence of N-M3s was assessed using a 2-level logistic regression model (quadrant-based analysis). RESULTS: One hundred thirty-five patients (43.7% men; 40.6 ± 11.5 yr old) were enrolled in this study. Patients who had at least 1 quadrant with 3 intact molars and an N-M3 were enrolled in group A (105 patients), and patients who had at least 1 quadrant with intact first and second molars without an M3 were enrolled in group B (30 patients). The periodontal parameters (ie, GI, PLI, PPD, CAL, BOP, and PPD5+) were markedly greater in group A. When other factors associated with periodontal disease were controlled, N-M3s were associated with the PPD5+ (odds ratio = 6.7) and BOP (odds ratio = 4.0) of the A-M2s. Other factors positively associated with A-M2 PPD5+ were location on the mandible, age older than 35 years, and smoking. CONCLUSIONS: The presence of N-M3s is a potential risk factor for the development of periodontitis in A-M2s.

LncRNA H19 and Target Gene-mediated Cleft Palate Induced by TCDD.

This study investigated the role of long non-coding RNAs (lncRNAs) in the development of the palatal tissues. Cleft palates in mice were induced by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Expression levels of long non-coding RNA H19 (lncRNA H19) and insulin-like growth factor 2 (IGF2) gene were measured by quantitative real-time polymerase chain reaction (qRT-PCR). The rate of occurrence of cleft palate was found to be 100% by TCDD exposure, and TCDD could cause short upper limb, cerebral fissure, webbed neck, and short neck. The expression levels of lncRNA H19 and IGF2 gene specifically showed embryo age-related differences on E13, E14, and E15 in the palatal tissues. The expression levels of lncRNA H19 and IGF2 gene showed an inverse relationship on E13, E14, and E15. These findings demonstrated that lncRNA H19 and IGF2 can mediate the development of mouse cleft palate.

The Endoscopic Prelacrimal Recess Approach to the Pterygopalatine Fossa and Infratemporal Fossa.

PURPOSE: The authors studied the anatomic importance of the endoscopic prelacrimal recess approach (PLRA) to the pterygopalatine fossa (PPF) and infratemporal fossa (ITF). METHODS: Ten adult heads (20 sides) from cadavers fixed in formalin were dissected using the PLRA. Anatomic dissections were detailed and several crucial landmarks measured. RESULTS: Identification of the infraorbital neurovascular bundle is the crucial step for the detection of other branches of the maxillary artery. The distance from the base of columella to inferior orifice of the nasolacrimal duct, sphenopalatine foramen, pterygold canal, foramen rotundum, foramen ovale was (32.97 ±â€Š3.44), (63.93 ±â€Š4.52), (66.81 ±â€Š3.44), (68.13 ±â€Š4.43), and (85.23 ±â€Š6.25) mm, respectively. The PLRA can be used to expose the entire maxillary sinus and PPF, most parts of the ITF (lateral pterygoid muscle, foramen ovale, mandibular division of the trigeminal nerve, and its divisions), maxillary artery and its branches, and the superior part of the medial pterygoid muscle (upon the floor of the maxillary sinus). The lateral boundary can be reached to visualize the temporomandibular joint and vertically oriented temporalis muscle. CONCLUSION: Use of the PLRA to the PPF and ITF offers a clear visual field, wide range of exposure, as well as preservation of the integrity of nasal structures.

Stem cells derived from "inflamed" and healthy periodontal ligament tissues and their sheet functionalities: a patient-matched comparison.

AIM: The aim of this study was to compare the properties of stem cells derived from "inflamed" and healthy periodontal ligament (PDL) tissues from patient-matched groups. MATERIAL AND METHODS: Patient-matched stem cells derived from root-attached "inflamed" and healthy PDL tissues from six donors, termed I-PDLSCs and H-PDLSCs, respectively, were investigated with regard to their stem cell properties, immunomodulatory effects and capacity to form robust cell sheets for therapeutic applications. RESULTS: We found that cells derived from both sources exhibited typical mesenchymal stem cell (MSC) characteristics. However, compared with H-PDLSCs, I-PDLSCs demonstrated an increased capacity to proliferate, a greater potential to migrate and a decreased capacity to differentiate into osteoblasts in vitro. When I-PDLSCs and H-PDLSCs were co-cultured with peripheral blood mononuclear cells, the MSCs derived from "inflamed" PDL tissues exhibited impaired immunomodulation. Although I-PDLSCs led to increased collagen type I, periostin and integrin ß1 content in the matrix, the cell sheets formed by I-PDLSCs were dysfunctional due to their impaired osteogenic/chondrogenic differentiation and tissue regeneration. CONCLUSIONS: These data provide additional evidence that I-PDLSCs are functionally compromised compared with H-PDLSCs. Nonetheless, their dominant abundance in the available tissues indicates that stem cells derived from damaged teeth extracted due to periodontitis warrant further exploration.