A nomogram-based predictive model for tooth survival in Chinese patients with periodontitis: An 11-year retrospective cohort study.

AIM: To develop a nomogram-based predictive model of tooth survival by comprehensively analysing clinical and radiographic risk factors of tooth loss (TL). MATERIALS AND METHODS: In this study, 3447 teeth of 131 subjects who underwent non-surgical periodontal treatment were examined retrospectively within a mean follow-up period of 11.6 years. The association of risk factors including clinical and radiographic parameters with TL was assessed using univariate and multivariate Cox regression analyses. A nomogram-based predictive model was developed, and its validation and discriminatory ability were analysed. RESULTS: In all, 313 teeth were lost in 94 patients in this study (overall tooth loss [OTL] 9.08%; 0.21 teeth/patient/year). Male, heavy smoking, molar teeth, probing depth (PD), attachment loss (AL), tooth mobility and radiographic bone loss were significantly associated with TL (p < .05). A gradient effect of tooth mobility on TL increased from degree I to III versus none (p < .0001). The area under the curve (AUC) of the model was 0.865. Calibration curve and decision curve analysis demonstrated good performance and high net benefit, respectively. CONCLUSIONS: Adopting a specific nomogram could facilitate the prediction of tooth survival and the development of tailored treatment plans in Chinese patients with advanced periodontitis.

Deep learning improves prediction of periodontal therapy effectiveness in Chinese patients.

THE OBJECTIVE: This study aims to propose a new model to predict the specific treatment effectiveness at site level by analyzing massive amounts of periodontal clinical data with deep learning methods. THE BACKGROUND DATA DISCUSSING THE PRESENT STATUS OF THE FIELD: In light of the low accuracy of current tools, the proposed models cannot fully meet the needs of clinical effectiveness prediction and cannot be applied to on site level prognosis development and formulation of specific treatment plan. MATERIALS AND METHODS: Periodontal examination data of 9273 Chinese patients were extracted and used to propose a Sequence-to-Sequence model after performing data management and reconstruction. The model was optimized by introducing the Attention mechanism. RESULTS: In the test set, the model obtained an average site-level probing depth (PD) accuracy (defined as the proportion of sites with <1 mm deviation of the predicted result from the true value) of 92.4% and high sensitivity (98.6%) for the pocket closure variable. For sites with baseline PD <5 mm, the model achieved a prediction accuracy of 94.6%, while it decreased to 79.9% at sites with PD ≥5 mm. In contrast, for teeth with initial mean PD ≥5 mm, the prediction accuracy significantly differed between molars and non-molars. CONCLUSION: Our model is the first to predict the site-level effectiveness with high accuracy and sensitivity. Future prediction models should incorporate deep learning for improved clinical prediction.

Aspirin/PLGA coated 3D-printed Ti-6Al-4V alloy modulate macrophage polarization to enhance osteoblast differentiation and osseointegration.

Although titanium (Ti) and Ti-based alloy have been widely used as dental and orthopedic implant materials, its bioinertness hindered the rapid osseointegration. Therefore, it is recommended to acquire ideal topographic and chemical characteristics through surface modification methods. 3D printing is a delicate manufacture technique which possesses superior controllability and reproducibility. While aspirin serve as a well-established non-steroidal anti-inflammatory agent. Recently, the importance of immune system in regulating bone dynamics has attracted increasing attention. We herein superimposed the aspirin/poly (lactic-co-glycolic acid) (ASP/PLGA) coating on the 3D-printed Ti-6Al-4V surface with uniform micro-structure to establish the Ti64-M-ASP/PLGA substrate. Scanning electron microscopy (SEM), x-ray photoelectron spectroscopy (XPS) and contact angle test confirmed the successful fabrication of the Ti64-M-ASP/PLGA substrate, with increased wettability and sustained release pattern of ASP. Compared with the Ti64 base material, the Ti64-M-ASP/PLGA substrate showed enhanced M2 and depressed M1 genes and proteins expressions in macrophages. The novel Ti64-M-ASP/PLGA substrate also displayed enhanced osteoblast proliferation, adhesion, extracellular mineralization ability and osteogenic gene expressions when cultured with macrophage conditioned medium in vitro. Furthermore, rat femora implantation model was used for in vivo evaluation. After 4 weeks of implantation, push out test, micro-computed tomography (micro-CT) and histological analyses all confirmed the superior osseointegration capabilities of the Ti64-M-ASP/PLGA implant than the other groups. Our study revealed the synergistic role played by 3D-printed micro topography and immunoregulatory drug aspirin in promoting osteogenesis in vitro and accelerating osseointegration in vivo, thus providing a promising method for better modifying the implant surface. Graphical abstract.

The prevalence and severity of periodontal disease in Mainland China: Data from the Fourth National Oral Health Survey (2015-2016).

AIM: To evaluate periodontal conditions in adults in mainland China based on data from the 4th National Oral Health Survey. MATERIALS AND METHODS: Data of adult subjects (35- to 44-year-old group [N = 4409], 55- to 64-year-old group [N = 4622], and 65- to 74-year-old group [N = 4428]) were analysed. Demographic, socio-economic, personal habit, dental history, and health attitude data were obtained using a questionnaire. Periodontal condition was assessed using the standardized case definitions of the 2018 classification scheme. A multivariate analysis was performed to investigate the relationship between periodontitis severity and age, smoking status, gender, and region using generalized additive models after adjusting for confounders. RESULTS: The frequency of subjects with periodontitis was 52.8%, 69.3%, and 64.6% in the three age groups, respectively. The frequency of subjects with severe periodontitis (stage III or IV) was 10.6%, 37.3%, and 43.5% in the three age groups, respectively. The severity of periodontal disease was positively associated with age. Current and former smokers exhibited significantly greater disease severity than non-smokers after adjustment for confounders. No significant difference of severity was found between males and females. CONCLUSION: Within the limitations of the study, the prevalence of periodontitis is very high among adults in mainland China. Periodontal status is associated with age and smoking status.

Nomogram prediction of vulnerable periodontal condition before orthodontic treatment in the anterior teeth of Chinese patients with skeletal Class III malocclusion.

OBJECTIVE: To establish and verify models predictive of thin periodontal phenotype and alveolar fenestration/dehiscence in the anterior teeth of patients with skeletal Class III malocclusion. MATERIAL AND METHODS: Retrospective data of 669 anterior teeth (305 in maxillae and 364 in mandibles) from 80 patients with skeletal Class III malocclusion before augmented corticotomy were collected. Distribution of thin periodontal phenotype and alveolar fenestration and dehiscence were evaluated and their associations with potential influencing factors were explored using univariate and multivariate analyses. The predictive models were visualized as nomograms, the accuracy of which was tested by receiver operating curve analyses. RESULTS: Thin phenotype was associated with Mazza bleeding index, sex, tooth type, probing depth and width of keratinized gingiva (WKG). Labial dehiscence was associated with age, jaw, labial bone thickness, mandibular plane angle, sagittal root position (SRP), sex, tooth type, and WKG. Labial fenestration was associated with sex, tooth type, SRP, and periodontal phenotype. The areas under the curves of nomogram prediction models for periodontal phenotype, alveolar dehiscence, and alveolar fenestration were 0.84, 0.81, and 0.73, respectively. CONCLUSIONS: Female sex, lateral incisor, and limited WKG may be risk factors for thin periodontal phenotype. Age, canine, male sex, mandible, thin labial bone thickness, and root positioned against the labial plate may be risk factors for labial dehiscence; and female sex, thick phenotype, root positioned against the labial plate, lateral incisor, and canine may be risk factors for labial fenestration. The predictive performance of the models was acceptable.

Prevalence of and risk factors for alveolar fenestration and dehiscence in the anterior teeth of Chinese patients with skeletal Class III malocclusion.

INTRODUCTION: This study investigated the prevalence of and risk factors for alveolar fenestration and dehiscence in the anterior teeth of Chinese patients with skeletal Class III malocclusion. METHODS: This study included clinical and radiographic examinations and intraoperative observations of 460 anterior teeth from 54 patients who underwent corticotomy and periodontal regenerative surgery before orthodontic treatment. Fenestration and dehiscence were detected and recorded during open-flap surgery. Univariate and multivariate analyses were performed to assess relationships between fenestration and dehiscence and age, sex, history of previous orthodontic treatment, mandibular plane angle, dentition, tooth position, sagittal root position, periodontal biotype, gingival recession, width of keratinized gingiva, and width of the basal bone. RESULTS: The prevalence of buccal alveolar bone defects was 16.1% (fenestration) and 20.7% (dehiscence) at the tooth level. Multivariate logistic regressions showed that fenestration was significantly associated with tooth position (canine vs central incisor, odds ratio [OR] = 3.324; P = 0.006; lateral incisor vs central incisor, OR = 5.588; P  <0.001), and sagittal root position (buccally positioned vs centrally positioned, OR = 5.865; P = 0.025). Dehiscence was significantly associated with dentition (mandible vs maxilla, OR = 11.685; P  <0.001), tooth position (canine vs central incisor, OR = 3.863; P = 0.007), age (OR = 1.227; P = 0.010), sex (male vs female, OR = 5.530; P = 0.026), and history of orthodontic treatment (yes vs no, OR = 4.773; P = 0.028). CONCLUSIONS: Buccally positioned teeth in the osseous housing, lateral incisors, and canines were more likely to exhibit alveolar fenestration. Mandibular teeth and canines, patients who were older, were male, and had a history of orthodontic treatment, were more likely to exhibit alveolar dehiscence.

Seramator thermalis gen. nov., sp. nov., a novel cellulose- and xylan-degrading member of the family Dysgonamonadaceae isolated from a hot spring.

Two anaerobic bacteria, designated strains SYSU GA16112T and SYSU GA16107, were isolated from a hot spring in Tengchong County, Yunnan Province, south-west PR China. Phylogenetic analyses based on 16S rRNA gene sequences showed that strains SYSU GA16112T and SYSU GA16107 belong to the family Dysgonamonadaceae. Cells of strains SYSU GA16112T and SYSU GA16107 were Gram-stain-negative, rod-shaped and non-motile. The major fatty acids (>10 %) of strains SYSU GA16112T and SYSU GA16107 were identified as anteiso-C15 : 0 and anteiso-C17 : 0 3OH. The polar lipid profile of strain SYSU GA16112T was found to consist of phosphatidylethanolamine, two unidentified aminophospholipids, two unidentified phosphoglycolipids, two unidentified aminolipids and one unidentified polar lipid, while that of strain SYSU GA16107 consisted of phosphatidylethanolamine, two unidentified polar lipids, three unidentified aminophospholipids, two unidentified phosphoglycolipids and one unidentified aminolipid. The genomic DNA G+C contents of strains SYSU GA16112T and SYSU GA16107 were determined to be 41.90 and 41.89 %, respectively, and the average nucleotide identity value between them was 99.99 %. Based on their morphological and physiological properties, and results of phylogenetic analyses, strains SYSU GA16112T and SYSU GA16107 are considered to represent a novel species of a novel genus, for which the name Seramator thermalis gen. nov., sp. nov. (type strain SYSU GA16112T=CGMCC 1.5281T=KCTC 15753T) is proposed.

A nomogram prediction for mandibular molar survival in Chinese patients with periodontitis: A 10-year retrospective cohort study.

AIMS: To develop a nomogram prediction model of mandibular molar survival by comprehensively analysing clinical and radiographic risk factors of mandibular molar loss. MATERIALS AND METHODS: Four hundred and seventy-eight mandibular molars of 139 subjects who underwent non-surgical periodontal treatment were examined retrospectively within a mean follow-up period of 11.1 years. The association of risk factors including clinical and radiographic parameters with mandibular molar loss was assessed using univariate and multivariate Cox regression analyses. A nomogram prediction model was developed, and the validation and discriminatory ability of it were analysed. RESULTS: Hundred and four molars were lost in this study. Probing depth (PD), attachment loss (AL), furcation involvement (FI), bleeding on probing (BOP), tooth mobility and radiographic bone loss were significantly associated with tooth loss (p < .01). A gradient effect of degree of FI on mandibular molar loss existed increasing from degree Ⅱ (HR = 2.37, 95% CI: 1.48, 3.79) to Ⅲ (HR = 5.61, 95% CI: 3.01, 10.45) versus none & degree Ⅰ. The area under the curve (AUC) of the model was 0.891. The calibration curve and decision curve analysis demonstrated good performance and high net benefit of nomogram, respectively. CONCLUSIONS: A specific nomogram could be adopted to predict the mandibular molar survival and formulate tailored treatment plans in Chinese.

A xylan-degrading thermophilic and obligate anaerobe Xylanivirga thermophila gen. nov., sp. nov., isolated from an anammox dominant wastewater treatment plant, and proposal of Xylanivirgaceae fam. nov.

In our search for novel anaerobes with potential carbohydrate polymers degrading activity, we have isolated a xylan-degrading bacterial strain SYSU GA17129T from an anammox bacteria dominant wastewater treatment plant. Phylogenetic analysis of the 16S rRNA gene sequence indicated the strain SYSU GA17129T belong to the order Clostridiales and shared highest sequence identity with Caldicoprobacter faecalis DSM 20678T (89.9%). The strain was thermophilic, obligately anaerobic, non-motile and rod shaped. Optimum growth of the strain was observed at 45 °C, pH 8.0 and in the presence of 0.5% NaCl (w/v). The chemotaxonomic features of the strain SYSU GA17129T comprised of C14:0 FAME, iso-C15:0 FAME and C16:0 FAME as the major fatty acids (>10%), diphosphatidylglycerol, phosphatidylinositol mannoside, an unidentified phospholipid, three unidentified polar lipids and two unidentified glycolipids as its polar lipids, and meso-diaminopimelic acid (meso-DAP) as the diamino acid in peptidoglycan. The G + C content of the genomic DNA was 35.9%. The strain could be distinguished from other defined families within the order Clostridiales by the differences in phenotypic and physiological characteristics, distinct phylogenetic lineage in 16S rRNA gene- and genome-based phylogenies and low genomic relatedness index. Based on these distinguishing properties, strain SYSU GA17129T is proposed to represent a new species of a new genus Xylanivirga thermophila gen. nov., sp. nov., within a new family Xylanivirgaceae fam. nov. The type species of the new taxon is SYSU GA17129T (=KCTC 15754T = CGMCC 1.5282T). This strain is characterized within the order Clostridiales, class Clostridia of the phylum Firmicutes.

Clinical performance of non-surgical periodontal therapy in a large Chinese population with generalized aggressive periodontitis.

AIM: This study aimed to evaluate clinical performance of non-surgical periodontal treatment (NSPT) and its influential factors in a large Chinese population with generalized aggressive periodontitis (GAgP). MATERIAL AND METHODS: Longitudinal periodontal examination data of 1,004 GAgP patients (numbers of patients with observation periods 6 weeks~, 3 months~, 6 months~, 1 year~, 3 years~ and >5 years were 203, 310, 193, 205, 70 and 23, respectively) were extracted from a hospital-based electronic periodontal charting record system and analysed by multilevel analysis. RESULTS: Mean probing depth (PD) and attachment loss (AL) reductions at patient level were 1.17 mm and 1.07 mm, respectively. Multilevel analysis demonstrated PD reductions after maintenance were mainly influenced by frequency of supportive periodontal treatment (FSPT), gender, adjunctive systemic use of antibiotics, baseline mobility, tooth type and baseline PD and bleeding index reductions were mainly influenced by FSPT, adjunctive systemic use of antibiotics, baseline AL, baseline mobility, tooth type and baseline PD. CONCLUSION: The clinical performance of NSPT on patients with GAgP was proved in the large Chinese population. Outcomes of NSPT were mainly influenced by FSPT, adjunctive systemic use of antibiotics, baseline mobility, tooth type and baseline PD.

Addition of nucleoside analogues to peg-IFNα-2a enhances virological response in chronic hepatitis B patients without early response to peg-IFNα-2a: a randomized controlled trial.

BACKGROUND: Current treatments for chronic hepatitis B (CHB) include pegylated interferon alpha (PEG-IFN-α) which is an immune modulator, and nucleos(t)ide analogs (NAs) which directly inhibit HBV DNA polymerase. With the limited efficacy of PEG-IFN-α and prolonged treatment periods associated with NAs, there is an urgent need for novel therapeutic strategies, especially for patients with a poor early response to anti-viral therapy. METHODS: In this study, 178 patients with chronic hepatitis B (n = 131) and compensated (n = 47) HBV-induced cirrhosis were enrolled, 120 patients with HBeAg (+). All the patients were treated for 12 weeks with PEG-IFN-α. Among them, a total of 138 patients with a poor virological response after 12 weeks were treated for an additional 48 weeks with Peg-IFNα-2a (control) (n = 43), with Peg-IFNα-2a + entecavir (ETV) (n = 49), or Peg-IFNα-2a + adefovir dipivoxil (ADV) (n = 46), and were followed for 48 weeks after therapy. Early virological response was defined as undetectable HBV DNA after anti-viral therapy for 12 weeks. Sustained virological response (SVR) was defined as no change in therapeutic effectiveness after 6 months follow-up, and no recurrence.Therapeutic efficacy was determined by evaluating HBV DNA levels, serum and liver HBsAg levels, liver function tests and liver histology. RESULTS: Patients in the Peg-IFNα-2a + ETV and Peg-IFNα-2a + ADV groups showed a significantly greater decrease in HBV DNA levels over time, and a significantly higher SVR compared to patients receiving Peg-INFα-2a monotherapy (both P values <0.05). Although patients receiving combination therapy had a significantly higher change in serum HBsAg levels compared to the monotherapy group, there was no significant difference in liver HBsAg levels between the three treatment groups. CONCLUSION: This study demonstrated that in patients with a poor virological response after 12 weeks of treatment with Peg-IFNα-2a alone, addition of ADV or ETV significantly reduced HBV DNA levels, serum HBsAg levels, and increased SVR. Individualization of anti-viral therapy would ensure that only patients who do not respond to Peg-IFNα-2a would receive combination therapy. Our data have important implications for the treatment of CHB patients who fail to show an early response to Peg-IFNα-2a monotherapy. TRIAL REGISTRATION: This trial was retrospectively registered on 2012 May 24 at the China Clinical Trials Registry (ChiCTR-OCC-12002196).

Effectiveness of non-surgical periodontal therapy in a large Chinese population with chronic periodontitis.

AIM: The aim of this study was to evaluate the effectiveness of non-surgical periodontal treatment (NSPT) and its influential factors in a large Chinese population with chronic periodontitis. METHODS: Periodontal examination data of 10,789 patients with at least one periodontal re-evaluation record were extracted from a hospital-based electronic periodontal charting record system. Probing depth (PD) and bleeding index (BI) reductions after NSPT and their influential factors were analysed by multilevel analysis. RESULTS: Mean PD reductions at patient level and site level were 0.62 and 0.65 mm respectively. Mean reductions of percentage of tooth with BI > 1 and BI > 2 were 14.9% and 25.21%. Multilevel analysis demonstrated that PD and BI reductions were mainly influenced by baseline PD, baseline attachment loss (AL), baseline mobility, tooth type and frequency of periodontal maintenance (FPM). Besides, PD reduction was associated with baseline BI for all sites and was associated with gender and smoking status for sites with baseline PD ≥ 5 mm. CONCLUSION: The effectiveness of NSPT on patients with chronic periodontitis was proved in a large Chinese population. Outcomes of NSPT were mainly influenced by baseline PD, baseline AL, baseline mobility, tooth type and FPM.

Metal-organic framework-based nanoplatform enhance fibroblast activity to treat periodontitis.

After periodontal tissue injury, reconstruct soft tissue sealing around the tooth surface is of fundamental importance to treat periodontitis. Among multiple cell types, fibroblast plays a central role in reestablishing functional periodontium. To enhance fibroblast activity, a novel metal-organic framework-based nanoplatform is fabricated using mesoporous Prussian blue (MPB) nanoparticles to load baicalein (BA), named MPB-BA. Drug release test displayed sustained BA release of MPB-BA. Cell proliferation, transwell migration and wound healing tests revealed accelerated fibroblast proliferation and migration for the established MPB-BA nanoplatform. Moreover, vinculin immunofluorescence staining, western blot and quantitative real-time PCR analysis showed up-regulated vinculin protein and integrin α5 and integrin ß1 gene expressions for MPB-BA, suggesting improved cell adhesion. In addition, hematoxylin and eosin (H&E) and Masson trichromatic staining suggested superior anti-inflammatory and collagen fiber reconstruction effects for MPB-BA in a rat experimental periodontitis model in vivo. Our study may provide a promising strategy for the treatment of periodontitis.

[Effect of polishing method and time on the fitness of CAD/CAM zirconia ceramic crown].

PURPOSE: To compare the effect of different polishing methods and time treatment on the fitness of CAD/CAM zirconia ceramic crowns. METHODS: Sixteen intact maxillary premolars were randomly divided into two groups, group A was treated with silicon carbide burs, while group B was treated with tungsten steel burs. At different polishing time points of the same tooth, digital impressions of each group were obtained, which were used to manufacture CAD/CAM zirconium ceramic crowns. After trial fitting, the gap impressions were obtained by using silicone rubber replication method, and the marginal and internal discrepancies were assessed. The data were statistically analyzed with SPSS 21.0 software package. RESULTS: The difference between the gap values of the marginal and internal markers of group A and group B was not statistically significant(P＞0.05). Compared with the no-polishing process, the differences of the marginal gap (39.67±8.35) µm and internal gap (45.18±7.16) µm of group A polished for 4 min, and the marginal gap (51.25±14.73) µm, and internal gap (48.56±6.45) µm of group B polished for 3 min, as well as the marginal gap (48.87±8.90) µm, and internal gap (45.99±7.12) µm of group B polished for 4 min, were all significant(P＜0.05). CONCLUSIONS: CAD/CAM zirconia ceramic crowns treated with silicon carbide bur for polishing 4 min and tungsten steel for 3 min has the best fitness.

Association between periodontitis and hypertension: cross-sectional survey from the Fourth National Oral Health Survey of China (2015-2016).

OBJECTIVES: To evaluate the association between periodontitis severity and hypertension based on Chinese epidemiological data. DESIGN: This cross-sectional survey enrolled adults from the Fourth National Oral Health Survey of China (2015-2016). SETTING: The data were obtained from the Fourth National Oral Health Survey of China (2015-2016). PARTICIPANTS: The study included individuals aged 35-44 years (n=4409), 55-64 years (n=4568) and 65-74 years (n=4218). PRIMARY AND SECONDARY OUTCOME MEASURES: Periodontal status, defined on the basis of the 2017 classification scheme, and periodontal parameters (eg, bleeding on probing (BOP)) were compared between individuals with hypertension and individuals with normotension. Smoothed scatterplots were constructed to demonstrate the associations of periodontal parameters and periodontal status with hypertension. RESULTS: Severe periodontitis (stages III and IV) was present in 41.4% of individuals with hypertension and 28.0% of individuals with normotension, respectively (p<0.001). The prevalence of severe periodontitis was higher in individuals with hypertension than that in individuals with normotension among participants aged 35-44 years (18.0% vs 10.1%, p<0.001) and 55-64 years (40.2% vs 36.7%, p=0.035), but not in participants aged 65-74 years (46.4% vs 45.1%, p=0.429). Therefore, the difference in periodontal status between individuals with hypertension and individuals with normotension decreased with age. There were higher prevalences of BOP, probing depth (PD) ≥4 mm and PD ≥6 mm in individuals with hypertension than in individuals with normotension (52.1% vs 49.2%, 19.6% vs 14.7% and 1.8% vs 1.1%, respectively). Periodontitis severity and the proportion of teeth with PD ≥4 or ≥6 mm were positively associated with hypertension. CONCLUSION: Periodontitis is associated with hypertension in Chinese adults. Hypertension prevalence increased with periodontitis severity, particularly among young participants. Accordingly, it is necessary to improve the education, awareness of periodontal treatment and preventive management among individuals at risk of hypertension, particularly in the younger population.

Biomechanical evaluation of various internal fixation patterns for unilateral mandibular condylar base fractures: A three-dimensional finite element analysis.

Finite element analysis (FEA) could efficiently simplify the mechanical behaviors of complex loaded constructions. Condylar base fracture related FEAs have been always published, but it is absent for the therapeutic effects of diverse implanting devices' locations and materials on osteosynthesis. The current FEA aimed to elucidate the biomechanical effects of unilateral mandibular condylar base fractures with open reduction and internal fixation (ORIF) of different locations and materials. The implanting positions included posterolateral border of ramus (A), anterolateral border along sigmoid notch (B), and lateral border in the middle area (C). Two different materials were presented, titanium and u-HA/PLLA (Poly-L-lactic acid combined with uncalcined and unsintered hydroxyapatite). For titanium, A + B presented lowest values of maximum von Mises stress in plates (198.66 MPa) and screws (237.39 MPa), and lowest value of peak displacement in the whole mandible (260.35 µm), while A + C presented lowest value of maximum von Mises stress in cortical bone surrounding screws (65.96 MPa). For u-HA/PLLA, A + B presented lowest value of maximum von Mises stress in screws (134.15 MPa), and lowest value of peak displacement in the whole mandible (374.43 µm), while A + C presented highest value of maximum von Mises stress in cortical bone surrounding screws (166.41 MPa). The findings suggest that both posterolateral border of mandibular ramus and anterolateral border along sigmoid notch are crucial for ORIF of unilateral mandibular condylar base fractures, whatever titanium or u-HA/PLLA devices. In addition, we speculate that titanium devices of position B could be adjusted backward and downward appropriately, but not for u-HA/PLLA device.

Photothermal-Controlled Release of IL-4 in IL-4/PDA-Immobilized Black Titanium Dioxide (TiO2) Nanotubes Surface to Enhance Osseointegration: An In Vivo Study.

Host immune response has gradually been accepted as a critical factor in achieving successful implant osseointegration. The aim of this study is to create a favorable immune microenvironment by the dominant release of IL-4 during the initial few days after implant insertion to mitigate early inflammatory reactions and facilitate osseointegration. Herein, the B-TNT/PDA/IL-4 substrate was established by immobilizing an interleukin-4 (IL-4)/polydopamine (PDA) coating on a black TiO2 nanotube (B-TNT) surface, achieving on-demand IL-4 release under near infrared (NIR) irradiation. Gene Ontology (GO) enrichment analyses based on high-throughput DNA microarray data revealed that IL-4 addition inhibited osteoclast differentiation and function. Animal experiment results suggested that the B-TNT/PDA/IL-4+Laser substrate induced the least inflammatory, tartrate-resistant acid phosphatase, inducible nitric oxide synthase and the most CD163 positive cells, compared to the Ti group at 7 days post-implantation. In addition, 28 days post-implantation, micro-computed tomography results showed the highest bone volume/total volume, trabecular thickness, trabecular number and the lowest trabecular separation, while Hematoxylin-eosin and Masson-trichrome staining revealed the largest amount of new bone formation for the B-TNT/PDA/IL-4+Laser group. This study revealed the osteoimmunoregulatory function of the novel B-TNT/PDA/IL-4 surface by photothermal release of IL-4 at an early period post-implantation, thus paving a new way for dental implant surface modification.

Nondestructive Assessment of Early Tooth Demineralization Using Cross-Polarization Optical Coherence Tomography.

New methods are needed for the nondestructive measurement of tooth demineralization and remineralization to monitor the progression of incipient caries lesions (tooth decay) for effective nonsurgical intervention and to evaluate the performance of anticaries treatments such as chemical treatments or laser irradiation. Studies have shown that optical coherence tomography (OCT) has great potential to fulfill this role since it can be used to measure the depth and severity of early lesions with an axial resolution exceeding 10 µm, it is easy to apply in vivo and it can be used to image the convoluted topography of tooth occlusal surfaces. In this paper, a review of the use of polarization-sensitive-OCT for the measurement of tooth demineralization is provided along with some recent results regarding improved methods for the detection of caries lesions in the earliest stages of development. Automated methods of analysis were used to measure the depth and severity of demineralized bovine enamel produced using simulated caries models that emulate demineralization in the mouth. Significant differences in the depth and integrated reflectivity from the lesions were detected after only a few hours of demineralization. These results demonstrate that cross-polarization-OCT is ideally suited for the nondestructive assessment of early demineralization.

Syndrome characteristics of traditional Chinese medicine: summary of a clinical survey in 767 patients with gastric cancer.

OBJECTIVE: The present study is a summary of syndrome types of gastric cancer in order of priority based on clinical practical situations, routine clinical syndrome differentiation and a large-sample clinical survey in 767 patients with gastric cancer. METHODS: Based on the six-type classification of gastric cancer in a previous study, a bedside syndrome differentiation diagnosis was made simultaneously by two attending doctors of traditional Chinese medicine (TCM to avoid possible diagnostic bias. A clinical differentiation survey form designed under the direction of epidemiologists was filled out by patients with gastric cancer in multiple centers, and the results were digitally valued and statistically analyzed. RESULTS: The symptoms and signs in each syndrome type of gastric cancer were ranked in order of priority as follows: distended pain, stringy pulse, eructation, mood-related pain, susceptibility to anger, acid regurgitation, hiccup, fullness sensation or distension after eating just a little, dizziness, thin pulse, abdominal enlargement, obstruction sensation after eating, moving pain, and uneven pulse in disharmony between liver and stomach; dark red tongue with little fur or a smooth surface, burning pain, rapid pulse, associated burning heat in anus, dry mouth, fissured tongue, thin pulse, tidal fever in the afternoon, nausea and vomiting, and night sweating in impairment of yin due to stomach heat; slender tongue fur, obstruction after eating, slow pulse, moderate pulse, rapid and irregular pulse, normal mood, abdominal pain, diarrhea, cold extremities, lower-extremity edema, cold intolerance, pale complexion, dizziness, emaciation, hiccup, silence, nausea, uneven pulse, acid regurgitation, fullness sensation or distension after eating just a little, vomiting, and constipation in deficiency-cold in spleen and stomach; uneven pulse, stabbing pain, tortuous sublingual vein, blue or purplish tongue, fixed pain, tarry stool or dark red stool, vomiting of dark red fluid, pale complexion, dry mouth without desire to drink, stringy pulse, white tongue fur, nausea, thin tongue fur, colic pain, hiccup, dizziness, acid regurgitation, bitter taste in mouth, slow pulse, rapid and irregular pulse, thin pulse, and pain relief by pressing in interior retention of toxin stagnation; slippery pulse, greasy and thick tongue fur, dry mouth without desire to drink, vomiting of bilious fluid, nausea, bitter taste in mouth, fullness sensation or distension after eating just a little, colic pain, and hiccup in stagnation of phlegm-dampness; abdominal pain relief by pressing, map-like tongue, thin pulse, weakness, yellowish complexion, dizziness, spontaneous sweating, fissured tongue, epigastric discomfort, night sweating, emaciation, cold intolerance, constipation, nausea, and dry tongue in deficiency of both qi and blood. CONCLUSION: The summarized syndrome types of gastric cancer from this study are consistent with the clinical situations and would prove to be more referential for TCM syndrome differentiation diagnosis and treatment of gastric cancer.

Influence of local anesthesia on the outcomes of non-surgical periodontal treatment.

BACKGROUND: There is limited evidence of the effects of local anesthesia (LA) on outcomes of non-surgical periodontal treatment (NSPT), in particular among the Chinese. This retrospective cohort study aimed to evaluate the effects of LA on short-term treatment outcomes of NSPT and to determine under what circumstances LA should be prescribed to improve these outcomes. METHODS: Data from periodontal examinations of 3980 patients were used. The data were from 3-month re-evaluation records of an electronic periodontal charting record system in the Department of Periodontology of Peking University School and Hospital of Stomatology from June 2008 to January 2015. Descriptive analyses included changes in probing depth (PD) and the Mazza bleeding index (BI). Two-level (patient and tooth) logistic regression models and three-level (patient, tooth, and site) linear regression models were constructed to analyze the influence of LA on PD for all teeth/sites and teeth/sites with an initial PD ≥ 5 mm. Decreases in PD and BI at sites under LA using the initial PD were also compared. RESULTS: A significantly higher mean decrease in PD after NSPT was found in the LA group than in the no local anesthesia (NLA) group (0.98 vs. 0.54 mm, t = 24.12, P < 0.001). A significantly higher probability of decreases was found in the LA group in BI (percentages of teeth with BI > 1 and BI > 2) for all teeth (16.7% vs. 13.8%, t = 3.75, P < 0.001; 34.7% vs. 28.1%, t = 6.73, P < 0.001) and PD for teeth with PD ≥ 5 mm (32.3% vs. 17.3%, t = 28.48, P < 0.001). The difference in PD between the LA and NLA groups increased as the initial PD increased. The difference between the two groups was 0.12 to 0.22 mm for sites with a baseline PD < 7 mm; however, it increased to 0.41 to 1.37 mm for sites with a baseline PD ≥ 7 mm. CONCLUSIONS: LA improved the decrease in PD after NSPT. Root debridement at sites with initial PD ≥ 7 mm should be performed under routine LA.