The influence of bone block graft position on bone dimensional changes in staged onlay horizontal ridge augmentation: A 6-month retrospective cohort study.

OBJECTIVES: To analyze changes in bone dimensions and their modulating factor in bone dimensions 6 months after horizontal ridge augmentation using autogenous bone grafts. MATERIALS AND METHODS: Thirty-eight patients with horizontally atrophic alveolar ridges of a single edentulous tooth at the maxillary anterior site were divided into two groups based on the fixation position of the bone block during ridge augmentation surgery (H0, vertical distance from the upper edge of the bone block to the alveolar crest). Patients were classified into a crestal level (CL) group if H0 ≤ 1 mm and a sub-crestal level (SCL) group if H0 > 1 mm. The width and height of the alveolar ridge were recorded using CBCT both before and 6 months after the augmentation procedure. RESULTS: The CL group comprised 20 patients with 23 implants, whereas the SCL group comprised 18 patients with 22 implants. All the augmentation sites exhibited vertical bone resorption. Vertical bone resorption in the SCL group (1.94 ± 2.11 mm) was significantly higher than that of the CL group (0.61 ± 0.64 mm). The SCL group showed significantly lower horizontal bone gain than the CL group (SCL: 1.02 ± 2.30 mm; CL: 3.19 ± 3.17 mm) at the cervical level. Peri-implant marginal bone loss increased significantly in the SCL group (1.00 ± 2.71 mm) compared to the CL group (0.64 ± 0.40 mm). CONCLUSION: The bone height decreased after horizontal ridge augmentation using autogenous onlay grafting. The fixation position of the bone block was a modulating factor. The SCL group showed more vertical bone loss, less horizontal bone gain 6 months after surgery, and more marginal bone loss after restoration.

Dually Amplified Electrochemical Aptasensor for Endotoxin Detection via Target-Assisted Electrochemically Mediated ATRP.

As the entering of bacterial endotoxin into blood can cause various life-threatening pathological conditions, the screening and detection of low-abundance endotoxin are of great importance to human health. Taking advantage of signal amplification by target-assisted electrochemically mediated atom transfer radical polymerization (teATRP), we illustrate herein a simple and cost-effective electrochemical aptasensor capable of detecting endotoxin with high sensitivity and selectivity. Specifically, the aptamer receptor was employed for the selective capture of endotoxin, of which the glycan chain was then decorated with ATRP initiators via covalent coupling between the diol sites and phenylboronic acid (PBA) group, followed by the recruitment of ferrocene signal reporters via the grafting of polymer chains through potentiostatic eATRP under ambient temperature. As the glycan chain of endotoxin can be decorated with hundreds of ATRP initiators while the further grafting of polymer chains through eATRP can recruit hundreds to thousands of signal reporters to each initiator-decorated site, the teATRP-based strategy allows for the dual amplification of the detection signal. This dually amplified electrochemical aptasensor has the ability to sensitively and selectively detect endotoxin at a concentration as low as 1.2 fg/mL, and its practical applicability has been further demonstrated using human serum samples. Owing to the simplicity, high efficiency, biocompatibility, and inexpensiveness of the teATRP-based amplification strategy, this electrochemical aptasensor holds great application potential in the sensitive and selective detection of low-abundance endotoxin and many other glycan chain-containing bio-targets.

Periodontitis-induced oral microbiome alterations provide clues on how periodontitis exacerbates colitis.

AIM: To evaluate whether and how microbiota-derived metabolites associated with periodontitis aggravate colitis in mice. MATERIALS AND METHODS: A mouse model of periodontitis and colitis was constructed. Unbiased transcriptomic analyses of the colon were performed to explore important pathways through which periodontitis exacerbated colitis. Oral and gut bacteria were analysed using 16S rRNA sequencing. Gas chromatography-mass spectrometry was used to observe the alterations of oral and gut metabolites. Isolated intestinal lamina propria lymphocytes were analysed by flow cytometry. Inflammasome pathway was detected using qRT-PCR, Western blotting or ELISA. RESULTS: Periodontitis activated the colonic inflammasome pathway and altered the gut microbial composition and metabolite profiles in mice with colitis. Notably, periodontitis induced increase of the faecal metabolite isoleucine (Ile) which was synthesized by microbiota and plants. Moreover, periodontitis upregulated the Ile levels in saliva, but not in serum, indicating that Ile might be an oral pathobiont-synthesizing metabolite that transited from the oral cavity to the gut. Ile triggered the inflammasome pathway, upregulated the number of inflammatory IL-1ßhigh MHCIIhigh Ly6Chigh monocytes in colonic lamina propria, and exacerbated colitis. Further studies found that the Ile metabolite acetyl-coenzyme A positively regulated NLRP3 inflammasome by KAT5-mediated acetylation of NLRP3. CONCLUSIONS: Our study revealed that alteration in periodontitis-induced microbial metabolites deteriorated colitis in a mouse model and that this was associated with Ile production.

Electrochemically Controlled Atom Transfer Radical Polymerization for Electrochemical Aptasensing of Tumor Biomarkers.

Tumor biomarkers are of great value in the liquid biopsy of malignant tumors. In this work, a simple and cost-friendly electrochemical aptasensor was presented for the highly sensitive and selective detection of glycoprotein tumor biomarkers. The DNA aptamer-modified electrode was used as the sensing interface to specifically capture the target glycoprotein tumor biomarkers, to which the alkyl halide initiators for atom transfer radical polymerization (ATRP) were then attached via the esterification crosslinking between the boronic acid group and the cis-dihydroxyl sites of the conjugated oligosaccharide chains on glycoprotein tumor biomarkers followed by the growth of long-chain polymers through electrochemically controlled ATRP (eATRP) to efficiently recruit the ferrocene detection tags. As there are tens to hundreds of cis-dihydroxyl sites on a glycoprotein tumor biomarker for attaching ATRP initiators while each long-chain polymer can recruit hundreds to thousands of ferrocene detection tags, a significantly high current signal can be generated even in the presence of ultralow-abundance targets. Hence, the eATRP-based electrochemical aptasensor is capable of sensitively and selectively detecting glycoprotein tumor biomarkers. Using alpha-fetoprotein as the model target, the limit of detection was demonstrated to be 0.32 pg/mL. Moreover, the aptasensor has been successfully applied to detect glycoprotein tumor biomarkers in human serum samples. In view of its high sensitivity and selectivity, simple operation, and cost-friendliness, the eATRP-based electrochemical aptasensor shows great promise in the glycoprotein-based liquid biopsy of malignant tumors, even at the early stage of development.

Electrochemical Detection of Femtomolar DNA via Boronate Affinity-Mediated Decoration of Polysaccharides with Electroactive Tags.

In view of their high efficiency and cost-effectiveness, polymers are of great promise as carriers for signal tags in amplified detection. Herein, we present a polysaccharide-amplified method for the electrochemical detection of a BRCA1 breast cancer gene-derived DNA target at the femtomolar levels. Briefly, peptide nucleic acid (PNA) with a complementary sequence was tethered as the capture probe for the DNA target, to which carboxyl group-containing polysaccharides were then attached via facile phosphate-Zr(IV)-carboxylate crosslinking, followed by the decoration of polysaccharide chains with electroactive ferrocene (Fc) signal tags via affinity coupling between a cis-diol site and phenylboronic acid (PBA) group. As the polysaccharide chain contains hundreds of cis-diol sites, boronate affinity can enable the site-specific decoration of each polysaccharide chain with hundreds of Fc signal tags, efficiently transducing each target capture event into the decoration of many Fc signal tags. As polysaccharides are cheap, renewable, ubiquitous, and biodegradable natural biopolymers, the use of polysaccharides for signal amplification offers the benefits of high efficiency, cost-effectiveness, excellent biocompatibility, and environmental friendliness. The linear range of the polysaccharide-amplified method for DNA detection was demonstrated to be from 10 fM to 10 nM (R2 = 0.996), with the detection limit as low as 2.9 fM. The results show that this method can also discriminate single base mismatch with satisfactory selectivity and can be applied to DNA detection in serum samples. In view of these merits, the polysaccharide-amplified PNA-based electrochemical method holds great promise in DNA detection with satisfactory sensitivity and selectivity.

Horizontal ridge augmentation in the anterior maxilla with in situ onlay bone grafting: a retrospective cohort study.

OBJECTIVES: This study aimed to introduce a digitally guided in situ autogenous onlay grafting technique and compare its effectiveness with the conventional (ex situ) onlay technique in augmenting horizontal bone defects of the anterior maxilla. MATERIALS AND METHODS: This retrospective cohort study included 24 patients who had received autogenous onlay bone grafts combined with guided bone regeneration (GBR) in the anterior maxilla. Fourteen patients were recruited into the in situ onlay grafting group (EG), and 10 were recruited into the ex situ onlay group (CG), defined by the donor sites. The clinical parameters, radiographic changes, micro-CT, and histological processes were evaluated after a mean follow-up period of 1.7 years. RESULTS: The horizontal bone width reflected significant bone modeling over time (p < 0.001) in the first 6 months. Multivariable analysis showed that the treatment modality (grouping) was a critical factor positively associated with vertical bone height alteration. However, neither the alteration rate of horizontal bone width nor the bone volume was associated with the treatment modality. The number of periosteal screws per graft positively affected horizontal contour maintenance (p < 0.05). No significant differences were observed between the groups in the clinical parameters (complications, success rate, and peri-implant parameters). The micro-CT and histological outcomes were similar between the groups. CONCLUSION: Despite the limitations of this study, in situ onlay grafting combined with GBR was an effective and reliable approach for horizontal bone augmentation in the anterior maxilla and appeared to demonstrate better stability in vertical bone remodeling. CLINICAL RELEVANCE: This study introduces a modified and minimally invasive technique of onlay grafting for horizontal bone augmentation. This in situ onlay grafting demonstrates superior stability in vertical bone remodeling. The trial registration number is ChiCTR2100054683.

The three-dimensional stability and accuracy of 3D printing surgical templates: An In Vitro study.

OBJECTIVE: To evaluate the three-dimensional (3D) stability and accuracy of additively manufactured surgical templates fabricated using two different 3D printers and materials. MATERIALS AND METHODS: Forty surgical templates were designed and printed using two different 3D printers: the resin group (n = 20) used a digital light processing (DLP) 3D printer with photopolymer resin, and the metal group (n = 20) employed a selective laser melting (SLM) 3D printer with titanium alloy. All surgical templates were scanned immediately after production and re-digitalized after one month of storage. Similarly, the implant simulations were performed twice. Three-dimensional congruency between the original design and the manufactured surgical templates was quantified using the root mean square (RMS), and the definitive and planned implant positions were determined and compared. RESULTS: At the postproduction stage, the metal templates exhibited higher accuracy than the resin templates (p < 0.001), and these differences persisted after one month of storage (p < 0.001). The resin templates demonstrated a significant decrease in three-dimensional stability after one month of storage (p < 0.001), whereas the metal templates were not affected (p > 0.05). No significant differences in implant accuracy were found between the two groups. However, the resin templates showed a significant increase in apical and angular deviations after one month of storage (p < 0.001), whereas the metal templates were not affected (p > 0.05). CONCLUSION: Printed metal templates showed higher fabrication accuracy than printed resin templates. The three-dimensional stability and implant accuracy of printed metal templates remained unaffected by one month of storage. CLINICAL SIGNIFICANCE: With superior three-dimensional stability and acceptable implant accuracy, printed metal templates can be considered a viable alternative technique for guided surgery.

Application of an assembled surgical guide for lateral approach sinus augmentation and sinus septum management: A technical note.

The presence of maxillary septa may render sinus augmentation more challenging particularly when encountered at the ideal implant position. This article demonstrated a novel technique for lateral access sinus augmentation using an assembled surgical guide to achieve proper lateral window outline, precise septum identification and osteotomy, and secure membrane detachment. This technique increases the predictability and efficiency of the procedure while reducing the risk of complications.

Implant Placement with Simultaneous Guided Bone Regeneration in the Anterior Region Close to the Periapical Lesion of Adjacent Teeth: A Combined Treatment Strategy to Prevent Complications.

PURPOSE: To evaluate the safety and performance of a potential novel strategy to resolve the above scenario by simultaneously performing implant-related surgery and endodontic microsurgery (EMS). MATERIALS AND METHODS: A total of 25 subjects requiring GBR during implant placement in anterior areas were allocated into two groups. In the experimental group (adjacent teeth with periapical lesions) with 10 subjects, implantation and GBR were performed for edentulous areas with simultaneous EMS for adjacent teeth. In the control group (adjacent teeth without periapical lesions) with 15 subjects, implantation and GBR were performed for edentulous areas. The clinical outcomes, radiographic bone remodeling, and patient-reported outcomes were assessed. RESULTS: Within a 1-year follow-up, the implant survival rate was 100% in both groups, with no significant difference regarding complications. All teeth achieved complete healing following EMS. Repeated analysis of variance (ANOVA) measurements revealed a significant change over time in horizontal bone widths and postoperative patient-reported outcomes, but no intergroup statistically significant differences (P > .05) in horizontal bone widths and visual analog scale scores of pain, swelling, and bleeding were observed. Likewise, the bone volumetric decrease (7.4% ± 4.5% in the experimental group and 7.1% ± 5.2% in the control group) from T1 (suture removal) to T2 (6 months after implantation) revealed no intergroup differences. The horizontal bone width gain at the implant platform was slightly lower in the experimental group (P < .05). Interestingly, the color-coded figures of both groups showed a facial reduction of grafted material in edentulous areas. However, the apical regions following EMS exhibited stable bone remodeling in the experimental group. CONCLUSION: This novel approach to address the problem involving implant-related surgery close to the periapical lesion of adjacent teeth appeared safe and reliable (no.: ChiCTR2000041153). Int J Oral Maxillofac Implants 2023;38:533-544. doi: 10.11607/jomi.9839.

Bioinspired Electro-RAFT Polymerization for Electrochemical Sensing of Nucleic Acids.

Sensing of ultralow-abundance nucleic acids (NAs) is integral to medical diagnostics and pathogen screening. We present herein an electrochemical method for the highly selective and amplified sensing of NAs, using a peptide nucleic acid (PNA) recognition probe and a bioinspired electro-RAFT polymerization (BERP)-based amplification strategy. The presented method is based on the recognition of target NAs by end-tethered PNA probes, the labeling of thiocarbonylthio reversible addition-fragmentation chain transfer (RAFT) agents, and the BERP-assisted growth of ferrocenyl polymers. The dynamic growth of polymers is electrochemically regulated by the reduction of 1-methylnicotinamide (MNA) organic cations, the redox center of nicotinamide adenine dinucleotide (NAD+, coenzyme I). Specifically, electroreduction of the MNA cations causes the fragmentation of thiocarbonylthio RAFT agents into radical species, triggering the polymerization of ferrocenyl monomers, thereby recruiting plenty of ferrocene electroactive tags for amplified sensing. It is obvious that the BERP-based strategy is inexpensive and simple in operation. Benefiting from the high specificity of the PNA recognition probe and the amplified signal by the BERP-based strategy, this method is highly selective and the detection limit is as low as 0.58 fM (S/N = 3). Besides, it is applicable to the sensing of NAs in serum samples, thus showing great promise in the selective and amplified sensing of NAs.

Horizontal bone augmentation of the edentulous area with simultaneous endodontic microsurgery of the adjacent tooth: A digitally-driven multidisciplinary case report with a 1-year follow-up.

PURPOSE: To introduce a novel and efficient procedure to solve a multidisciplinary issue connected to implant-related surgery in areas near periapical lesions of adjacent teeth using single-stage combined surgery while exploring a new way to prevent retrograde peri-implantitis. MATERIALS AND METHODS: A 31-year-old woman diagnosed with a Kennedy III dentition defect in the maxillary right central incisor and posttreatment apical periodontitis in the maxillary right lateral incisor was treated using a multidisciplinary procedure. First, the preoperative data were collected from intraoral, extraoral facial and CBCT scans. Then, the aesthetic appearance of the anterior teeth was planned digitally and implant insertion was simulated. Next, virtual bone augmentation was carried out with reference to the simulated implant position, and according to the virtual augmentation, the templates for bone shell harvesting (also used for apical osteotomy and root tip resection during endodontic microsurgery) and bone shell grafting of the edentulous area were designed and fabricated. The templates for combined surgery (endodontic microsurgery and horizontal bone augmentation) consisted of one basal template and multiple interchangeable attachments via a plugin design to make guided endodontic microsurgery and digitally guided bone augmentation more efficient. Combined surgery was then carried out using the templates for guidance. During surgery, the apical inflammation affecting the maxillary right lateral incisor was first removed and its preserved apical bony window was prepared as an autogenous bone shell for bone augmentation of the maxillary right central incisor site. Guided bone regeneration of the edentulous area and guided tissue regeneration were then performed for the adjacent tooth. Six months after the combined surgery, digital guided implant surgery was carried out for the edentulous area. The final prosthesis was delivered in accordance with the preoperative aesthetic design and achieved using an implant-supported restoration for the maxillary right central incisor, full crown restoration for the maxillary right lateral incisor, and ceramic veneers for the maxillary left central and lateral incisors for space closure. RESULTS: The horizontal bone augmentation in the edentulous area and endodontic microsurgery on the neighbouring tooth were performed successfully in a single-stage surgical procedure; thus, augmentation of the resorbed alveolar bone and removal of infection in the adjacent site were achieved simultaneously. At the 1-year follow-up after combined surgery, the healing of the natural maxillary right lateral incisor and the area having undergone bone augmentation showed promising results with no postoperative complications. CONCLUSIONS: This novel digital workflow appears effective in addressing the problem of periapical lesions in retained teeth adjacent to the edentulous area that requires horizontal bone augmentation in one surgical procedure, providing an efficient way of resolving the problem using endodontics and implantology, and preventing retrograde peri-implantitis.