The effects of Helicobacter pylori eradication therapy on salivary pepsin concentration in patients with laryngopharyngeal reflux.

OBJECTIVE: To investigate the effect of Helicobacter pylori (HP) eradication therapy on salivary pepsin concentration in laryngopharyngeal reflux (LPR) patients with HP infection. MATERIALS AND METHODS: A total of 477 patients with suspected LPR were enrolled from June 2020 to September 2021. Reflux symptom index, reflux finding score, the positive rates and disintegrations per minute values of HP infection detected by 14C urea breath test and salivary pepsin concentrations analyzed using enzyme-linked immunosorbent assay were compared in LPR patients and non-LPR patients with or without HP infection. HP-positive patients were treated with HP eradication therapy while HP-negative patients with PPI therapy. RESULTS: The scores of nagging cough (0.88 vs. 0.50, P = 0.035), erythema or hyperemia (1.93 vs. 1.78, P = 0.035) and vocal fold edema (1.04 vs. 0.85, P = 0.025) were higher in the LPR (+) Hp (+) subgroup than in LPR (+) Hp (-) subgroup. The concentrations of salivary pepsin in the Hp (+) subgroup were higher than in the Hp (-) subgroup either in LPR patients (75.24 ng/ml vs. 61.39 ng/ml, P = 0.005) or the non-LPR patients (78.42 ng/ml vs. 48.96 ng/ml, P = 0.024). Compared to baseline (before treatment), scores of nagging cough (0.35 vs. 0.84, P = 0.019) and erythema or hyperemia (1.50 vs. 1.83, P = 0.039) and the concentrations of salivary pepsin (44.35 ng/ml vs. 74.15 ng/ml, P = 0.017) in LPR patients with HP infection decreased after HP treatment; yet, this was not observed for the LPR patients without HP infection treated with PPI only (P > 0.05). CONCLUSION: HP infection may aggravate the symptoms and signs of LPR patients, partly by increasing their salivary pepsin concentration.

Successful Surgical Protocols in the Treatment of Peri-Implantitis: A Narrative Review of the Literature.

BACKGROUND: The aim was to identify and evaluate those surgical protocols reporting on positive clinical outcomes for treating peri-implantitis with 12 or more months of follow-up. Method of surface decontamination (SDC) was evaluated for any correlation with outcomes. RESULTS: A literature search was performed of all articles published in English between January 1, 2001 and April 30, 2015. Of the 639 identified, 26 satisfied the inclusion criteria. Outcomes reported on included reductions in bleeding on probing (BoP) and probing depth (PD), mean radiographic bone fill (RBF), and mean change in marginal soft tissue levels (MR±). Methods of SDC included mechanical debridement (MD) with and without saline use, MD plus laser or photodynamic therapy, MD with air powder abrasion, MD with chemotherapeutic implant surface decontamination, and combination approaches. The results suggested that various methods of SDC were effective. Heterogeneity of the studies made it impossible to determine correlations between clinical outcome and SDC method. Most studies over 12 months reporting better treatment outcomes employed a bone replacement. Additionally, studies where patients with periodontitis were treated before their peri-implantitis care also had better outcomes. CONCLUSION: The current review failed to reveal any correlation between any particular method for SDC or defect treatment protocol and positive clinical outcomes. Further comparative studies are warranted to determine the most appropriate approach for both of these topics.

Thermally Responsive Hydrogel Blends: A General Drug Carrier Model for Controlled Drug Release.

Thermally responsive hydrogels have drawn significant research attention recently because of their simple use as drug carrier at human body temperature. Here we design a hybrid hydrogel that incorporates a hydrophilic polymer, polyethyleneimine (PEI), into the thermally responsive hydrogel poly(N-isopropylacrylamide) (PNIPAm), as a general drug carrier model for controlled drug release. In this work, on one hand, PEI modifies the structure and the size of the pores in the PNIPAm hydrogel. On the other hand, PEI plays an important role in tuning the water content in the hydrogel and controls the water release rate of the hydrogel below the lower critical solution temperature (LCST), resulting in a tunable release rate of the drugs at human body temperature (37 °C). Different release rates are shown as different amounts of PEI are incorporated. PEI controls the release rate, dependent on the charge characteristics of the drugs. The hydrogel blends described in this work extend the concept of a general drug carrier for loading both positively and negatively charged drugs, as well as the controlled release effect.

A Narrative Review of the Diagnosis, Etiology, and Treatment of Halitosis Over the Past Three Decades.

Although the term "halitosis" was first coined in 1874, people have become increasingly aware of this problem more recently during the COVID-19 pandemic due to extensive wearing of protective masks. In fact, following dental caries and periodontal disease, halitosis is the third most prevalent reason for patients going to the dentist. Due to multifactorial etiology, the diagnosis of halitosis requires a rigorous health/dental/social history, a clinical examination, and measurements. The treatment ranges from the use of dentifrices, mouthwashes, tongue scraping, and masking products, and more recently includes photodynamic therapy, probiotics, and ozone. The purpose of this narrative review was to examine the published literature concerning halitosis over the past 30 years and discuss the diagnosis, etiology, and treatment of the disease.

Reconstructing Peri-implant and Papillary Soft Tissue in the Esthetic Area Using Interdental Tissue, a Tuberosity Connective Tissue Graft, and a Tunneling Approach: A Case Report.

Long-term survival of dental implants in both fully and partially edentulous patients has been proven successful, as reported in the literature. However, maintenance of soft-tissue quality and volume is often difficult due to the multiple surgeries involved in implant placement and the physiological resorption of bone after tooth extraction. Soft-tissue augmentation is frequently necessary to improve soft-tissue contour and can be done simultaneously with implant or abutment placement or following the final insertion of the implant-supported prostheses. The purpose of this case report is to demonstrate a surgical procedure used to augment a peri-implant buccal soft-tissue defect using interdental palatal tissue from a pocket reduction procedure in combination with a distal wedge graft from the tuberosity as connective tissue utilizing a tunneling approach in the esthetic area. The implant restorations in the reported case were delivered 1 year prior to the soft-tissue reconstruction.

Biocompatible micelles based on comb-like PEG derivates: formation, characterization, and photo-responsiveness.

A novel comb-like derivative CPEG-g-DNQ was prepared by incorporating light responsive 2-diazo-1,2-naphthoquinone (DNQ) groups into the structure of comb-like poly(ethylene glycol) (CPEG). DLS and TEM results showed that CPEG-g-DNQ self-assembled into spherical micelles with an average size of about 135 nm in water. Upon exposure to light, the micelles could be disrupted because of the conversion of hydrophobic DNQ to hydrophilic 3-indenecarboylic acid. Additionally, hydrophobic coumarin 102 was successfully loaded into the micelles and photo-induced ON-OFF release was demonstrated by fluorescence spectroscopy. MTT assay revealed that the micelles are biocompatible. These photo-responsive micelles might have great potential for controlled release of hydrophobic drugs.

Bone Ring Allograft: Digitally Guided Placement in the Anterior Esthetic Area. A Retrospective Case Series.

This case series demonstrates a surgical technique consisting of a digitally planned and guided placement of a bone ring allograft and implant in the anterior esthetic zone. Eight consecutive patients with horizontal and vertical defects in the anterior maxilla underwent augmentation with a commercially available bone ring allograft and simultaneous implant placement using two digital guides. After 6 to 8 months, implants were uncovered and restored with a screw-retained prosthesis. Follow-up periods ranged from 8 to 24 months. All eight implants met predefined success criteria with no adverse events. Radiographic measurements demonstrated stable peri-implant bone levels 1 year after implantation, with bone loss ranging from 0.0 to 1.4 mm. All patients were satisfied with the total treatment time, postsurgical healing, and final esthetic outcome. This case series describes a one-stage procedure in which a bone ring allograft and implant are simultaneously placed for treatment of a severely defective ridge in the anterior maxilla. The technique appears to be reliable for use in the esthetic zone, with minimal first-year loss of peri-implant bone. In combination with a digital guide, accurate implant and bone ring placement can be achieved, resulting in reduced chair time and fewer surgical procedures for the patient.

A Modified Technique of Tacking Acellular Dermal Matrix to Increase Keratinized Mucosa Around Dental Implants as an Alternative to a Free Gingival Graft: A Case Report.

INTRODUCTION: Free autogenous graft was the gold standard to increase the keratinized mucosa (KM) and vestibular depth. The major downfall of this technique is the postoperative morbidity at the donor site. The purpose of this case report is to demonstrate a modified technique using acellular dermal matrix (ADM) to increase the KM around implants to achieve faster healing with less postoperative morbidity. CASE PRESENTATION: Patient presented with inadequate keratinized tissue band and shallow vestibule at submerged implant sites bilaterally. Initially, surgical procedure of vestibuloplasty in conjunction with free gingival graft (FGG) was performed at one side. However, patient opted for the allograft as a substitute for the other side due to the postoperative discomfort from palatal donor site. On the left side, the FGG procedure was performed in a conventional way stabilizing with sutures. On the right side, the ADM was stabilized with tacks only at recipient site and left exposed. The new vestibule was established and stabilized with tacks.  A significant gain of KM and vestibule depth was observed at the site of using ADM when compared with baseline. For the site of using FGG, KM was increased. However, the vestibule was rebounded compared with the site of using ADM with tacks. CONCLUSIONS: The use of ADM stabilized with tacks is a predictable procedure that can increase KM and establish stable vestibule around dental implants. It can lead to less chair time, faster healing, and reduced postoperative morbidity compared with autogenous soft tissue graft.

The Link Between Periodontitis/Peri-implantitis and Cardiovascular Disease: A Systematic Literature Review.

A link between periodontitis and cardiovascular disease has been reported in the literature. For this systematic review, the keywords "cardiovascular disease" (CVD) were combined with "periodontitis" and "peri-implantitis" and were used to search for literature published on MEDLINE and PubMed between 1990 and 2020. Hand searching was also performed. A total of 206 articles were identified, 51 of which were reviewed. A link between periodontal disease and CVD can be explained by both the infection and inflammatory pathways. Interventional studies on the treatment of periodontal disease related to CVD have shown conflicting results. Therefore, based on published studies, CVD should presently be considered a comorbidity of periodontitis (with an association but no direct cause and effect documented). The association of CVD with peri-implantitis has too few studies to draw any conclusions. More studies are necessary before any conclusions can be made between CVD and periodontitis and CVD and peri-implantitis regarding possible links and the extent of association.

Silver Nanowire-Bacterial Cellulose Composite Fiber-Based Sensor for Highly Sensitive Detection of Pressure and Proximity.

Fiber-based sensors are desirable to provide an immersive experience for users in the human-computer interface. We report a hierarchically porous silver nanowire-bacterial cellulose fiber that can be utilized for sensitive detection of both pressure and proximity of human fingers. The conductive fiber was synthesized via continuous wet-spinning at a speed of 20 m/min, with a diameter of 53 µm, the electrical conductivity of 1.3 × 104 S/cm, a tensile strength of 198 MPa, and elongation strain of 3.0% at break. The fibers were coaxially coated with a 10 µm thick poly(dimethylsiloxane) dielectric elastomer to form the fiber sensor element which is thinner than a human hair. Two of the sensor fibers were laid diagonally, and the capacitance changes between the conductive cores were measured in response to pressure and proximity. In the touch mode, a fiber-based sensor experienced monotonic capacitance increase in the pressure range from 0 to 460 kPa, and a linear response with a high sensitivity of 5.49 kPa-1 was obtained in the low-pressure regime (<0.5 kPa). In touchless mode, the sensor is highly sensitive to objects at a distance of up to 30 cm. Also, the fiber can be easily stitched into garments as comfortable and fashionable sensors to detect heartbeat and vocal pulses. A fiber sensor array is able to serve as a touchless piano to play music and accurately determine the proximity of an object. A 2 × 2 array was further shown for two- and three-dimensional location detection of remote objects.

Long-Term Retrospective Evaluation of Success of Narrow-Diameter Implants in Esthetic Areas: A Consecutive Case Series with 3 to 14 Years Follow-up.

This retrospective study reports on the outcome of 19 narrow-diameter implants (NDIs) placed in 14 consecutively treated patients 3 to 14 years postloading. Peri-implant bone remodeling, bone loss, esthetic outcomes, and patient satisfaction with the final restoration were evaluated. No implant failures or prosthetic complications were reported, yielding a 100% survival rate and a 84.2% success rate. All 14 patients reported that they were very satisfied with the esthetic results. The average mesial and distal bone remodeling was 1.99 mm and 1.84 mm, respectively. This represents physiologic bone loss post-implant placement. Only 5 implants presented with bone loss, producing an average mesial and distal bone loss of 0.14 mm and 0.17 mm, respectively. Bone loss was measured on the threads of the implant from the time of restoration to the time of follow-up. The bone loss did not exceed 0.2 mm per year on any implant. These screw-retained NDIs present a cost-effective, esthetically acceptable alternative for restoring limited spaces in the anterior esthetic zone.

Effects of chemical cleaning on RO membrane inorganic, organic and microbial foulant removal in a full-scale plant for municipal wastewater reclamation.

Of all of the strategies for controlling reverse osmosis (RO) membrane fouling, chemical cleaning is indispensable. To study the effects of chemical cleaning on membrane foulant removal, a comparative analysis of RO membranes before and after common alkaline and acid cleaning was conducted by dissecting lead and terminal RO membranes in a full-scale municipal wastewater reclamation plant. Most foulants on the membranes were removed by chemical cleaning processes. Calcium was the major inorganic component of the foulants because of its highest concentration in the feed water. Aluminum and iron were also abundant elements on the membranes due to their high deposition ratios and low removal efficiencies. Hydrophilic neutrals (HIN) and hydrophobic neutrals (HON) were the two largest dissolved organic matter (DOM) fractions on the membranes before cleaning. HIN and hydrophilic acids (HIA) were not effectively removed. Chemical cleaning removed 94% and 90% of the total bacteria on the lead and tail membranes and considerably changed the structure of the microbial communities. Bacteria excessively producing extracellular polymeric substance (EPS), such as Pseudomonas and Zoogloea, were much more resistant to the chemical cleaning process. After cleaning, the membrane microbial community structures were more similar to those in the feed water than the structures on the membranes before cleaning. These results shed light on the effects of cleaning in a full-scale RO plant, improves our understanding of the removal of foulants and provides potential research directions for cleaning methods and RO pretreatment processes.