A large-cohort study of 2971 cases of epulis: focusing on risk factors associated with recurrence.

BACKGROUND: To analyze the clinicopathological features of different histological subtypes of epulis, and evaluate the risk factors associated with recurrence. MATERIALS AND METHODS: A retrospective study including 2971 patients was performed. The patients' sex, age, location, size, histological subtypes, recurrence information, oral hygiene habits, periodontitis symptoms and smoking history were retrieved from the patient medical records and follow-up information. RESULTS: Among the 2971 cases, focal fibrous hyperplasia (FFH) was the most common lesion (60.92%), followed by peripheral ossifying fibroma (POF) (29.32%), pyogenic granuloma (PG) (8.08%) and peripheral giant cell granuloma (PGCG) (1.68%). The peak incidence of epulis was in the third and fourth decade of life, with a mean age of 45.55 years. Female predominance was found in all types of lesions with a female to male ratio of 1.71:1. PG had the highest recurrence rate (17.18%), followed by POF (12.98%), FFH (9.55%) and PGCG (8.82%). Histological subtypes were significantly correlated with the recurrence of epulis (P = 0.013). Regular supportive periodontal therapy (P = 0.050) had a negative correlation with recurrence, whereas symptoms of periodontitis (P < 0.001) had a positive correlation with the recurrence of epulis. CONCLUSIONS: Controlling the periodontal inflammation and regular supportive periodontal therapy might help reduce the recurrence of epulis.

Lipidomic analysis reveals altered lipid profiles of gingival tissues with periodontitis.

AIM: The role of lipids in periodontitis has not been well studied. Thus, this study aimed to explore periodontitis-associated lipid profile changes and identify differentially expressed lipid metabolites in gingival tissues. MATERIALS AND METHODS: Gingival tissues from 38 patients with periodontitis (periodontitis group) and 38 periodontally healthy individuals (control group) were collected. A ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry-based non-targeted metabolomics platform was used to identify and compare the lipid profiles of the two groups. The distribution and expression of related proteins were subsequently analysed via immunohistochemistry to further validate the identified lipids. RESULTS: Lipid profiles significantly differed between the two groups, and 20 differentially expressed lipid species were identified. Lysophosphatidylcholines (lysoPCs), diacylglycerols (DGs), and phosphatidylethanolamines (PEs) were significantly up-regulated, while triacylglycerols (TGs) were downregulated in the periodontitis group. Moreover, the staining intensity of ABHD5/CGI-58, secretory phospholipase A2 (sPLA2), and sPLA2-IIA was significantly stronger in the gingival tissues of patients with periodontitis than in those of healthy controls. CONCLUSIONS: LysoPCs, DGs, and PEs were significantly up-regulated, whereas TGs were down-regulated in gingival tissues of patients with periodontitis. Correspondingly, the immunohistochemical staining of ABHD5/CGI-58, sPLA2, and sPLA2-IIA in gingival tissues was consistent with the downstream production of lipid classes (lysoPCs, TGs, and DGs).

Oriented face-centered cubic to hexagonal close-packed martensitic transition, grain morphology, and mechanical properties of Co-Cr alloy fabricated by selective laser melting.

STATEMENT OF PROBLEM: Removable partial dentures (RPDs) can be fabricated by selective laser melting (SLM) with different build orientations. How microstructures and mechanical properties of SLM Co-Cr alloy are affected by different build orientations is unclear. PURPOSE: The purpose of this in vitro study was to investigate the phase structures, grain morphology, and mechanical properties of SLM Co-Cr alloy with different build orientations. MATERIAL AND METHODS: SLM Co-Cr tensile specimens were fabricated at orientation angles of 0, 45, and 90 degrees between the building and longitudinal direction named the T0, T45, and T90 design groups (n=14). Mechanical properties were obtained by tensile testing conducted by using a universal testing machine according to the International Organization for Standardization (ISO) 22674. The grains along the longitudinal direction of the specimens and phase structures were observed before and after tensile testing by electron backscatter diffraction. One-way analysis of variance followed by the Bonferroni post hoc test and Kruskal-Wallis test were used for statistical analysis (α=.05). RESULTS: The 0.2% yield strengths in descending order were T90 (870 MPa)>T45 (840 MPa)>T0 (786 MPa) (P<.05); the elongations were T0 (21.8%)>T45 (15.6%)>T90 (8.7%) (P<.05); the ultimate tensile strengths were T45 (1226 MPa)>T90 (1200 MPa)>T0 (1149 MPa) (P<.05). The average grain sizes in the T0, T45, and T90 groups were 22 µm, 18 µm, and 14 µm, respectively. After the tensile test, a face-centered cubic (FCC) to hexagonal close-packed (HCP) martensitic transition was found in each group, and the phase transition area fractions were T0 (38.3%)>T45 (11.4%)>T90 (0.7%). CONCLUSIONS: The FCC to HCP martensitic transition, grain morphology, and mechanical properties of SLM Co-Cr alloy depended on the build orientations. The oriented phase transition and grains affected the anisotropic mechanical properties of SLM Co-Cr alloy.

Effect of two heat treatments on mechanical properties of selective-laser-melted Co-Cr metal-ceramic alloys for application in thin removable partial dentures.

STATEMENT OF PROBLEM: Heat treatment has been used to reduce the residual stress of alloys fabricated by selective laser melting (SLM) to avoid deformation. Co-Cr metal-ceramic alloys are used to fabricate metal-ceramic restorations and removable partial dentures (RPDs) on the same substrate by SLM. A heat treatment that enables the fabrication of metal-ceramic restorations and RPDs with excellent mechanical properties should be evaluated. PURPOSE: The purpose of this in vitro study was to determine the effects of 2 heat treatments on the mechanical properties of SLM Co-Cr metal-ceramic alloys intended for the fabrication of thin RPDs. MATERIAL AND METHODS: Tensile bars were manufactured using cast metal-ceramics (C-MC group), RPD alloys (C-RPD group), and SLM Co-Cr metal-ceramic alloys. The SLM specimens were subjected to 2 different heat treatments, L1 at 880°C and L2 at 1100°C, and were further divided into subgroups (L1-MC, L1-RPD, L2-MC, and L2-RPD). Thirty-six tensile specimens were prepared in C-RPD, L1-RPD, and L2-RPD (simulated partial denture alloys for clinical use) and in C-MC, L1-MC, and L2-MC (simulated metal-ceramic alloys); 18 metal-ceramic bond strength specimens were prepared in C-MC, L1-MC, and L2-MC groups (n=6). The tensile test and 3-point bend test were conducted using a universal testing machine. The fracture surfaces of the L2-RPD tensile bar were examined using a scanning electron microscope. The Student t test (α=.05) was used for statistical analysis. RESULTS: No significant differences were observed between the bond strengths of L1-MC and C-MC (P=.74) or between those of L2-MC and C-MC (P=.124). The 0.2% yield strength (σ0.2) and elongation of all SLM specimens exceeded the minimum requirements required for the fabrication of thin RPDs as prescribed in ISO 22674:2016. The σ0.2 value of L1-MC and L2-MC was significantly higher than that of C-MC. Significant differences in σ0.2 values were found among the 3 RPD groups, L1-RPD>L2-RPD>C-RPD. For the elongation, significant differences were found among the 3 groups, L2-RPD>C-RPD>L1-RPD. The fracture surface of L2-RPD showed clear submicroscale dimples with fusion defects. CONCLUSIONS: When Co-Cr metal copings and RPD frameworks were fabricated on the same substrate simultaneously using SLM, heat treatment at 1100°C was found more suitable than at 880°C to release residual stress, considering the toughness required for dental prostheses.

Effects of heat treatment on metal-ceramic combination of selective-laser-melted cobalt-chromium alloy.

STATEMENT OF PROBLEM: Components fabricated by selective laser melting (SLM) deform because of residual stress, but heat treatment allows the release of that stress and avoids deformation. Although dental cobalt-chromium (Co-Cr) alloy has been specifically designed for SLM, the effects of heat treatment on the metal-ceramic combination of SLM Co-Cr restorations require investigation. PURPOSE: The purpose of this in vitro study was to evaluate the effects of heat treatment on the metal-ceramic combination of SLM Co-Cr alloy. MATERIAL AND METHODS: Following ISO 9693:2012, Co-Cr metal strips (Solibond C Plus cast alloy and SLM powders; YETI Dental) were fabricated with a dimension of 25×3×0.5 mm by casting and SLM. The SLM specimens were divided into 3 subgroups (n=15 for each subgroup). Two subgroups were subjected to heat treatment at 880°C (SLM-880) and 1100°C (SLM-1100). The third subgroup was not subjected to heat treatment and served as a control (As-SLM). Cast specimens (n=15) also acted as a control. A porcelain layer with a thickness of 1.1 mm was fired to the central area (3×8 mm) of each specimen. The 3-point bend test was used to evaluate the metal-ceramic bond strength (τb). The fractured metal surfaces were examined by the naked eye, using a digital camera, and also using a scanning electron microscope. The area fraction of adherence porcelain (AFAP) was determined by measuring the atomic percentage of silicon using energy-dispersive x-ray spectroscopy (EDS). One-way ANOVA and the Kruskal-Wallis test, followed by the Mann-Whitney test (α=.05), were used for statistical analysis. RESULTS: The 1-way ANOVA found no significant difference in the bond strength among the 4 groups. The EDS analysis indicated that specimens in the groups receiving heat treatment (SLM-880 and SLM-1100) showed higher AFAP values than those in the As-SLM group (P<.05). The SLM-880 also showed significantly higher AFAP values than the SLM-1100. Compared with the cast group, significant differences in AFAP values were also observed, and the specimens in the order of highest to lowest AFAP values were SLM-880>cast>As-SLM; no significant difference was found between the SLM-1100 and cast groups. CONCLUSIONS: Heat treatment at 880°C and 1100°C did not affect the metal-ceramic bond strength of Co-Cr alloy made by SLM but did improve the porcelain adherence. SLM-fabricated and heat-treated Co-Cr alloy shows comparable or more porcelain adherence than cast specimens.

Periodontal therapy as adjunctive treatment for gastric Helicobacter pylori infection.

BACKGROUND: Helicobacter pylori is estimated to affect about half the world's population and is considered as the main cause of chronic gastritis and peptic ulcer disease. Eradication of H. pylori infection accelerates ulcer healing and prevents relapse, reducing incidence of H. pylori-related gastric diseases. Numerous studies have provided evidence that the oral cavity could be a potential reservoir for H. pylori. The presence of oralH. pylori might affect the efficiency of eradication therapy and act as a causal force for its recurrence. Conversely, other investigators have indicated that the colonization and growth of H. pylori differs between the oral cavity and the stomach. Considering the open debate on the topic, it's necessary to clarify whether periodontal therapy is an effective adjunctive treatment for gastric H. pylori infection. OBJECTIVES: To assess the effects of periodontal therapy plus eradication therapy versus eradication therapy alone for gastric H. pylori infection. The secondary objective is to compare the non-recurrence rate at long-term follow up in different treatment groups. SEARCH METHODS: We identified randomized controlled trials (RCTs) by searching the Cochrane Central Register of Controlled Trials (CENTRAL) (2015, Issue 8), MEDLINE (1946 to August 2015), EMBASE (1980 to August 2015), and the Chinese Biomedical Database (1978 to August 2015). We also searched both ClinicalTrials.gov and the WHO ICTRP portal in October 2015. We handsearched the reference lists of included studies to identify relevant trials. SELECTION CRITERIA: RCTs comparing periodontal therapy plus eradication treatment with eradication treatment alone, regardless of language of publication. DATA COLLECTION AND ANALYSIS: Two reviewers selected the trials that met the inclusion criteria and extracted the details of each study independently. The data were pooled using both fixed-effect and random-effects models and results calculated as odds ratios (OR) with their 95% confidence intervals (CIs) based on an intention-to-treat analysis. However, because there was little difference in the results from these two models, we only reported the results from the fixed-effect model. MAIN RESULTS: We included seven small RCTs involving 691 participants aged 17 to 78 years in our meta analyses. The primary result showed that periodontal therapy combined with H. pylori eradication treatment increased the eradication rate of gastric H. pylori compared with eradication treatment alone (OR 2.15; 95% CI 1.47 to 3.14; P < 0.0001) in people with H. pylori infection. In addition, periodontal therapy also had benefits on long-term gastric H. pylori eradication. After eradication of H. pylori, the non-recurrence rate of gastric H. pylori infection increased in participants treated with periodontal therapy compared with those who received eradication therapy alone (OR 3.60; 95% CI 2.11 to 6.15; P < 0.00001). According to the GRADE approach, the overall quality of the evidence was 'moderate' for eradication rate of gastric H.pylori and 'low' for non-recurrence rate of gastric H. pylori. AUTHORS' CONCLUSIONS: Overall, periodontal therapy could increase the efficiency of H. pylori eradication and the non-recurrence rate of gastricH. pylori. In view of the limited number and quality of included studies, it will be necessary to conduct more well-designed, multicenter, and large-scale RCTs to determine the effects of periodontal therapy in eradicating gastric H. pylori and suppressing the recurrence of this bacterium in the stomach.

Potential effectiveness of parenteral nemonoxacin in the treatment of Clostridioides difficile infections: in vitro, ex vivo, and mouse studies.

Introduction: Antimicrobial therapy plays a crucial role in the management of CDI patients. However, the standard agent for treating CDIs is limited to oral fidaxomicin or vancomycin. For patients made nil by mouth, there is a clinically urgent and essential need to develop an intravenous antibiotic. Methods: For C. difficile with the lowest MIC of nemonoxacin and vancomycin, the inhibitory effects were tested using the kinetic time-kill assay and ex vivo co-culture model. The effectiveness of nemonoxacin and vancomycin in inhibiting spore germination, the sporicidal activity, and the treatment of mice with CDIs were compared. Results: For clinical isolates and laboratory strains, lower MICs of nemonoxacin against C. difficile than levofloxacin and ciprofloxacin were observed, even in those harboring point mutations in the quinolone-resistance determining region. Although nemonoxacin failed to suppress spore outgrowth and germination in C. difficile, it exhibited an effective inhibitory effect against C. difficile in the kinetic time-kill assay and the ex vivo co-culture model. Mice receiving intraperitoneal nemonoxacin had less weight loss, higher cecum weight, a longer colon length, and lower expression of the tcdB gene, compared with untreated mice. Notably, there were no significant differences observed in weight loss, cecum weight, colon length, or tcdB gene expression between mice treated with vancomycin and those treated with any dose of nemonoxacin. Similarly, no significant differences were found between mice receiving combination therapy of intraperitoneal nemonoxacin plus oral vancomycin and those treated with intraperitoneal nemonoxacin or oral vancomycin alone. Discussion: The potential role of nemonoxacin, which can be administered parenterally, for treating CDIs was evidenced through the in vitro, ex vivo, and mouse models.

Periodontal Guided Tissue Regeneration Membranes: Limitations and Possible Solutions for the Bottleneck Analysis.

Guided tissue regeneration (GTR) is an important surgical method for periodontal regeneration. By placing barrier membrane on the root surface of the tooth to guide the adhesion and proliferation of periodontal ligament cells, periodontal tissue regeneration can be achieved. This review intends to analyze the current limitations of GTR membranes and to propose possible solutions for developing new ones. Limitations of current GTR membranes include nonabsorbable membranes and absorbable synthetic polymer membranes exhibit weak biocompatibility; when applying to a large defect wound, the natural collagen membrane with fast degradation rate have limited mechanical strength, and the barrier function may not be maintained well. Although the degradation time can be prolonged after cross-linking, it may cause foreign body reaction and affect tissue integration; The clinical operation of current barrier membranes is inconvenient. In addition, most of the barrier membranes lack bioactivity and will not actively promote periodontal tissue regeneration. Possible solutions include using electrospinning (ELS) techniques, nanofiber scaffolds, or developing functional gradient membranes to improve their biocompatibility; adding Mg, Zn, and/or other metal alloys, or using 3D printing technology to improve their mechanical strength; increasing the concentration of nanoparticles or using directional arrangement of membrane fibers to control the fiber diameter and porosity of the membrane, which can improve their barrier function; mixing natural and synthetic polymers as well as other biomaterials with different degradation rates in proportion to change the degradation rate and maintain barrier function; to improve the convenience of clinical operation, barrier membranes that meets personalized adhesion to the wound defect can be manufactured; developing local controlled release drug delivery systems to improve their bioactivity. Impact statement This review provides an up-to-date summary of commonly commercial periodontal guided tissue regeneration membranes, and analyze their limitations in clinical use. Using studies published recently to explore possible solutions from several perspectives and to raise possible strategies in the future. Several strategies have tested in vivo/in vitro, which will guide the way to propel clinical translation, meeting clinical needs.

Experience of high polymer gel pad assisted ultrasound monitoring in the treatment of infant urolithiasis during extracorporeal shock wave lithotripsy.

In the extracorporeal shock wave lithotripsy for infants, we used a medical polymer gel pad to assist ultrasonic positioning, so that the ultrasonic probe could be far away from the shock wave energy field. Although not affecting the ultrasonic positioning and monitoring effect, we discussed the protective effect of this method on the ultrasonic probe. A retrospective analysis was made on 21 infants (0-3 years old) who received ESWL in our hospital from June 2021 to February 2023. After the stones were accurately located by B-ultrasound before surgery, a 4 * 5 * 10 cm medical polymer gel pad was placed between the skin and the ultrasonic probe to keep the ultrasonic probe away from the shock wave energy field. The B-ultrasonic wave source locked the target stone through the gel pad, and the lithotripter Dornier Compact Delta II was used for lithotripsy. The extracorporeal shock wave lithotripsy was completed under the whole process of B-ultrasonic monitoring. All patients completed the surgery under ultrasound monitoring, and there were no abnormalities in the ultrasound probe during the surgery. The average stone size was 0.60 ± 0.21 cm, the surgical time was 39.8 ± 13.8 min, and the total energy of lithotripsy was 7.41 ± 4.35 J. There were no obvious complications in all patients after the surgery. After 2 weeks of ultrasound examination, the success rate of lithotripsy in 21 patients reached 85.7%. We believe that the use of the gel pad increases the distance between the ultrasonic probe and the skin, leaving the probe away from the shock wave energy field, avoiding the damage of the shock wave source to the ultrasonic probe, and does not affect the monitoring effect of ultrasound on stones and the success rate of lithotripsy, which is worthy of further promotion in the field of children's urinary stones.

Minimally invasive percutaneous nephrolithotomy in preschool age children with kidney calculi (including stones induced by melamine-contaminated milk powder).

PURPOSE: This study was undertaken to assess the safety and efficacy of minimally invasive percutaneous nephrolithotomy (mini-PCNL) using ureteroscope and pneumatic intracorporeal lithotripsy in preschool age children with kidney calculi. METHODS: We studied 27 renal units in 20 patients of preschool age (≤ 6 years) who underwent mini-PCNL at our institute. The mean age was 42.6 months (range 14-68 months). The average stone burden was 1.85 cm (range 0.9-2.8 cm). Eight patients aged 14 to 58 months had been exposed to melamine-tainted powdered formula. The mini-PCNL was performed with an X-ray-guided peripheral puncture. Minimal tract dilatation was undertaken to fit a 14-16 Fr peel-away sheath. Ureteroscope and pneumatic intracorporeal lithotripsy were used to fragment the stones. RESULTS: Complete clearance was achieved in 23 renal units (85.2 %) with mini-PCNL monotherapy. This has increased to 92.6 % after adjunctive ESWL. The average fall in hemoglobin was 1.28 g/dL. None of the patients required blood transfusion. The median length of hospital stay was 8.2 days. Patients were followed up every 6 months for 2 years. There has been only one recurrence of stone and no long-term complications. CONCLUSION: Mini-PCNL is a effective treatment for pediatric kidney stones refractory to extracorporeal shock wave lithotripsy, including stones induced by melamine-contaminated milk powder. The "mini-PCNL" technique, which uses ureteroscope and pneumatic intracorporeal lithotripsy, is a safe and feasible modality for treating renal calculi in preschool age children.

[Analysis of thyroid dysfunction and influencing factors in chronic hepatitis C patients treated with peg-IFNa-2a and ribavirin].

OBJECTIVE: To analyze the frequency of thyroid dysfunction and determine its influencing factors in chronic hepatitis C (CHC) patients treated with pegylated-interferon alpha (peg-IFNa)-2a and ribavirin (RBV) combination therapy. METHODS: A total of 194 CHC patients were treated with peg-IFNa-2a and RBV for 48 weeks. Development of thyroid dysfunction was recorded. Clinical and biological factors from pre-treatment (baseline) to post-treatment were statistically analyzed to determine correlation with thyroid dysfunction in this patient population. RESULTS: Fifty-two (26.80%) of 194 peg-IFNa-2a/RBV-treated patients developed thyroid dysfunction. Dysfunction severity ranged from hyperthyroidism (n = 1, 0.52%) and hypothyroidism (n = 10, 5.15%) to subclinical hyperthyroidism (n = 4, 2.06%) and subclinical hypothyroidism (n = 37, 19.07%). The dysfunction rate was significantly higher after peg-IFNa-2a/RBV treatment (26.80% vs. 12.37% at baseline, x2 = 12.829, P less than 0.05, odds ratio (OR) = 0.386, 95% confidence interval (CI): 0.226-0.657), in females (33.00% vs. 20.21% in males, P less than 0.05, 95% CI: 1.016-3.040), and in thyroid auto-antibody positive patients (64.29% vs. 23.89% in negative patients, P less than 0.05, 95% CI: 1.681-36.183). Early virological response did not have any significant effect on dysfunction rate (23.00% vs. 30.85% no early virological response, x2 = 1.522, P more than 0.05) nor did end of treatment response (27.19% vs. 26.25% no response at end of treatment, x2 = 0.021, P more than 0.05). Patients who developed thyroid dysfunction had higher interleukin (IL)-6 at baseline (i.e. before peg-IFNa-2a/RBV treatment) (27.08+/-14.90 vs. 11.65+/-5.46 in patients who maintained normal thyroid function, t = 3.127, P less than 0.05, 95% CI: 5.28-25.58). IL-6 levels were not significantly different between the two groups at 24 weeks (6.30+/-2.47 vs. 6.81+/-2.80, t = 0.352, P more than 0.05). IL-6 levels before and after 48 weeks of treatment in normal thyroid function patients were 27.08+/-14.90 and 6.30+/-2.47, t = 3.632, P less than 0.05, and in thyroid dysfunction patients were 11.65+/-5.46 and 6.81+/-2.80, t = 1.997, P more than 0.05. CONCLUSION: Peg-IFNa-2a/RBV combination therapy may cause thyroid dysfunction, especially hypothyroidism, in CHC patients. Female sex and thyroid auto-antibody positivity may put CHC patients at higher risk of developing thyroid dysfunction during peg-IFNa-2a/RBV therapy. Elevated IL-6 may be a predictive marker of peg-IFNa-2a/RBV-induced thyroid dysfunction.

Multidisciplinary non-surgical treatment of advanced periodontitis: A case report.

BACKGROUND: Patients with severe periodontitis often require multidisciplinary treatment to achieve healthy periodontal tissue, normal occlusion, and optimal aesthetics. In the present study, we aimed to evaluate the efficacy of multidisciplinary non-surgical treatment in a patient with stage IV/ grade C periodontitis, malocclusion, and dentition defects. CASE SUMMARY: A 47-year-old woman visited our periodontology department due to teeth mobility problems and difficulties chewing food. The patient had no history of drug allergies or systemic disease. Initial therapy involved scaling and root planning with a Gracey scaler and periodontal ultrasonic therapeutic apparatus using a periodontal endoscope (Perioscopy, Zest Dental Solutions, United States) to control the periodontal inflammation prior to treatment. Five months later, orthodontic treatment was then performed to treat occlusion and overall aesthetics. After completion, a Maryland bridge was used to restore Nos. 22, 31, and 41 teeth. Florida probing (Florida probe, United States) was performed every 2-3 mo to evaluate the periodontal condition throughout treatment. Overall, multidisciplinary non-surgical treatment resulted in satisfactory aesthetic results with healthy periodontal tissue and stable occlusion. CONCLUSION: In some patients with stage IV/grade C periodontitis, systematic and sequential non-surgical treatment can provide excellent therapeutic results.

A novel cone-beam CT scanning technique for measuring periodontal soft tissues in the esthetic area.

PURPOSE: This study investigated and tested a novel cone-beam computed tomography (CBCT) scanning technique capable of obtaining clear contours of soft tissues in the esthetic area. METHODS: Twenty-three periodontally healthy participants underwent this novel CBCT scanning technique. Soft tissue morphological parameters were measured on the CBCT images obtained. Intraoral clinical data were also collected at the same locations, and the accuracy of the CBCT method was tested. RESULTS: The median (interquartile range [IQR]) of the supracrestal gingival tissue thickness as 0.91 (0.73-1.13) mm, and the thickness of the central incisors was significantly greater than that of the canines (P < 0.05). The median (IQR) of keratinized tissue thickness was 0.73 (0.55-0.91) mm, which also showed a significantly greater thickness in the central incisors than in the canines (P < 0.05). Bland-Altman analysis suggested that CBCT could be accurate for measuring soft tissues in the esthetic area. CONCLUSION: The novel CBCT technique described yields clear contours of soft tissues in the esthetic area without the need for auxiliary tools. Moreover, measurements of soft tissue morphological parameters on CBCT appear to be accurate.

[Treatment of penile strangulation and sexual psychological analysis of the patients].

OBJECTIVE: To find the best treatment of penile strangulation and to analyze the sexual psychological factors of the patients. METHODS: We retrospectively analyzed the experiences in removing foreign objects around the penis in 21 patients aged 19 - 61 years with the strangulation time varying from 10 hours to 4 days. The objects were mostly made of metal or plastics. RESULTS: All the objects were successfully removed, 5 of them with the help of lubricant, 4 by aspirating the corpus cavernosum, 8 by shipping with pliers, 2 with the diamond-tipped dental drill, and the other 2, which virtually defied cutting, by aspirating the corpus cavernosum following degloving surgery. CONCLUSION: In removing foreign objects around the penis, simpler methods should be given precedence over more complex ones, and for those that virtually defy cutting, the best option is degloving surgery with particular attention to the survival of the penile skin flap.

Effects of a self-ligating appliance for orthodontic treatment of severe adult periodontitis.

This study was conducted to investigate the short-term effects of a self-ligating appliance for orthodontic treatment of severe adult periodontitis. Thirty patients diagnosed as severe periodontitis were recruited at Nanjing Stomatological Hospital, P. R.China, between January 2012 and January 2016. General clinical and demographic data were collected from the patients, all of whom were treated with a self-ligating appliance. Probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP) and plaque index (PI) were measured before appliance placement, and at 1 and 3 months after appliance placement, respectively. Results showed the rate of tooth loss, mean PPD, mean CAL and the BOP ratio were more favorable in healthy subjects than in the patients. Smokers accounted for a significantly higher proportion of the patients in comparison with the healthy subjects. Clinical outcomes revealed that both the mean PPD and mean CAL were significantly decreased compared with the baseline (P < 0.05). Furthermore, the percentage of BOP, PI and bone mineral density were also significantly decreased at 1 month after treatment (P < 0.05). The volume of gingival crevicular fluid, as well as the levels of alkaline phosphatase, aspartate aminotransferase and glutathione peroxidase, were significantly increased in the first month after treatment, being decreased at 2 months, and finally returning to normal in the third month. In summary, orthodontic treatment using a self-ligating appliance can apparently improve the periodontal condition of patients with severe adult periodontitis.

Evaluation of polydimethylsiloxane-based substrates for in vitro culture of human periodontal ligament cells.

Periodontal ligament (PDL) cells are regarded as the cell type with the highest potential for periodontal regeneration. Biophysical cues of the culture substrate are increasingly identified as vital parameters to affect cell behavior. Compared to traditional tissue culture polystyrene (TCPS), polydimethylsiloxane (PDMS) substrates corroborate more closely the elastic modulus values of the physiological environment. Consequently, the aim of this study was to evaluate the effect of PDMS-based substrates with different stiffness on cellular responses of human PDL cells. PDMS substrates with different stiffness were fabricated by varying the ratio of base to curing component. The influence of PDMS substrates on PDL cell spreading and cytoskeletal morphologies, motility, proliferation, stemness gene expression, and osteogenic differentiation was evaluated and compared to that on conventional TCPS. PDL cells cultured on PDMS substrates exhibited a smaller cell size and more elongated morphology, with less spreading area, fewer focal adhesions, and faster migration than cells on TCPS. Compared to TCPS, PDMS substrates promoted the rapid in vitro expansion of PDL cells without interfering with their self-renewal ability. In contrast, the osteogenic differentiation ability of PDL cells cultured on PDMS was lower in comparison to cells on TCPS. PDL cells on PDMS exhibited similar cell morphology, motility, proliferation, and self-renewal gene expression. The stiffer PDMS substrate increased the osteogenic gene expression of PDL cells compared to the soft PDMS group in one donor. These data indicate that PDMS-based substrates have the potential for the efficient PDL cell expansion.

Multiarm-polyethylene glycol-polyglutamic acid peptide dendrimer: Design, synthesis, and dissolving thrombus.

Thrombotic events affect many individuals in a number of ways, all of which can cause significant morbidity and mortality. Nattokinase (NK), as a novel thrombolytic drug, has been used for thrombolytic therapy. It not only possesses plasminogen activator activity, but also directly digests fibrin through limited proteolysis. However, it may undergo inactivation and denaturation in the harsh external environment. In this study, a multiarm-polyethylene glycol-polyglutamic acid peptide dendrimer was fabricated and used as a carrier for NK protection and delivery. Different arm numbers of polyethylene glycol-polyglutamic acid peptide dendrimers (x-PEG(G3 )x , x = 2, 4, 6, 8) were designed, prepared, and characterized by 1 H NMR and FTIR. Then, x-PEG(G3 )x were loaded with NK to form nanocomposites. Their size and morphology were determined by dynamic light scattering and transmission electron microscopy. Enzyme activity was evaluated via UV-Vis absorbance spectra, fluorescence spectra, circular dichroism spectra, and zeta potential measurements. The study reveals that the obtained x-PEG(G3 )x /NK nanocomposites possess high enzyme activity. In addition, the nanocomposites show increased viability of rat macrophage cells, and excellent thrombolysis ability in vitro and in vivo. This work establishes a multiarm-polyethylene glycol-polyglutamic acid peptide dendrimer with potential application in NK carrier and thrombolytic therapy. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 1687-1696, 2018.