A review of the literature: antibiotic usage and its relevance to the infection in periodontal flaps.

OBJECTIVE: This study aimed to investigate the systemic antibiotic usage in the perioperative period of periodontal flaps and its relevance to the infection after surgeries through reviewing the papers of the last decade. MATERIALS AND METHODS: A search was conducted for the studies of randomized clinical trials between 2005 and 2014 that reported periodontal flaps in chronic periodontitis patients. Data were extracted and the rate of the systemic antibiotic use, the infection rate after surgeries and the number needed to treat (NNT) to prevent one infected case were calculated. The impact of antibiotic use and materials used in surgeries on the infection was evaluated. RESULTS: Eighty-three trials were included. Antibiotics were used in 73.7% of the patients and 75.4% of the flaps. Infection occurred in only five flaps where enamel matrix proteins (EMD) or EMD + bone grafts were used in intrabony defects. Only 0.170% of the surgeries got infected in total. When all kinds of surgeries were included for analysis, the infection rate was 0.073% for the surgeries using antibiotics, which was lower than the infection rate 0.693% for the surgeries not using antibiotics (p < .05). The infection rate was very low in general. NNT was 203 when all the surgeries were included for analysis. Therefore, the difference of the infection rates between using antibiotics and not might lack clinical significance. CONCLUSIONS: Considering the very low incidence of the infection and the disadvantages of the systemic antibiotic use, we suggest not using systemic antibiotics in the perioperative period of periodontal flaps to prevent infection.

Deferoxamine compensates for decreases in B cell counts and reduces mortality in enterovirus 71-infected mice.

Enterovirus 71 is one of the major causative agents of hand, foot and mouth disease in children under six years of age. No vaccine or antiviral therapy is currently available. In this work, we found that the number of B cells was reduced in enterovirus 71-infected mice. Deferoxamine, a marine microbial natural product, compensated for the decreased levels of B cells caused by enterovirus 71 infection. The neutralizing antibody titer was also improved after deferoxamine treatment. Furthermore, deferoxamine relieved symptoms and reduced mortality and muscle damage caused by enterovirus 71 infection. This work suggested that deferoxamine has the potential for further development as a B cell-immunomodulator against enterovirus 71.

Dysregulation of lncRNA TFAP2A-AS1 is involved in the pathogenesis of pulpitis by the regulation of microRNA-32-5p.

OBJECTIVE: This study was designed to evaluate TFAP2A-AS1 expression in the dental pulp of teeth with or without pulpitis and to determine the function of TFAP2A-AS1 in pulp cells. METHODS: GSE92681 was analyzed to filter out differentially expressed lncRNAs. Pulp samples from teeth with pulpitis and healthy teeth (control) were examined using real-time (RT) quantitative polymerase chain reaction (qPCR). Human dental pulp stem cells (hDPSCs) were cultured in a specific medium for osteogenic induction, or treated with lipopolysaccharide (LPS) to simulate inflammation. The viability and apoptosis of human DPSCs (hDPSCs) were determined by XTT assay and apoptosis detection kit. Inflammation was induced by LPS and assessed by measuring the expression and release of inflammatory cytokines after TFAP2A-AS1 knockdown. Osteogenic differentiation of hDPSCs was investigated by determining expression levels of osteogenic markers and alkaline phosphatase (ALP) activity after TFAP2A-AS1 overexpression. The downstream microRNA (miRNA) was predicted. Dual-luciferase reporter was used to confirm the binding between miR-32-5p and TFAP2A-AS1. RESULTS: The expression of TFAP2A-AS1 was evaluated in inflamed pulp using RT-qPCR. TFAP2A-AS1 had a discriminatory ability for healthy individuals and patients with pulpitis. The expression of TFAP2A-AS1 decreased upon the osteogenic differentiation of hDPSCs, and increased upon the LPS induction. TFAP2A-AS1 can reverse the osteogenic differentiation of hDPSCs, as evidenced by decreased levels of dentine sialophosphoprotein, dentin matrix protein-1, and ALP activity. TFAP2A-AS1 knockdown can promote cell proliferation of hDPSCs and relieve LPS-induced inflammation, as evidenced by decreased levels of TNF-α, IL-1ß, and IL-6. miR-32-5p was identified as a downstream miRNA of TFAP2A-AS1. CONCLUSION: This study demonstrated the expression and potential function of TFAP2A-AS1 in the human dental pulp. TFAP2A-AS1 can inhibit odontogenic differentiation but promote inflammation in pulp cells.

Polyethylene and polypropylene microplastics reduce chemisorption of cadmium in paddy soil and increase its bioaccessibility and bioavailability.

Microplastics (MPs) usually coexist with heavy metals (HMs) in soil. MPs can influence HMs mobility and bioavailability, but the underlying mechanisms remain largely unexplored. Here, polyethylene and polypropylene MPs were selected to investigate their effects and mechanisms of sorption-desorption, bioaccessibility and bioavailability of cadmium (Cd) in paddy soil. Batch experiments indicated that MPs significantly reduced the Cd sorption in soil (p < 0.05). Accordingly, soil with the MPs had lower boundary diffusion constant of Cd (C1= 0.847∼1.020) and the Freundlich sorption constant (KF = 0.444-0.616) than that without the MPs (C1 = 0.894∼1.035, KF = 0.500-0.655). X-ray diffraction, X-ray photoelectron spectroscopy and Fourier transform infrared spectroscopy analyses suggested that the MPs reduced Cd chemisorption, by covering the soil active sites and thus blocking complexation of Cd with active oxygen sites and interrupting the formation of CdCO3 and Cd3P2 precipitates. Such effects of MPs enhanced about 1.2-1.5 times of Cd bioaccessibility and bioavailability in soil. Almost the same effects but different mechanisms of polyethylene and polypropylene MPs on Cd sorption in the soil indicated the complexity and pervasiveness of their effects. The findings provide new insights into impacts of MPs on the fate and risk of HMs in agricultural soil.

Improved bio-electricity production in bio-electrochemical reactor for wastewater treatment using biomass carbon derived from sludge supported carbon felt anode.

Microbial fuel cell (MFC), a promising bio-electrochemical reactor could decompose organics in wastewater by redox processes of electro-active microorganism in anode and produce bio-energy, and the total MFC performance could mainly rely on electrochemical performance anode. Here, biomass carbon derived from municipal sludge was employed as low-cost and high-performance bio-anode for enhancing bioelectricity generation and wastewater treatment in MFC simultaneously. The electrochemical tests demonstrated that the large electrochemical active surface area, strong conductivity, and good biocompatibility in sludge carbon (SC) electrode resulted in higher power density (615.2 mW m-2) and lower power loss (5.4%) than those of none carbon (NC) electrode in long term operation. After 30-cycle of continuous running, the low loss of chemical oxygen demand (COD) removal was achieved up to 5.2%, which was smaller than that of NC electrode (14.1%), indicating that the MFC with SC anode could effectively treat wastewater and keep stable redox processes in anode electrode. After the formation of biofilm, the charge transfer resistance of SC electrode (16.38 Ω) was 72.4% lower than that of NC electrode (59.35 Ω). High-throughput analysis of biofilm exhibit Proteobacteria was the dominant electro-active bacteria, and the modification of SC could slightly change the bacterial community. Therefore, resource utilization of natural wastes provided the novel concept of anode catalyst fabrication for MFC in enhancing electron transfer, power output and wastewater decomposition.

Cone-beam computed tomography performance in measuring periodontal bone loss.

The present study aimed to evaluate the performance of cone-beam computed tomography (CBCT) in assessing periodontal bone loss. If effective, CBCT could potentially be a more comfortable and accurate way to evaluate this disease. One hundred and eighty tooth sites from 13 patients were included. Clinical attachment level (CAL) was measured, then CBCT images were acquired prior to periodontal surgery. Three periodontists measured the distance between the cemento-enamel junction and alveolar bone crest at the mesio-buccal, mid-buccal, disto-buccal, mesio-lingual/palatal, mid-lingual/palatal, and disto-lingual/palatal sites. Comparisons of measurements were made among three methods. Inter-observer and intra-observer variances were also analyzed. Statistically significant differences were found between CBCT and CAL + 2.04 mm (P = 0.000), as well as intra-surgical evaluation (P = 0.001). All sites showed differences in CBCT versus intra-surgical measurement and versus CAL + 2.04 comparisons, except the buccal sites (P = 0.187 and 0.147, respectively). This study indicates that the results of CBCT do not agree with results of intra-surgical measurement. As a result, CBCT should be used with caution and only when necessary, to avoid radiation hazards.

Enhanced activity of macrophage M1/M2 phenotypes in periodontitis.

OBJECTIVE: Monocytes/macrophages play a key role in mobilizing host defense against microbial infection. The selectivity of gene expression can turn macrophages into M1- or M2-type and the plasticity and differentiation of both M1 and M2 macrophages may play important roles in the development of periodontal disease. Our research aimed to study the association between the ratio of M1/M2 macrophage and inflammatory cytokines IL-1ß, MMP-9, and investigate the expressions of M1-and M2-type macrophages in gingivitis and chronic periodontitis. METHODS: Forty specimens were collected from gingivitis individuals (n=20) and chronic periodontitis (n=20). Probing depth (PD), clinical attachment level (CAL), plaque index (PI) and bleeding on probing (BOP) were recorded. The expressions of M1- and M2-type macrophages are detected with immunohistochemical method and the relative expressions of M1-, M2-type macrophage, IL-1ß and MMP-9 were assayed using real-time polymerase chain reactions. RESULTS: The M1 and M2 peptide were mainly observed in the cytoplasm of gingival connective tissue. The ratio of M1/M2 was significant higher in chronic periodontitis group compared with that in gingivitis one. In addition, the relative expressions of IL-1ß and MMP-9 also increased in periodontitis group and was correlated with the ratios of M1/M2. Meanwhile, PD was positively correlated with ratios of M1/M2. CONCLUSIONS: Periodontal inflammation associates with an enhancement of ratio of M1/M2 phenotypes of macrophages. M1/M2 ratio could provide useful information on the periodontal tissue health status.

Organic composite-mediated surface coating of human acellular bone matrix with strontium.

Acellular bone matrix (ACBM) provides an osteoconductive scaffold for bone repair, but its osteoinductivity is poor. Strontium (Sr) improves the osteoinductivity of bone implants. In this study, we developed an organic composite-mediated strontium coating strategy for ACBM scaffolds by using the ion chelating ability of carboxymethyl cellulose (CMC) and the surface adhesion ability of dopamine (DOPA). The organic coating composite, termed the CMC-DOPA-Sr composite, was synthesized under a mild condition, and its chemical structure and strontium ion chelating ability were then determined. After surface decoration, the physicochemical properties of the strontium-coated ACBM (ACBM-Sr) scaffolds were characterized, and their biocompatibility and osteoinductivity were determined in vitro and in vivo. The results showed that the CMC-DOPA-Sr composite facilitated strontium coating on the surface of ACBM scaffolds. The ACBM-Sr scaffolds possessed a sustained strontium ion release profile, exhibited good cytocompatibility, and enhanced the osteogenic differentiation of mesenchymal stem cells in vitro. Furthermore, the ACBM-Sr scaffolds showed good histocompatibility after subcutaneous implantation in nude mice. Taken together, this study provided a simple and mild strategy to realize strontium coating for ACBM scaffolds, which resulted in good biocompatibility and improved osteoinductivity.

[FABRICATION AND BIOCOMPATIBILITY EVALUATION OF POLYURETHANE- ACELLULAR MATRIX COMPOSITE SCAFFOLD IN VITRO AND IN VIVO].

OBJECTIVE: To prepare a composite scattold using bladder acellular matrix (BACM) and polyurethane (PU) for bladder repair and regeneration, and to evaluate its mechanical properties and biocompatibility. METHODS: Fresh bladder tissues were obtained from New Zealand rabbits and then treated with 1%SDS and 1%Triton X-100 to obtain BACM. The BACM was combined with PU to fabricate PU-BACM composite scaffold. The tensile strength and elongation at break of BACM and PU-BACM scaffolds were tested. Scaffolds and extracts of scaffolds were prepared to evaluate the biocompatibility. For cell-proliferation analysis, cell counting kit 8 method was used at 1, 3, 5, and 7 days after co-culture of human. bladder smooth muscle cell (HBSMC) and scaffolds. The cell cycle was tested by flow cytometry after HBSMC co-cultured with extracts of scaffolds and DMEM culture medium (control group) for 24 hours. Finally, 12 New Zealand rabbits were used to establish the model of bladder repair and regeneration. Incision of 5 mm was made on the bladder, and PU-BACM scaffold was sutured with the incision. The rabbits were sacrificed at 10, 20, 40, and 60 days after surgery to observe the inflammatory cell infiltration, new tissues formation, and regeneration of epithelium by HE staining. RESULTS: The tensile strength of BACM and PU-BACM composite scaffold was (5.78 ± 0.85) N and (11.88 ± 3.21) N, and elongation at break was 14.46% ± 3.21% and 23.14% ± 1.32% respectively, all showing significant diffeence (t = 3.182, P = 0.034; t = 4.332, P = 0.012). The cell-proliferation rates of controls, PU, BACM, and PU-BACM were 36.78% ± 1.21%, 30.49% ± 0.89%, 18.92% ± 0.84%, and 22.42% ± 1.55%, it was significantly higher in PU-BACM than BACM (P < 0.05). In the bladder repair and regeneration experiment, inflammatory cell infiltration was observed at 10 days after operation, and reduced at 20 days after implantation. In the meanwhile, the degradation of scaffolds was observed in vivo. The regeneration of epithelium could be observed after 40 days of implantation. At 60 days after implantation, in situ bladder tissue formed. CONCLUSION: PU-BACM composite scaffold has higher mechanical properties and better biocompatibility than BACM scaffold. PU-BACM composite scaffold will not lead to strong immune response, and new bladder tissue can form in the in vivo rabbit bladder repair experiment. These results can provide research basis and theoretical data for further study.

Tissue engineered esophagus scaffold constructed with porcine small intestinal submucosa and synthetic polymers.

Acellular porcine small intestinal submucosa (SIS) has been successfully used for reconstructing esophagus with half circumferential defects. However, repairing full circumferential esophageal defects with SIS has been restricted due to the latter's poor mechanical properties. In the present study, synthetic polyesters biomaterial poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHHx) and poly(lactide-co-glycolide) (PLGA) have been used to improve the mechanical properties of SIS. Feasibility of SIS/PHBHHx-PLGA composite material scaffold for esophageal tissue engineering has been assessed through a series of testing. The appropriate mixing ratio of PHBHHx and PLGA polymers has been determined as 5:5 by mechanical testing and in vitro degradation experiment. The morphology of constructed membranous and tubular scaffolds was also characterized. As confirmed by enzyme-linked immunosorbent assay, the contents of VEGF and TGF-ß have respectively reached 657 ± 18 ng mL(-1) and 130 ± 4 pg mL(-1) within the SIS/PHBHHx-PLGA specimens. Biocompatibility of the SIS/PHBHHx-PLGA specimens with rat bone marrow mesenchymal stem cells (MSCs) was also evaluated by scanning electron microscopy and a live-dead cell viability assay. Actin filaments of MSCs on the composite materials were labeled. Biological safety of the extract from SIS/PHBHHx-PLGA specimens, measured as hemolysis rate, was all lower than 5%. Compared with SIS and SIS/PHBHHx-PLGA specimens, inflammatory reaction provoked by the PHBHHx-PLGA specimens in rats was however more severe. Our results have suggested that SIS/PHBHHx-PLGA composite material can offer a new approach for esophageal tissue engineering.

[Effect of staple on growth rate of vertebral growth plates in goat scoliosis].

OBJECTIVE: To further investigate the possible mechanism of the correction of scoliosis with Staple by quantifying the effect of Staple on growth rate of vertebral growth plates in goat scoliosis. METHODS: Experimental scoliosis was created in 10 juvenile female goats by using unilateral pedicle screws asymmetric tethering. After 8-10 weeks, goats were divided randomly into Staple treated group (n=5) and control group (n=5). All tethers were removed in both groups and Staple group underwent anterior vertebral stapling with 4-5 shape memory alloy Staples along the convexity of the maximal curvature after posterior tether being removed. All goats were observed for an additional 8-13 weeks, the Cobb angle were measured to observe the correction of scoliosis. The fluorochromes Oxytetracycline and Calcein were administered respectively 18 and 3 days before death to label the ossifying front under the growth plates. Superior intervertebral disc of apical vertebra and two adjacent growth plates were completely harvested in all goats. All specimens were embedded with polymethyl methacrylate and sliced undecalcified. The growth rates of the vertebral growth plates were calculated by measuring the distance between the two fluorescent lines with fluorescence microscope. RESULTS: Nine (5 in Staple treated group and 4 in control group) of 10 tethered goats had progressive scoliotic curves of significant magnitude after 8-10 weeks of tethering. In Staple treated group, the Cobb angles were (34.8 +/- 12.4) degrees at the instant after treatment, and (15.6 +/- 11.7) degrees 8-13 weeks after treatment; showing statistically significant difference (P < 0.05). In the control group, the Cobb angles were (49.3 +/- 18.0) degrees at the instant after treatment, and (49.0 +/- 17.6) degrees 8-13 weeks after treatment; showing no statistically significant difference (P > 0.05). In Staple treated group, the growth rate of growth plate in the concavity (3.27 +/- 0.96) microm/d was higher than that in convexity (1.84 +/- 0.52) microm/d (P < 0.05), while the growth rate of the concavity did not differ significantly from that of the convexity in control group (P > 0.05). CONCLUSION: Staple can significantly alter the growth rates of two sides of vertebrae in scoliosis with the growth rate of concavity exceeding the one of convexity, which results in correction of deformity.