The impact of different states of type 2 diabetes when stratified by baseline HbA1c on the periodontal outcomes of non-surgical periodontal treatment: A systematic review and network meta-analysis.

BACKGROUND: Type 2 diabetes mellitus (T2DM) has been considered by many studies to have a bidirectional relationship with periodontitis. This systematic review and network meta-analysis aimed to investigate the impact of different states of T2DM when stratified by baseline HbA1c on the clinical outcomes of non-surgical periodontal treatment (NSPT). METHODS: This study followed the Preferred Reporting Items for Meta-Analyses (PRISMA) guidelines and involved an electronic literature search (from inception to the 2nd of January 2023). The study included at least two groups of patients: chronic periodontitis only (No-DM) or periodontitis and well-controlled/poorly controlled type 2 diabetes mellitus (WC/PC-T2DM). Clinical outcomes included probing depth (PD) reduction, bleeding on probing reduction, and clinical attachment level (CAL) gain. Direct and indirect comparisons between groups were assessed by network meta-analysis, thus allowing us to establish a treatment ranking. RESULTS: Ten prospective cohort studies (11 data sets) were included for qualitative analysis and network meta-analysis. The data included in this study had high consistency; in addition, a funnel plot and Egger's test showed that the articles had low publication bias. Network meta-analysis showed that the effect of NSPT in the No-DM group was significantly better than the WC-T2DM group [weighted mean difference (WMD) = 0.09, 95% confidence interval (CI) (0.01, 0.18)] and the PC-T2DM group [WMD = 0.09, 95% CI (0.01, 0.18)] in terms of CAL gain and better than the PC-T2DM group [WMD = 0.15, 95% CI (0.02, 0.28)] in terms of PD reduction. According to the surface under the cumulative ranking value, the No-DM group had the highest probability of achieving the best outcome following NSPT. CONCLUSIONS: Collectively, our analyses show that T2DM exerts significant effects on the outcomes of NSPT.

[Identification of Epmedii Folium and its counterfeit leaf of Quercus variabilis].

Epmedii Folium is a commonly used traditional Chinese drug, and is beneficial for the "liver" and "kidney" s function in Chinese medicine. Recently, the origin of this drug is more complex. Most of the identification studies are emphasized on the species certified by the pharmacopoeia and other related species from the same genus of Epimedium, but few was emphasized on the counterfeit. In this paper, one counterfeit of Epmedii Folium, identified as the dried leaf of Quercus variabilis (Fam. Fagaceae), has been reported based on field investigation, comparing specimen of Epmedii Folium and Q. variabilis,using the macroscopic, microscopic and TmC methods. It is resulted that they could be identified clearly not only by the macroscopic features, such as the vein character and the tooth apex, but also by the microscopic features, such as the vascular bundles of the midrib, the non-glandular hair, the anticlinal wall of the epidermis cell and the calcium oxalate crystal. Furthermore their TLC chromatograms showed also difference. This study will give reference for the identification of Epmedii Folium and the related supervision and inspection work.

Comparison of implantation accuracy among different navigated approaches: A systematic review and network meta-analysis.

PURPOSE: Dental implants are a common method for the treatment of tooth loss, and its accuracy directly affects forward efficacy and stability. This study compared the accuracy of different modalities of dental implant placement (dynamic navigation [DN], fully guided [FG] static navigation, partially guided [PG] static navigation, and free handed [FH]) through a network meta-analysis. MATERIALS AND METHODS: This study followed the Preferred Reporting Items for Meta-Analyses (PRISMA) guidelines and conducted an electronic literature search (Inception-Oct 2, 2022). The comparison of implant accuracy in all the included randomized controlled trials (RCTs) conformed to at least one of the following: deviation at the crown of the implant, deviation at the apical portion of the implant, or angular deviation of the implant. RESULTS: Twenty-six articles were included for the qualitative analysis (17 RCTs; 3 prospective studies; 6 retrospective studies), and 17 RCTs of which were included for network meta-analysis. The data included in this study had high consistency, and the funnel plot showed that the articles had low publication bias. Compared with FH, FG and DN had higher accuracy in coronal deviation (P<0.05), and FG, DN, and PG had higher accuracy in apical deviation and angular deviation (P<0.05). According to the SUCRA value, FG had the highest accuracy in coronal deviation, while DN had the highest accuracy in apical deviation and angular deviation. CONCLUSIONS: According to the results of this literature review, the accuracy of DN, FG, and PG were higher than those of FH. DN showed the highest accuracy in terms of apical deviation and angular deviation. FG had the best control over the coronal deviation. There was no statistical difference between DN and FG in terms of accuracy. Given the limitations of the current study, further validation is required in the future.

In situ controlled release of stromal cell-derived factor-1α and antimiR-138 for on-demand cranial bone regeneration.

Bone regeneration involves complex physiological processes, which is generally regulated and controlled by multiple bioactive molecules. In situ controlled release of combined bioactive factors in a spatiotemporal sequence for adapting the demand of bone regeneration is a desired strategy. In this study, nanoparticle/hydrogel composite system was constructed by incorporating stromal cell derived factor-1α (SDF-1α) and chitosan/tripolyphosphate/hyaluronic acid/antimiRNA-138 nanoparticles (CTH/antimiR-138 NPs) in chitosan/ß-sodium glycerol phosphate (CS/GP) hydrogel for rat critical-size calvarial bone regeneration. The fast release of SDF-1α promoted the migration of mesenchymal stem cells (MSCs) for 6 d, while the sustained release of antimiR-138 from the nanoparticle/hydrogel compound enhanced the osteogenic differentiation of MSCs over 21 d. 8 weeks after surgery, calvarial specimens were evaluated by microcomputed tomography (µ-CT), histological analysis and immunohistochemistry. Comparing with blank group and hydrogel group, hydrogels incorporated with SDF-1α and/or CTH/antimiR-138 NPs significantly enhanced bone regeneration (p<0.05). In addition, the expression of collagen type-1 (COL-1), osteopontin (OPN) and osteocalcin (OCN) proteins were enhanced in the combined drug group (incorporated both SDF-1α and CTH/antimiR-138 NPs) in comparison to the hydrogel group. Our research indicated the in situ formation of NPs/hydrogel composite could provide temporal sequence-release of SDF-1α and CTH/antimiR-138 NPs for on-demand MSCs homing and cranial bone regeneration.

Comparison of Different Periodontal Healing of Critical Size Noncontained and Contained Intrabony Defects in Beagles.

BACKGROUND: Regenerative techniques help promote the formation of new attachment and bone filling in periodontal defects. However, the dimensions of intraosseous defects are a key determinant of periodontal regeneration outcomes. In this study, we evaluated the efficacy of use of anorganic bovine bone (ABB) graft in combination with collagen membrane (CM), to facilitate healing of noncontained (1-wall) and contained (3-wall) critical size periodontal defects. METHODS: The study began on March 2013, and was completed on May 2014. One-wall (7 mm × 4 mm) and 3-wall (5 mm × 4 mm) intrabony periodontal defects were surgically created bilaterally in the mandibular third premolars and first molars in eight beagles. The defects were treated with ABB in combination with CM (ABB + CM group) or open flap debridement (OFD group). The animals were euthanized at 8-week postsurgery for histological analysis. Two independent Student's t-tests (1-wall [ABB + CM] vs. 1-wall [OFD] and 3-wall [ABB + CM] vs. 3-wall [OFD]) were used to assess between-group differences. RESULTS: The mean new bone height in both 1- and 3-wall intrabony defects in the ABB + CM group was significantly greater than that in the OFD group (1-wall: 4.99 ± 0.70 mm vs. 3.01 ± 0.37 mm, P < 0.05; 3-wall: 3.11 ± 0.59 mm vs. 2.08 ± 0.24 mm, P < 0.05). The mean new cementum in 1-wall intrabony defects in the ABB + CM group was significantly greater than that in their counterparts in the OFD group (5.08 ± 0.68 mm vs. 1.16 ± 0.38 mm; P < 0.05). Likewise, only the 1-wall intrabony defect model showed a significant difference with respect to junctional epithelium between ABB + CM and OFD groups (0.67 ± 0.23 mm vs. 1.12 ± 0.28 mm, P < 0.05). CONCLUSIONS: One-wall intrabony defects treated with ABB and CM did not show less periodontal regeneration than that in 3-wall intrabony defect. The noncontained 1-wall intrabony defect might be a more discriminative defect model for further research into periodontal regeneration.

Periodontal Wound Healing by Transplantation of Jaw Bone Marrow-Derived Mesenchymal Stem Cells in Chitosan/Anorganic Bovine Bone Carrier Into One-Wall Infrabony Defects in Beagles.

BACKGROUND: This study aims to evaluate the performance of chitosan/anorganic bovine bone (C/ABB) scaffold seeded with human jaw bone marrow-derived mesenchymal stem cells (hJBMMSCs) in supporting the healing/repair of 1-wall critical-size periodontal defects. METHODS: Physical properties of the C/ABB scaffold were compared with those of the chitosan scaffold. hJBMMSCs were obtained from healthy human alveolar bone during the extraction of third molar impacted teeth. One-wall (7 × 4 mm) infrabony defects were surgically created at the bilateral mandibular third premolars and first molars in six beagles. The defects were randomly assigned to six groups and implanted with different scaffolds: 1) chitosan (C) scaffold; 2) C scaffold with hJBMMSCs (C + cell); 3) C/ABB scaffold (C/ABB); 4) C/ABB scaffold with hJBMMSCs (C/ABB + cell); 5) ABB scaffold (ABB); and 6) open flap debridement (control). The animals were euthanized 8 weeks after surgery for histologic analysis. RESULTS: The C/ABB scaffold had a porous structure and increased compressive strength. Both C/ABB and C/ABB + cell exhibited the newly formed cellular mixed-fiber cementum, woven/lamellar bone, and periodontal ligament. Cementum formation was significantly greater in group C/ABB + cell than in group C/ABB (2.64 ± 0.50 mm versus 0.91 ± 0.55 mm, P <0.05). For new bone (NB) height, group C/ABB + cell and C/ABB showed mean ± SD values of 2.83 ± 0.29 mm and 2.65 ± 0.52 mm and for NB area 8.89 ± 1.65 mm and 8.73 ± 1.94 mm(2), respectively. For NB (height and area), there was no significant difference between the two groups. CONCLUSIONS: The combination of hJBMMSCs and C/ABB scaffolds could promote periodontal repair. Future studies are expected to further optimize the combination and lead to an ideal periodontal regeneration.