Surgical management and final outcomes of chondrosarcoma of the temporomandibular joint: case series and comprehensive literature review.

BACKGROUND: Surgical management for chondrosarcoma of the temporomandibular joint (TMJ) is challenging due to the anatomical location involving the facial nerve and the functional joint. The purpose of this case series was to analyze the largest number of TMJ chondrosarcoma cases reported from a single institution and to review the literature about chondrosarcoma involving the TMJ. METHODS: Ten TMJ chondrosarcoma patients at Seoul National University Dental Hospital were included in this study. Radiographic features, surgical approaches, histopathologic subtypes, and treatment modalities were evaluated. All case reports of TMJ chondrosarcoma published in English from 1954 to 2021 were collected under PRISMA guidelines and comprehensively reviewed. RESULTS: The lesions were surgically resected in all 10 patients with efforts to preserve facial nerve function. Wide excision including margins of normal tissue was performed to ensure adequate resection margins. All TMJs were reconstructed with a metal condyle except one, which was reconstructed with vascularized costal bone. At last follow-up, all patients were still alive, and there had been no recurrence. Among 47 cases (patients from the literature and our cases), recurrence was specified in 43 and occurred in four (9.5%). CONCLUSIONS: For surgical management of TMJ chondrosarcoma, wide excision must consider preservation of the facial nerve. Reconstruction using a metal condyle prosthesis and a vascularized free flap is reliable. A more conservative surgical approach correlates with a favorable prognosis for facial nerve recovery. Nevertheless, wide excision is imperative to prevent tumor recurrence. In cases in which the glenoid fossa is unaffected by the tumor, it is deemed unnecessary to reconstruct the glenoid fossa within an oncological setting.

Classification of Skeletal Phenotypes of Adult Patients With Cleft Skeletal Class III Malocclusion Using Principal Component Analysis and Cluster Analysis.

The purpose of this study was to classify the skeletal phenotypes of adult patients with skeletal class III (C-III) malocclusion and unilateral or bilateral cleft lip and palate using principal component analysis and cluster analysis. The samples consisted of 81 adult C-III patients with cleft lip and palate (CLP) who underwent orthognathic surgery (OGS) or distraction osteogenesis (59 males and 22 females; 50 unilateral cleft lip and palate and 31 bilateral cleft lip and palate; mean age when lateral cephalograms were taken, 22.2±4.6 y). Thirteen angular and one ratio cephalometric variables were measured. Using 4 representative variables obtained from principal component analysis (SNA, SNB, Gonial angle, and Bjork sum), K-means cluster analysis was performed to classify the phenotypes. Then, statistical analysis was conducted to characterize the differences in the variables among the clusters. Five clusters were obtained from 3 groups: severely retrusive maxilla and moderately retrusive mandible group: cluster-1 (23.5%, severely hyperdivergent pattern), cluster-4 (27.2%, moderately hyperdivergent pattern), and cluster-5 (11.1%, normodivergent pattern); moderately retrusive maxilla and normal mandible group: cluster-2 (30.9%, normodivergent pattern); normal maxilla and moderately protrusive mandible group: cluster-3 (7.4%, normodivergent pattern). Although skeletal phenotypes were diverse, distribution of sex and cleft type did not differ among 5 clusters ( P >0.05). Sixty-two percent of cleft patients showed a severely retrusive maxilla and moderately retrusive mandible (cluster-1, cluster-4, and cluster-5), which indicated that these are the main cause of skeletal C-III malocclusion in CLP patients who were treated with OGS. Therefore, it is necessary to consider presurgical orthodontic treatment and surgical planning based on the skeletal phenotypes of CLP patients.

Facial Asymmetry Phenotypes in Adult Patients With Unilateral Cleft Lip and Palate and Skeletal Class III Malocclusion Using Principal Component Analysis and Cluster Analysis.

The purpose of this study was to classify and characterize facial asymmetry (FA) phenotypes in adult patients with unilateral cleft lip and palate (UCLP) and skeletal class III malocclusion. The samples comprised 52 adult UCLP patients (36 men and 16 women; mean age, 22.43 y) who had undergone orthognathic surgery for correction of class III malocclusion. After measurement of 22 cephalometric parameters in posteroanterior cephalograms taken 1 month before orthognathic surgery, principal component analysis was performed to obtain 5 representative parameters [deviation (mm) of ANS (ANS-dev), maxillary central incisor contact point (Mx1-dev), and menton (Me-dev); cant (degree) of the maxillary anterior occlusal plane (MxAntOP-cant) and mandibular border (MnBorder-cant)]. K-means cluster analysis was conducted using these representative parameters. The differences in cephalometric parameters among the clusters were statistically analyzed. The FA phenotypes were classified into 4 types: No-cant-and-No-deviation type (cluster-4, n=16, 30.8%); MxMn-cant-MxMn-dev to the cleft-side type (cluster-3, n=4, 7.7%); Mx-cant-Mn-shift to the cleft-side type (cluster-2, n=15, 28.8%); and Mn-cant-Mn-dev to the noncleft-side type (cluster-1, n=17, 32.7%). Asymmetry in the maxilla and/or mandible were observed in 70% of patients. One third of patients (cluster-2 and cluster-3; sum, 36.5%) exhibited significant cant of MxAntOP induced by cleft and cant or shift of the mandible to the cleft side. Another one third of patients (cluster-1, 32.7%) demonstrated significant deviation and cant of the mandible to the noncleft-side despite cleft in the maxilla. This FA phenotype classification might be a basic guideline for diagnosis and treatment planning for UCLP patients.

PFK activation is essential for the odontogenic differentiation of human dental pulp stem cells.

Dental pulp stem cells (DPSCs) can differentiate into diverse cell lineages, including odontogenic cells that are responsible for dentin formation, which is important in pulp repair and tooth regeneration. While glycolysis plays a central role in various cellular activities in both physiological and pathological conditions, its role and regulation in odontogenic differentiation are unknown. Here, we show that aerobic glycolysis is induced during odontoblastic differentiation from human DPSCs. Importantly, we demonstrate that during odontoblastic differentiation, protein expression levels of phosphofructokinase 1 muscle isoform (PFKM) and PFK2, but not other glycolytic enzymes, are mainly upregulated by AKT activation, resulting in increased total PFK enzyme activity. Increased PFK activity is essential to enhance aerobic glycolysis, which plays an important role in the odontoblastic differentiation of human DPSCs. These findings underscore that PFK activation-induced aerobic glycolysis accompanies, and participates in, human DPSCs differentiation into odontogenic lineage, and could play a role in the regulation of dental pulp repair.

Factors Affecting Functional Sensory Recovery After Inferior Alveolar Nerve Repair Using the Nerve Sliding Technique.

PURPOSE: The nerve sliding technique (NST) was introduced for repairing inferior alveolar nerve (IAN) defect and overcoming the disadvantages of conventional surgical treatment methods such as nerve graft. This study was conducted to identify factors associated with functional sensory recovery (FSR) following inferior alveolar nerve repair using the NST. PATIENTS AND METHODS: This was a retrospective cohort study including all patients who underwent IAN repair using the NST at Seoul National University Dental Hospital, Department of Oral and Maxillofacial Surgery from February 2009 to March 2020. The damaged part of the IAN was excised, and the incisive branch was transected intentionally to perform direct anastomosis without tension. Cox proportional hazard analysis was utilized to determine the relationships between predictor variables (age, gender, chief complaints, preoperative sensory results, duration from injury to repair, length of nerve tissue resected during the procedure, and neuroma formation) and outcome variable (time to FSR). RESULTS: The sample was composed of 16 patients with a mean age of 56.1 ± 10.1 years, 25% were males and 75% were females. The mean nerve gap deficit was 7.69 mm (3-15 mm). Ten patients (62.5%) achieved FSR with a median time from operative treatment to FSR of 84.5 days. Dental implant placement was found as the main cause for IAN injury (93.8%) and 56.2% of patients complained of hypoesthesia and dysesthesia. Factors associated with time to FSR at 1 year were age, chief complaint, and early repair. Younger patients (P = .041) and patients without dysesthesia (P = .019) were more likely to achieve FSR. Higher proportion of early repair group achieved FSR, although not statistically significant (P = .068). CONCLUSIONS: The use of NST in repair of IAN defects up to 15 mm achieved 62.5% FSR. Younger age and absence of dysesthesia were associated with higher FSR.

Three-Dimensional Facial Soft Tissue Changes After Orthognathic Surgery in Cleft Patients Using Artificial Intelligence-Assisted Landmark Autodigitization.

ABSTRACT: The purpose of this study was to investigate three-dimensional facial soft tissue changes after bimaxillary orthognathic surgery (BOGS) in patients with cleft lip and palate. The samples consisted of 34 Korean young adult patients with skeletal class III malocclusion who underwent BOGS for maxillary advancement/posterior impaction and mandibular setback. They were divided into cleft-class III (C-CIII) group (n = 18) and noncleft-class III (NC-CIII) group (n = 16). Three-dimensional computed tomography images were taken 1 month before (T1) and 3 months after (T2) surgery. After 34 hard/soft tissue landmarks were automatically identified using software, the amount and direction of change in landmarks and the amount of change in 16 soft tissue variables during T1-T2 were calculated. Then, statistical analysis was performed. Compared to NC-CIII group, C-CIII group showed more posteriorly-positioned hard/soft tissue landmarks, larger alar width, alar base width and philtrum width, and more obtuse nasal tip angle at both T1 and T2 stages. C-CIII group exhibited higher soft-to-hard tissue movement ratios at the bottom of the nose (ΔSn/ΔANS, 1.08 versus 0.81) and the upper part of the upper lip (ΔPoint A'/ΔPoint A, 1.08 versus 0.91), but a lower ratio at the lower part of the upper lip (ΔLs'/ΔIs, 0.72 versus 1.01) than NC-CIII group. The number of hard-soft tissue landmarks with high correlation (>0.90) was smaller in C-CIII group than in NC-CIII group (2 versus 6). Scar tissues and abnormal muscles in the nose and upper lip might elicit different responses in the nasolabial soft tissues to BOGS between C-CIII and NC-CIII patients.

NELL-1 Increased the Osteogenic Differentiation and mRNA Expression of Spheroids Composed of Stem Cells.

Background and objectives: NELL-1 is a competent growth factor and it reported to target cells committed to the osteochondral lineage. The secreted, osteoinductive glycoproteins are reported to rheostatically control skeletal ossification. This study was performed to determine the effects of NELL-1 on spheroid morphology and cell viability and the promotion of osteogenic differentiation of stem cell spheroids. Materials and Methods: Cultures of stem cell spheroids of gingiva-derived stem cells were grown in the presence of NELL-1 at concentrations of 1, 10, 100, and 500 ng/mL. Evaluations of cell morphology were performed using a microscope, and cell viability was assessed using a two-color assay and Cell Counting Kit-8. Evaluation of the activity of alkaline phosphatase and calcium deposition assays involved anthraquinone dye assay to determine the level of osteogenic differentiation of cell spheroids treated with NELL-1. Real-time quantitative polymerase chain reaction (qPCR) was used to evaluate the expressions of RUNX2, BSP, OCN, COL1A1, and ß-actin mRNAs. Results: The applied stem cells produced well-formed spheroids, and the addition of NELL-1 at tested concentrations did not show any apparent changes in spheroid shape. There were no significant changes in diameter with addition of NELL-1 at 0, 1, 10, 100, and 500 ng/mL concentrations. The quantitative cell viability results derived on Days 1, 3, and 7 did not show significant disparities among groups (p > 0.05). There was statistically higher alkaline phosphatase activity in the 10 ng/mL group compared with the unloaded control on Day 7 (p < 0.05). A significant increase in anthraquinone dye staining was observed with the addition of NELL-1, and the highest value was noted at 10 ng/mL (p < 0.05). qPCR results demonstrated that the mRNA expression levels of RUNX2 and BSP were significantly increased when NELL-1 was added to the culture. Conclusions: Based on these findings, we conclude that NELL-1 can be applied for increased osteogenic differentiation of stem cell spheroids.

Elucidating the Trade-off between Membrane Wetting Resistance and Water Vapor Flux in Membrane Distillation.

Membrane distillation (MD) has been receiving considerable attention as a promising technology for desalinating industrial wastewaters. While hydrophobic membranes are essential for the process, increasing membrane surface hydrophobicity generally leads to the reduction of water vapor flux. In this study, we investigate the mechanisms responsible for this trade-off relation in MD. We prepared hydrophobic membranes with different degrees of wetting resistance through coating quartz fiber membranes with a series of alkylsilane molecules while preserving the fiber structures. A trade-off between wetting resistance and water vapor flux was observed in direct-contact MD experiments, with the least-wetting-resistant membrane exhibiting twice as high vapor flux as the most wetting-resistant membrane. Electrochemical impedance analysis, combined with fluorescence microscopy, elucidated that a lower wetting resistance (still water-repelling) allows deeper penetration of the liquid-air interfaces into the membrane, resulting in an increased interfacial area and therefore a larger evaporative vapor flux. Finally, we performed osmotic distillation experiments employing anodized alumina membranes that possess straight nanopores with different degrees of wetting resistance, observed no trade-off, and substantiated this proposed mechanism. Our study provides a guideline to tailor the membrane surface wettability to ensure stable MD operations while maximizing the water recovery rate.

Fracture of Standard Titanium Mandibular Reconstruction Plates and Preliminary Study of Three-Dimensional Printed Reconstruction Plates.

PURPOSE: A cohort review was performed to compare the effect of a number of variables on mandible reconstruction plate (R-plate) survival and to identify the potential risk factors for plate fracture. We also reported our preliminary results of 3-dimensional (3D) printed reconstruction plates. PATIENTS AND METHODS: The data from patients who had undergone mandibular reconstruction using reconstruction plates were evaluated for age, gender, mandibular resection indication, defect site and length, remaining occluded teeth, reconstruction plate type, simultaneous soft or bone tissue reconstruction, and radiotherapy. The plate survival rate was estimated using the Kaplan-Meier curve, and the variables were compared using the log-rank (Mantel-Cox) test. Multifactorial risk correlation was determined using logistic regression analysis. RESULTS: The study included 159 patients who had been followed for 97 ± 5.4 months. Of the 159 patients, 22 had experienced plate fracture that had occurred within 20 months. Most of the plate fractures had occurred near the mandibular bone stump, passing through the shoulder of the plate hole or the bridge between the subsequent plate holes. The overall survival was 86.2%. Patients with few occluded teeth (type I) had a significantly greater R-plate survival rate compared with those with many occluded teeth (P = .045). Laterocentral "LC" defects had a significantly lower survival rate (44.4%) compared with lateral "L" defects (84.5%; P = .00). The survival rates with soft tissue (88.7%) or bone tissue reconstruction (100%) were significantly different compared with that for R-plate alone (40%; P = .000 and P = .004, respectively). Four patients received 3D printed R-plates and were followed for 2 to 8 months (mean, 4 months) with no complications. CONCLUSIONS: Patients with many remaining occluded teeth, LC defect, and the absence of simultaneous soft or bone tissue reconstruction were associated with a lower plate survival rate. Bending of the plate increased the incidence of plate fracture, and the use of 3D printed customized R-plates seems a valuable alternative.

3D-Printed Ceramic Bone Scaffolds with Variable Pore Architectures.

This study evaluated the mechanical properties and bone regeneration ability of 3D-printed pure hydroxyapatite (HA)/tricalcium phosphate (TCP) pure ceramic scaffolds with variable pore architectures. A digital light processing (DLP) 3D printer was used to construct block-type scaffolds containing only HA and TCP after the polymer binder was completely removed by heat treatment. The compressive strength and porosity of the blocks with various structures were measured; scaffolds with different pore sizes were implanted in rabbit calvarial models. The animals were observed for eight weeks, and six animals were euthanized in the fourth and eighth weeks. Then, the specimens were evaluated using radiological and histological analyses. Larger scaffold pore sizes resulted in enhanced bone formation after four weeks (p < 0.05). However, in the eighth week, a correlation between pore size and bone formation was not observed (p > 0.05). The findings showed that various pore architectures of HA/TCP scaffolds can be achieved using DLP 3D printing, which can be a valuable tool for optimizing bone-scaffold properties for specific clinical treatments. As the pore size only influenced bone regeneration in the initial stage, further studies are required for pore-size optimization to balance the initial bone regeneration and mechanical strength of the scaffold.

Bone Regeneration Capability of 3D Printed Ceramic Scaffolds.

In this study, we evaluated the bone regenerative capability of a customizable hydroxyapatite (HA) and tricalcium phosphate (TCP) scaffold using a digital light processing (DLP)-type 3D printing system. Twelve healthy adult male beagle dogs were the study subjects. A total of 48 defects were created, with two defects on each side of the mandible in all the dogs. The defect sites in the negative control group (sixteen defects) were left untreated (the NS group), whereas those in the positive control group (sixteen defects) were filled with a particle-type substitute (the PS group). The defect sites in the experimental groups (sixteen defects) were filled with a 3D printed substitute (the 3DS group). Six dogs each were exterminated after healing periods of 4 and 8 weeks. Radiological and histomorphometrical evaluations were then performed. None of the groups showed any specific problems. In radiological evaluation, there was a significant difference in the amount of new bone formation after 4 weeks (p < 0.05) between the PS and 3DS groups. For both of the evaluations, the difference in the total amount of bone after 8 weeks was statistically significant (p < 0.05). There was no statistically significant difference in new bone between the PS and 3DS groups in both evaluations after 8 weeks (p > 0.05). The proposed HA/TCP scaffold without polymers, obtained using the DLP-type 3D printing system, can be applied for bone regeneration. The 3D printing of a HA/TCP scaffold without polymers can be used for fabricating customized bone grafting substitutes.

Effects of Chewing Exerciser on the Recovery of Masticatory Function Recovery after Orthognathic Surgery: A Single-Center Randomized Clinical Trial, a Preliminary Study.

Background and Objectives: The aim of this study was to evaluate the effects of the chewing exerciser (CE) on the functional recovery of the masticatory muscles after orthognathic surgery. Material and Methods: This randomized clinical trial was conducted in patients undergoing bimaxillary orthognathic surgery including bilateral sagittal split ramus osteotomy. Postoperative physiotherapy (PT) was performed for 3 weeks starting 3 weeks after the surgery. The patients were randomly divided into two groups: control (Con) (conventional PT) group and CE group (use of CE in addition to conventional PT). The masticatory function was evaluated based on three standards: bite force (BF), amount of mouth opening (MO), and surface electromyography (sEMG) of the anterior temporal muscle (TA), masseter muscle (MM), sternocleidomastoid muscle, and anterior belly of digastric muscle before, 3 weeks (before PT) and 6 weeks after the surgery (after PT). Results: Finally, 22 subjects participated in this study: 10 patients for Con group and 12 patients for CE group. In both groups, the BF, which was reduced significantly after the surgery, recovered after the PT similar to that before the surgery. In both groups, the MO was also significantly reduced by the surgery. However, it did not recover as much, as it was before the surgery after applying the PT. There was no difference in BF and MO between the two groups. All muscles did not show significant changes in sEMG by surgery and PT at both resting and clenching states. Conclusion: Applying CE as a PT after orthognathic surgery did not cause any harmful side effects. In both groups, the weakened muscle activity after orthognathic surgery (OGS) was adequately restored 6 weeks after the surgery. However, CE did not offer a statistically significant benefit to the masticatory function in the recovery process after OGS.

The effect of CPNE7 on periodontal regeneration.

Introduction: Preameloblast-conditioned medium (PA-CM), as a mixture of dental epithelium-derived factors, has been reported to regenerate dentin and periodontal tissues in vitro and in vivo. The aim of this study was to investigate the biological effect of Cpne7 on the proliferation, migration, and cementoblast differentiation of periodontal cells in vitro, and on the regeneration of periodontal tissue using periodontal defect model with canine in vivo. Materials and methods: The effect of Cpne7 on cell proliferation, migration, and cementoblast differentiation of periodontal cells were evaluated in vitro. A periodontal defect canine model was designed and the defects were divided into five groups: Group 1: No treatment (negative control), Group 2: Collagen carrier only, Group 3: PA-CM with collagen carrier (positive control), Group 4: PA-CM + CPNE7 Antibody (Ab) with collagen carrier, and Group 5: recombinant CPNE7 (rCPNE7) protein with collagen carrier. Results: Cpne7 was expressed in HERS cells and periodontal ligament (PDL) fibers. By real-time PCR, Cpne7 increased expression of Cap compared to the control. In the periodontal defect canine model, rCPNE7 or PA-CM regenerated periodontal complex, and the arrangement of the newly formed PDL-like fibers were perpendicular to the newly formed cementum and alveolar bone like Sharpey's fibers in natural teeth, while PA-CM + CPNE7 Ab showed irregular arrangement of the newly formed PDL-like fibers compared to the rCPNE7 or PA-CM group. Conclusion: These findings suggest that Cpne7 may have a functional role in periodontal regeneration by supporting periodontal cell attachment to cementum and facilitating physiological arrangement of PDL fibers.

Maxillary Sinus Augmentation With Calcium Phosphate Double-Coated Anorganic Bovine Bone: Comparative Multicenter Randomized Clinical Trial With Histological and Radiographic Evaluation.

PURPOSE: The purpose of this study was to evaluate the clinical, histological and radiographic outcomes of the calcium phosphate double-coated anorganic bovine bone (InduCera; Oscotec Inc., Seongnam, Gyeonggi, Republic of Korea) compared with that of anorganic bovine bone (Bio-Oss; Geistlich Biomaterials, Wolhusen, Switzerland) in maxillary sinus augmentation, prospectively. PATIENTS AND METHODS: Twenty-eight sinuses in 25 patients (3 bilateral) with vertical alveolar bone height from 2 to 5 mm were included in this study. The maxillary sinus was augmented with InduCera or Bio-Oss, followed by a healing period of 6 months. Trephine cores were obtained for histomorphometric evaluation with the implant placement. Cone-beam computed tomography (CBCT) scans were taken at 1 week and 6 months after sinus augmentation. RESULTS: The graft sites were healed without any notable complications in both groups. In histomorphometric analysis, the area of the newly formed bone was measured as 21.37 ± 8.87% for InduCera and 23.02 ± 5.88% for Bio-Oss, with no significant differences. Radiographically, no statistically significant differences were calculated between the groups in bone height at baseline, the height of bone augmentation, the final alveolar bone height (alveolar bone height + augmented height) after 6 months in panoramic radiograph. There were also no significant differences in the shrinkage rate of the grafted area volume in CBCT. CONCLUSION: Although calcium phosphate double-coated anorganic bovine bone showed no additional effect compared with anorganic bovine bone from a histological and radiographical point of view, it could be used as the bone graft material in maxillary sinus augmentation.

Effectiveness of Low-Level Laser Therapy with a 915 Nm Wavelength Diode Laser on the Healing of Intraoral Mucosal Wound: An Animal Study and a Double-Blind Randomized Clinical Trial.

Background and objectives: Diode laser has been the most popular low-level laser therapy (LLLT) technique in dentistry due to its good tissue penetration, lower financial costs, small size for portable application, and convenience to use. A series of recent studies with 940 nm or 980 nm lasers demonstrated that LLLT showed positive effects after third molar extraction or periodontal flap surgery. However, the effects of LLLT on intraoral mucosal wound healing after surgical incision have not yet been determined in human clinical study. Materials and Methods: The present study was performed to determine the efficacy and safety of 915 nm wavelength low-level laser therapy (LLLT) in mucosal wound healing. A total of 108 Sprague-Dawley rats were used. They were divided into three groups: Abrasive wound group, immediate LLLT once group, and daily LLLT group. As a clinical study, a total of 16 patients with split-mouth design subjected to bilateral mandibular third molar extraction were allocated into the LLLT group and placebo group. The process of LLLT was performed on postoperative days 0, 1, and 7, and parameters related to wound healing were analyzed on days 1, 7, and 14. Results: Repeated laser irradiation promoted mucosal wound healing of the rats. In the clinical study, although there were no significant statistical differences between the LLLT and placebo groups in all inflammatory parameters, the early stage mucosal healing tendency of wound dehiscence was higher in the LLLT group than in the placebo group clinically on postoperative day 1. Conclusions: The present results showed that 915 nm LLLT could be applied safely as an auxiliary therapy for mucosal wound healing.

Measurement of hepatitis B virus DNA in fresh versus processed dentin from chronically infected patients.

BACKGROUND: Demineralized dentin matrix (DDM) is commonly used as a bone-graft substitute. This study measured and compared human hepatitis B viruses (HBV) DNA in fresh dentin to that of dentin processed into DDM extracted during dental treatment from HBV-infected patients. The hypothesis was that the processing procedure for DDM would inactivate or eliminate HBV in the dentin matrix obtained from infected patients. METHODS: Dentin from eighteen HBV-infected patients was collected and each dentin specimen was divided into two fragments. One fragment was used before processing as fresh dentin (control group) and the other was processed into DDM (experimental group). DNA was extracted and purified from each fresh and processed dentin specimen and the HBV DNA copy number quantitated by real time polymerase chain reaction. The HBV DNA copy number in the fresh dentin specimens were compared relative to serologic test results. The second parameter was to evaluate the effectiveness of the processing procedure (defatting, demineralization, freeze-drying, and sterilization) to inactivate or eliminate HBV by comparing the DNA copy number in the processed DDM with that in the matched fresh dentin specimens. All results were analyzed using Mann-Whitney U test to compare numerical measurements between groups and differences were considered statistically significant at P-values less than 0.05. RESULTS: The presence of HBV DNA was detected in 55.56% (10/18) of the fresh dentin specimens. For the ten HBV DNA-positive fresh dentin specimens, HBV DNA was detected in two (20%) of the matched processed dentin specimens. The copy number of HBV DNA in the two positive processed dentin specimens was 1.79 and 4.03, which were statistically lower than that of the fresh dentin specimens (P = 0.0167). CONCLUSIONS: The results from this study suggested that fresh dentin may be a carrier of HBV and that the procedure used to generate DDM extensively reduced the levels of HBV DNA. Further studies are needed to evaluate the infectivity of HBV in processed dentin.

Association of toothbrushing and proximal cleaning with periodontal health among Korean adults: Results from Korea National Health and Nutrition Examination Survey in year 2010 and 2012.

AIM: Toothbrushing (TB), dental flossing (DF) and inter-dental brushing (IDB) are regarded as fundamental self-care methods for periodontal health. Few evidences on its effectiveness on periodontal health are available. Hence, this study aimed to evaluate the association of TB, DF, IDB and interaction effect with periodontal health. MATERIALS AND METHODS: The nationally representative 4,766 Korean adults aged 19 years and older were cross-sectionally surveyed in 2010 and 2012. Periodontal health was defined as Community Periodontal Index 1-2 for gingivitis and 3-4 for periodontitis. The information about variables was from interview and blood analyses. Multivariable logistic regression analyses and the interaction effect between TB and proximal cleaning (PC: DF and/or IDB) were applied. RESULTS: Toothbrushing thrice or more per day and DF were associated with a lower prevalence of periodontitis by both 44%, while the preventive fraction of DF on gingivitis was 30%. The preventive fraction of interaction effects between TB thrice or more and PC were 78% for periodontitis and 68% for gingivitis among 40-59 year age group. CONCLUSIONS: Toothbrushing and PC are independently associated with periodontal health. Hence, periodontists should recommend TB thrice or more per day and PC such as DF and IDB to promote periodontal health.

Dentinal tubule sealing effects of 532-nm diode-pumped solid-state laser, gallic acid/Fe3+ complex, and three commercial dentin desensitizers.

The purpose of this study was to compare dentinal tubule sealing effects of a 532-nm diode-pumped solid-state (DPSS) laser, gallic acid/Fe3+ complex, and three commercially available dentin desensitizers. Human premolars (n = 44) extracted for orthodontics had standardized cervical cavities prepared, etched (37% phosphoric acid) and randomly assigned to either a control (n = 4), or one of five treatment groups (n = 8/group). Desensitizing treatments were either a 532-nm DPSS laser, gallic acid/Fe3+ complex, oxalate-based Super Seal™ (SS), DIO™ Enamel Coating Pen Pro Tooth (Dio), or adhesive-type Hybrid Coat™ (HC). Dentinal fluid flow (DFF) was monitored continuously in real time during the application of each desensitizing agent, by using a nanoliter-scaled fluid flow-measuring device. Following treatment, morphological changes on dentinal surfaces and within tubules were observed by scanning electron microscopy (SEM). DFF rates were significantly reduced after treatment in all experimental groups (P < 0.05), except SS (P > 0.05). The gallic acid/Fe3+ complex reduced DFF rates the most, and significantly (P < 0.05) more than the three commercial dentin desensitizers. There were no significant differences in DFF reduction rates between the gallic acid/Fe3+ complex and the DPSS laser groups (P > 0.05). There were no significant differences in DFF reduction rates among the three commercial dentin desensitizers (P > 0.05). SEM examination of treated dentin showed that the degree of occlusion of dentinal tubules correlated closely with the corresponding reduction in DFF rates. The gallic acid/Fe3+ complex and 532-nm DPSS laser were superior to other desensitizing methods in occluding dentinal tubules and reducing DFF rates.

Antifouling Thin-Film Composite Membranes by Controlled Architecture of Zwitterionic Polymer Brush Layer.

In this study, we demonstrate a highly antifouling thin-film composite (TFC) membrane by grafting a zwitterionic polymer brush via atom-transfer radical-polymerization (ATRP), a controlled, environmentally benign chemical process. Initiator molecules for polymerization were immobilized on the membrane surface by bioinspired catechol chemistry, leading to the grafting of a dense zwitterionic polymer brush layer. Surface characterization revealed that the modified membrane exhibits reduced surface roughness, enhanced hydrophilicity, and lower surface charge. Chemical force microscopy demonstrated that the modified membrane displayed foulant-membrane interaction forces that were 1 order of magnitude smaller than those of the pristine TFC membrane. The excellent fouling resistance imparted by the zwitterionic brush layer was further demonstrated by significantly reduced adsorption of proteins and bacteria. In addition, forward osmosis fouling experiments with a feed solution containing a mixture of organic foulants (bovine-serum albumin, alginate, and natural organic matter) indicated that the modified membrane exhibited significantly lower water flux decline compared to the pristine TFC membrane. The controlled architecture of the zwitterionic polymer brush via ATRP has the potential for a facile antifouling modification of a wide range of water treatment membranes without compromising intrinsic transport properties.

Autogenous demineralized dentin matrix from extracted tooth for the augmentation of alveolar bone defect: a prospective randomized clinical trial in comparison with anorganic bovine bone.

OBJECTIVES: The aim of this study was to prospectively evaluate the clinical efficacy and histological outcome of the autogenous tooth graft material (AutoBT) compared to that of anorganic bovine bone (Bio-Oss® , Geistlich, Switzerland) in post-extraction alveolar bone augmentation. PATIENTS AND METHODS: A total of 33 graft sites in 24 patients were included in this study. AutoBT was used in 21 sites of 15 patients and Bio-Oss® was used in 12 sites of 9 patients for alveolar bone augmentation 2-4 weeks after dental extraction. Vertical dimension of grafted bone was measured both at the time of graft placement and at implant fixture placement after 6 months. Trephine cores were harvested for the histomorphometric evaluations during implant placement when feasible. The primary stability of implant fixture was also measured. RESULTS: Infection of graft material or graft bed was not observed and graft sites healed without any notable complications in both groups. The vertical dimensions of alveolar bone increased by 5.38 ± 2.65 mm in AutoBT group and 6.56 ± 3.54 mm in Bio-Oss® group at 6 months post-extraction. Histomorphometrically, new bone formation of AutoBT-grafted site was 31.24 ± 13.87% while that of Bio-Oss® was 35.00 ± 19.33%. The implant stability quotient (ISQ) of implants placed in AutoBT-grafted sites measured 72.80 ± 10.81 while those placed in Bio-Oss® -grafted sites measured 70.0 ± 12.86. There were no statistically significant differences between measurements of the two groups. CONCLUSION: Autogenous demineralized dentin matrix from extracted tooth grafted to extraction sockets for the augmentation of vertical dimension was as effective as augmentation using anorganic bovine bone. Both groups showed favorable wound healing, similar amount of implant stability, and histologically confirmed new bone formation. Thus, the results of this study suggest that autogenous tooth graft material is a viable option for alveolar bone augmentation following dental extraction.