Fabricating a surgical template for guiding sinus floor elevation in the maxillary sinus septa with simultaneous implant placement: A dental technique.

The presence of sinus septa, common anatomic structures of the maxillary sinus, may increase the incidence of surgical complications during sinus floor elevation. This article introduces a digital protocol for achieving safe and precise sinus floor elevation with an individualized surgical template that combines implant placement and the lateral sinus window technique. This technique facilitates precise preplanning and preparation of the lateral osteotomy window and the implant site and reduces surgical complications, shortens surgical duration, and improves patient-related outcomes.

Influence of radiotherapy on dental implants placed in individuals before diagnosed with head and neck cancer: focus on implant-bed-specific radiation dosage.

OBJECTIVES: The influence of radiotherapy on implants placed before diagnosed as head and neck cancer (HNC) is a potentially informative but poorly explored topic. The aims of this study were to investigate the influence of implant-bed-specific radiation dose on dental implants and to evaluate the impact of these implants on radiation dosimetry. MATERIAL AND METHODS: We conducted a retrospective study with 58 irradiated patients that received dental implant restorations before undergoing radiation treatment for HNC. The radiological success rate and the peri-implant bone resorption values were measured radiographically at 1 and 3 years after radiotherapy. Patients with no implants matching tumor site and stage served as a control group (n = 58). RESULTS: The median implant-bed-specific radiation dose was 40.3 Gy, which was significantly lower than tumor bed 62.4 Gy. An implant-bed-specific radiation dose higher than 40.0 Gy showed a significantly decreased radiologic success rate when compared to lower doses. Finally, evaluation of the radiation treatment plans revealed similar radiation hot spots in the test group of patients with implants and those of the control group. CONCLUSION: Our study confirms that radiotherapy negatively worsens peri-implant bone resorption, especially for implant-bed-specific dose more than 40 Gy, and the presence of implants within the radiation fields does not alter radiation dosimetry. The findings could be clinically informative to both surgeons and radio-oncologists. CLINICAL RELEVANCE: The interactions between radiotherapy and implants placed prior to radiotherapy treatment remain a largely unexplored topic. Based on the analysis of 3-dimensional modulated radiation plans, this study demonstrates the impact of implant-bed-specific radiation dose on marginal bone resorption of implants placed pre-radiation and considers the influence of these implants on radiation dosimetry. REGISTRATION NUMBER: CHICTR2100051923: ( http://www.chictr.org.cn/usercenter.aspx ).

Seven-year follow-up of a patient with hereditary gingival fibromatosis treated with a multidisciplinary approach: case report.

BACKGROUND: Hereditary gingival fibromatosis (HGF) is rare in clinical practice, and the long-term results of the combined orthodontic-periodontal treatment of HGF are rarely reported. CASE PRESENTATION: This study reports for the first time the results of seven years of follow-up in a seven-year-old girl with HGF. The diagnosis was confirmed by clinical signs, family history and histopathological examination. First, periodontal scaling and oral hygiene reinforcement were performed regularly in the mixed dentition stage. Next, gingivoplasty was performed on the permanent dentition. Two months after the surgery, treatment with fixed orthodontic appliances was conducted. The teeth were polished on a monthly basis, and oral hygiene was reinforced to control gingival enlargement. Gingival hypertrophy recurred slightly, and gingivectomies were performed in the months following the start of orthodontic treatment. Follow-up was performed for 24 months with orthodontic retention, and gingival enlargement remained stable after the combined treatment. CONCLUSIONS: The risk of gingival hyperplasia recurrence during and after orthodontic treatment is high, but satisfying long-term outcomes can be achieved with gingivectomy, malocclusion correction, and regular follow-up maintenance.

Head-to-head comparative pharmacokinetic and biodistribution (PK/BD) study of two dexamethasone prodrug nanomedicines on lupus-prone NZB/WF1 mice.

HPMA copolymer-based dexamethasone prodrug (P-Dex) and PEG-based dexamethasone prodrug (PEG-Dex, ZSJ-0228) were previously found to passively target the inflamed kidney and provide potent and sustained resolution of nephritis in NZB/WF1 lupus-prone mice. While both prodrug nanomedicines effectively ameliorate lupus nephritis, they have demonstrated distinctively different safety profiles. To explore the underlining mechanisms of these differences, we conducted a head-to-head comparative PK/BD study of P-Dex and PEG-Dex on NZB/WF1 mice. Overall, the systemic organ/tissue exposures to P-Dex and Dex released from P-Dex were found to be significantly higher than those of PEG-Dex. The high prodrug concentrations were sustained in kidney for only 24 h, which cannot explain their lasting therapeutic efficacy (>1 month). P-Dex showed sustained presence in liver, spleen and adrenal gland, while the presence of PEG-Dex in these organs was transient. This difference in PK/BD profiles may explain PEG-Dex' superior safety than P-Dex.

Evaluation of controlled-release triamcinolone acetonide-loaded mPEG-PLGA nanoparticles in treating experimental autoimmune uveitis.

Uveitis is a recurrent, sight-threatening intraocular inflammatory disease and is treated with glucocorticoids in clinical practice. In the present study, methoxypoly(ethyleneglycol)-poly(dl-lactide-co-glycolic acid) (mPEG-PLGA) nanoparticles in combination with triamcinolone acetonide (TA) were fabricated using a modified double emulsification method. Further, we characterized the TA-loaded nanoparticles, and investigated the effects of TA-loaded nanoparticles on experimental autoimmune uveitis rats, including histopathological examination and the alterations in interleukin (IL)-17 and IL-10 at mRNA and protein levels in either aqueous humor or serum. As a result, the TA-loaded nanoparticles were a well-defined spherical shape with a mean particle size of 82 nm. The in vitro release profile showed that the TA-loaded nanoparticles could sustain for more than 45 days, and possessed higher anti-inflammatory effects compared to TA alone after pathological examination, resulting in decreased IL-17 and elevated IL-10 levels in both aqueous humor and serum. Based on these findings, it can be concluded that TA-loaded mPEG-PLGA nanoparticles can potentially provide a better anti-inflammatory effect in treating chronic and recurrent uveitis in clinical practice.

Influence of a mesial cantilever on stress, strain, and axial force in fixed partial dentures with a distally tilted implant in the atrophic posterior maxilla.

PURPOSE: This study aimed to investigate whether the presence of a mesial cantilever influences the biomechanical behavior and screw loosening in fixed partial dentures (FPDs) with a distally tilted implant in the atrophic posterior maxilla and where to best place the distal implant. METHODS: Two configurations of implant-supported four-unit FPDs were modelled using finite element analysis. Five interabutment distances were considered. The stress and strain distributions in the implants, abutments, and prosthetic screws were verified under occlusal loading. The development of the axial force on the abutments and screws was also examined. Two-sample t-tests were used to identify differences (P < 0.05). RESULTS: The von Mises stress distributions of the components in the two configurations were similar, as were the maximum plastic strains of the distal prosthetic screws, distal implants, and 30° abutments. The difference in the maximum plastic strains of the straight abutments was statistically significant. The preload of the 30° abutment screws was significantly reduced after the initial loading. In the absence of a mesial cantilever, the axial force on the straight abutments increased. However, when a mesial cantilever was used, the preload of the straight abutments was maintained, and the axial force on the prosthetic screws fluctuated less. The axial force fluctuation of the abutments gradually decreased as the interabutment distance increased. CONCLUSIONS: Mesial cantilever usage had minimal effect on stress or strain distribution in FPD implants, abutments, or prostheses. However, it helped resist screw loosening. The distal screw access hole was preferably positioned close to the prosthetic end.

Granular limestone amended sand filters for enhanced removal of nanoplastics from water: Performance and mechanisms.

Effluent from wastewater treatment plants (WWTPs) has been regarded as one of the major contributors of nanoplastics (NPs) in the environment. Improving the performance of rapid sand filter (RSF) systems in WWTPs is thus in urgent need. In this study, granular limestone, a low-cost and abundant natural material, was integrated into RSF systems to enhance NP removal from water. Laboratory filtration columns packed with pure sand and limestone-amended sand were applied to remove polystyrene nanospheres (100 nm) from deionized water (DIW) and artificial wastewater (AWW) under different grain size and flow velocity conditions. Pure sand filter showed neglectable NP removal from DIW but much higher NP removal from AWW, especially when fine sand was employed. Limestone amended RSF had a significant improvement in the removal of NPs for all the tested conditions and the removal efficiency of NPs became greater with increasing amount of limestone in columns. The sensitivity of NP immobilization to flow velocity changed significantly with different combinations of filter and background solutions. Coupled effects of physical straining, electrostatic interaction, cation screening and bridging, and surface roughness controlled the retention behaviors of NPs in the columns. The higher removal efficiency of NPs by limestone can be mainly attributed to its chemical composition as well as its surface heterogeneity and roughness. Results of this study demonstrate that limestone can offer extensive application potential for enhancing the performance of RSF systems in WWTPs to remove NPs from wastewater.

The Effect of Fiducial Marker Number and Configuration on Registration Error in Dynamic Implant Surgery.

Objective: To verify the effect of fiducial marker number and configuration on target registration error (TRE) for dynamic computer-aided zygomatic implant surgery. Material and Methods: All patients who underwent zygomatic implant surgery with navigation from January 2018 to December 2021 were enrolled. For each patient, 6 to 8 miniscrews were placed intraorally as fiducial markers before the surgery. After the registration procedure, the TRE, which represents the distance between the target of the image space and the real position of the fiducial markers, was calculated. SPSS (22.0) was used for statistical analysis. Results: A total of 325 titanium miniscrews were placed in 47 patients who underwent zygomatic implant placement by navigation. The lowest TRE was 0.2 mm, compared to the highest TRE of 1.9 mm. There was no significant difference in the mean TRE value among the different titanium miniscrew groups (P = .07). A total of 8 miniscrews in 7 patients were lost in the maxillary tuberosity area prior to and during navigation surgery, which resulted in an irregular polygonal distribution of fiducial markers. However, there was no statistically significant difference in TRE between a polygonal distribution (0.62 ± 0.35 mm) and an irregular polygonal distribution (0.68 ± 0.33 mm) (P = .35). Conclusion: A scattered, polygonal distribution with of a minimum of five fiducial markers in an edentulous maxilla could achieve acceptable TRE values in registration. It seems that the registration error was not influenced by the absence of one corner in a polygon distribution.

Low temperature-resistant superhydrophobic and elastic cellulose aerogels derived from seaweed solid waste as efficient oil traps for oil/water separation.

Aerogel has excellent application potential in adsorption, heat preservation, and other areas due to its typical advantages of low density and high porosity. However, there are several issues with the use of aerogel in oil/water separation, including weak mechanical qualities and challenges in eliminating organic contaminants at low temperature. Inspired by cellulose Iα, which has excellent performance at low temperature, this study used cellulose Iα nanofibers extracted from seaweed solid waste as the skeleton, through covalent cross-linked with ethylene imine polymer (PEI) and hydrophobic modification of 1, 4-phenyl diisocyanate (MDI), supplemented by freeze-drying technology to form three-dimensional sheet, and successfully obtained cellulose aerogels derived from seaweed solid waste (SWCA). The compression test shows that the maximum compressive stress of SWCA is 61 kPa, and the initial performance still maintains 82% after 40 cryogenic compression cycles. In addition, the contact angles of water and oil on the surface of the SWCA were 153° and 0°, respectively, and the stable hydrophobic time in simulated seawater is more than 3 h. By combining the elasticity and superhydrophobicity/superoleophilicity, the SWCA with an oil absorption capacity of up to 11-30 times its mass, might be utilized repeatedly for the separation of an oil/water mixture.

Virtual pterygoid implant planning in maxillary atrophic patients: prosthetic-driven planning and evaluation.

PURPOSE: The study aims to use cone beam computed tomography (CBCT) to (1) define the virtual valid length of pterygoid implants in maxillary atrophic patients from the prosthetic prioritized driven position and (2) measure the implant length engaged in the pterygoid process according to the HU difference of the pterygoid maxillary junction. MATERIALS AND METHODS: Virtual pterygoid implants were planned with CBCT of maxillary atrophic patients in the software. The entry and angulation of the implant were planned according to the prosthetic prioritized driven position in the 3D reconstruction image. The planned implant length and the valid length defined as the implant between the pterygoid maxillary junction and pterygoid fossa were recorded. The relationship between the implant and sinus cavity was also evaluated. RESULTS: A total of 120 CBCT samples were enrolled and virtually planned. The mean age of the patients was 56.2 ± 13.2 years. One hundred and sixteen samples could successfully place virtual implants according to the criterion. The mean implant length and mean implant length beyond the pterygoid maxillary junction were 16.3 ± 4.2 mm (range, 11.5-18 mm) and 7.1 ± 3.3 mm (range, 1.5-11.4 mm), respectively. Ninety percent of virtually planned implants had a close relationship with the sinus cavity, and implants exhibited longer lengths when they had no relation with the sinus. CONCLUSION: From a prosthetic prioritized driven position with fixed entry and angulation, pterygoid implants achieve adequate bone anchorage length beyond the pterygoid maxillary junction. Due to the individual anatomy and the volume of the maxillary sinus, the implants presented a different positional relationship with the maxillary sinus.

Calcium Phosphate Ceramics and Synergistic Bioactive Agents for Osteogenesis in Implant Dentistry.

Implant-supported dental prosthetics are widely used in dental practice. Sufficient peri-implant bone tissue is a crucial prerequisite for the long-term success of this treatment, as insufficient peri-implant bone volume hampers dental implant installation and negatively influences dental implant stability. However, due to tooth extraction, bone metabolism diseases, and trauma, bone defects in the jaw are common in patients, particularly in the elderly and those suffering from underlying conditions. If this is the case, the alveolar ridge has to be augmented for reliable implant placement. Various biomaterials, growth factors (GFs) or GF-based products, and trace elements have been tested and used for alveolar ridge augmentation. Among those biomaterials, calcium phosphates (CaPs) are the most popular due to their promising biocompatibility, great osteoconductivity, and distinguishing osteogenesis. Combining CaPs with GFs or trace elements can further favor bone defect repair. This review mainly focuses on applying artificial CaP biomaterials and their combination with bioactive agents to repair bone defects in implant dentistry.

Radiographic and histological evaluation of bone formation induced by rhBMP-2-incorporated biomimetic calcium phosphate material in clinical alveolar sockets preservation.

PURPOSE: We assessed the efficiency of low-dose recombinant human bone morphogenetic protein-2 (rhBMP-2) incorporated biomimetic calcium phosphate on ß-tricalcium phosphate (ß-TCP) (rhBMP-2/BioCaP/ß-TCP) on bone formation in a model of socket preservation using cone beam computed tomography (CBCT) scanning and histological examination. METHODS: Forty patients undergoing minimally invasive single-root tooth extraction for dental implantation were randomized to three groups according to the material used for socket preservation: filling with rhBMP-2/BioCaP/ß-TCP, ß-TCP, or natural healing (kept unfilled) (controls). The alveolar sockets (including the control group) were covered by two-layer collagen membranes and sutured. Two CBCT scans were taken, one immediately after socket preservation procedure (baseline) and another 6 weeks later. Gray values (GVs) obtained from CBCT were recorded. During insertion of the dental implant, biopsies were taken and analyzed histologically for new bone formation, residual material, and unmineralized bone tissue at the core of the biopsy. RESULTS: The mean (± standard deviation) changes of GVs of the CBCT scans at the central area of filled materials were as follows: 373.19 ± 157.16 in the rhBMP-2/BioCaP/ß-TCP group, 112.26 ± 197.25 in the ß-TCP group, and -257 ± 273.51 in the control group. The decrease of GVs in the rhBMP-2/BioCaP/ß-TCP group as compared with the ß-TCP group was statistically significant (P < 0.001). Differences in new bone formation (P = 0.006) were also found: 21,18% ± 7.62% in the rhBMP-2/BioCaP/ß-TCP group, 13.44% ± 6.03% in the ß-TCP group, and 9.49% ± 0.08% in controls. The residual material was10.04% ± 4.57% in the rhBMP-2/BioCaP/ß-TCP group vs. 20.60% ± 9.54%) in the ß-TCP group (P < 0.001). Differences in unmineralized bone tissue (P < 0.001) were also found (68.78% ± 7.67%, 65.96% ± 12.64%, and 90.38% ± 7.5% in the rhBMP-2/BioCaP/ß-TC, ß-TCP, and control groups, respectively). CONCLUSIONS: This study shows that rhBMP-2/BioCaP/ß-TCP is a promising bone substitute with fast degradation and potent pro-osteogenic capacity that can be useful for socket preservation in implant dentistry. TRIAL REGISTRATION: ChiCTR, ChiCTR2000035263. Registered 5 August 2020, https://www.chictr.org.cn/ChiCTR2000035263 .

Microplastics cause reproductive toxicity in male mice through inducing apoptosis of spermatogenic cells via p53 signaling.

BACKGROUND: Studies on male reproductive toxicity of microplastics are still scarce and the precise mechanism is not distinct. METHODS: C57BL/6 male mice were given oral gavage treatments treated with 5 µm (MPs) and 80 nm (NPs) polystyrene microplastics every day for 60 consecutive days in a row at dosages of 0, 10 and 40 mg/kg/d. The major damage of MPs and NPs were assessed by the assays in vivo and in vitro. Transcriptome sequencing was applied to screen the key involved pathways. RESULTS: In the 10 mg/kg/d NPs group, there was an increase in testicular organ coefficient, and in the 40 mg/kg/d MPs group, an increase in epididymal weight was observed. Vacuolization of spermatogenic cell layer, interstitial congestion, and germ cell apoptosis were found in the testes of MPs and NPs treatment mice at different dose groups. Higher apoptosis rate was observed in GC-2 cells after MPs and NPs treatment at different concentrations. Transcriptome analysis suggested that p53 pathway might be the key signal pathway of the cell apoptosis, and the expressions of p53 and other markers of cell apoptosis were indeed altered after exposure to MPs and NPs. CONCLUSIONS: MPs and NPs can cause reproductive toxicity in male mice through inducing apoptosis of spermatogenic cells via p53 signaling pathway, indicating MPs and NPs exposure be an unnegligible risk factor for reproductive health in male mice.

Synthesis and adsorption performance of three-dimensional gels assembled by carbon nanomaterials for heavy metal removal from water: A review.

This review focuses on the removal of heavy metals from water by three-dimensional gels with carbon nanomaterials as the main building units. It highlights the fundamental knowledge, most recent advances, and future prospects of carbon nanomaterial-assembled gels (CNAGs) as effective adsorbents for heavy metals in water. Various synthesis methods of CNAGs including template-assisted, self-assembly and other methods are systematically summarized and evaluated. Adsorption performances of CNAGs to typical cationic and anionic heavy metals, especially lead, cadmium, mercury, chromium, and arsenic, are thoroughly examined and discussed in detail. These analyses bring out that composite CNAGs constructed from carbon nanomaterials with polymers or other engineered nanoparticles are the most promising adsorbents for heavy metal removal from water. Current challenges and future research directions that are critical to the applications of CNAGs in the removal of heavy metals from contaminated water are outlined at the end of the review.

A single-arm clinical trial investigating the feasibility of the zygomatic implant quad approach for Cawood and Howell Class 4 edentulous maxilla: An option for immediate loading.

INTRODUCTION: The traditional way to treat maxillary edentulous Cawood and Howell Class 4 (CH4) patients who exhibit the knife-edge ridge form of edentulous jaws that are adequate in height and inadequate in width is extensive autologous bone grafting for conventional implant placement. PURPOSE: To evaluate the feasibility of the zygomatic implant (ZI) quad approach in edentulous CH4 patients who presented a knife-edge ridge form in the anterior maxilla for immediate loading. MATERIAL AND METHODS: Eligible patients with maxillary CH4 edentulism treated with the ZI quad approach were enrolled. Bone reduction and implant placement were performed under the guidance of a navigation system according to preoperative planning. The outcome variable was the implant survival rate, and additional variables were the ratio of immediate loading, complications and the relationship of the zygomatic implant path to the sinus wall. Statistical analysis was performed with the SAS statistical package. RESULTS: Fifteen patients (3 men, 12 women; age range, 19-71 years; average age 47.2 years) eligible for the study received the ZI quad approach from January 2017 through January 2020. All ZIs achieved osseointegration, with no implant loss after early healing and a mean follow-up of 17.2 ± 6.2 months. Thirteen of 15 patients (86.7%) received immediate loading. No critical anatomic structure injuries occurred during surgery. Most mesially placed implants (23/30, 76.6%) presented ZAGA 2 and 3, and most distally placed implants were distributed in ZAGA 0 (20/30, 66.7%). DISCUSSION: In terms of realizing immediate loading in CH4 patients with a knife-edge ridge form in the anterior maxilla, quad approaches have advantages over other grafting methods. At the same time, it seems the survival rate of zygomatic implants is comparable with that of other indications. With the limitations of this study, the quad approach might be a feasible option to realize edentulous maxillary reconstruction and to make immediate loading possible.

Real-Time Dynamic Navigation System for the Precise Quad-Zygomatic Implant Placement in a Patient with a Severely Atrophic Maxilla.

Zygomatic implants (ZIs) are an ideal way to address cases of a severely atrophic edentulous maxilla and maxilla defects because they replace extensive bone augmentation and shorten the treatment cycle. However, there are risks associated with the placement of ZIs, such as penetration of the orbital cavity or infra-temporal fossa. Furthermore, the placement of multiple ZIs makes this surgery risky and more difficult to perform. Potential intraoperative complications are extremely dangerous and may cause irreparable losses. Here, we describe a practical, feasible, and reproducible protocol for a real-time surgical navigation system for precisely placing quad-zygomatic implants in the severely atrophic maxilla of patients with residual bone that does not meet the requirements of conventional implants. Hundreds of patients have received ZIs at our department based on this protocol. The clinical outcomes have been satisfactory, the intraoperative and postoperative complications have been low, and the accuracy indicated by infusion of the designed image and postoperative three-dimensional image has been high. This method should be utilized during the entire surgical procedure to ensure ZI placement safety.

Efficient capture of Cr(VI) by carbon hollow fibers with window-like structure.

Removal of toxic Cr(VI) from contaminated water is significant for environmental protection. High efficient adsorbents with outstanding adsorption performance are highly demanded. Herein, we reported that window-like structured carbon hollow fibers (WL-CHF) derived from Enteromorpha prolifera could capture toxic Cr(VI) from aqueous solutions with high adsorption capacity, fast adsorption rate, and excellent recyclable performance. The excellent adsorption performance could be attributed to the unique structure that combines a variety of advantages: large specific surface area, fast diffusion processes, and easy access of adsorption sites for Cr(VI). In addition, the adsorption process was fitted well with pseudo-second-order model and Langmuir isotherm model. The potential mechanism on Cr(VI) removal includes reduction-cation exchange and electrostatic interaction with surface oxygen-containing functional groups. This study highlights new opportunities for designing adsorbents for Cr(VI) removal from Cr-polluted water.

Comparative accuracy of cone-beam CT and conventional multislice computed tomography for real-time navigation in zygomatic implant surgery.

BACKGROUND: Cone-beam computed tomography (CBCT) and conventional multislice CT (MSCT) are both used in zygomatic implant navigation surgery but the superiority of one technique versus the other remains unclear. PURPOSE: This study compared the accuracy of CBCT and MSCT in zygomatic implant navigation surgery by calculating the deviations of implants. MATERIAL AND METHODS: Patients with severely atrophic maxillae were classified into two groups according to the use of CBCT- or MSCT-guided navigation system. The entry and apical distance deviation, and the angle deviation of zygomatic implants were measured on fused operation images. A linear effect model was used for analysis, with statistical significance set at P < .05. RESULTS: A total of 72 zygomatic implants were inserted as planned in 23 patients. The comparison of deviations in CBCT and MSCT groups showed a mean (± SD) entry deviation of 1.69 ± 0.59 mm vs 2.04 ± 0.78 mm (P = .146), apical deviation of 2 ± 0.68 mm vs 2.55 ± 0.85 (P < .001), and angle deviation of 2.32 ± 1.02° vs 3.23 ± 1.21° (P = .038). CONCLUSION: Real-time zygomatic implant navigation surgery with CBCT may result in higher values for accuracy than MSCT.

Particle and bacteria uptake by Japanese flounder (Paralichthys olivaceus) red blood cells: Size dependence and pathway specificity.

Red blood cells (RBCs) are traditionally considered non-professional phagocytes functioning predominately in oxygen transport. In the present study, we examined the ability of Japanese flounder (Paralichthys olivaceus), a teleost species with important economic values, RBCs to uptake inorganic particles and bacteria in different size/form, as well as the involving endocytic pathways. We found that flounder RBCs exhibited relatively high uptake/attachment capacities for 0.1 µm-1.0 µm (diameter) latex beads, but not for 2.0 µm beads. For the 0.1 µm beads, the uptake/attachment was executed through macropinocytosis and caveolae-mediated pathway, while for 0.5 µm and 1.0 µm beads, the uptake/attachment depended primarily on macropinocytosis and partially on the caveolin-mediated pathway. In addition to latex beads, flounder RBCs also exhibited an apparent capacity to engulf both live and inactivated bacteria. For live bacteria, the endocytosis was clathrin-mediated, while for inactivated bacteria, clathrin- as well as non-clathrin-mediated endocytosis were involved. Taken together, these results demonstrated that teleost RBCs possess particle uptake/attachment and bacteria phagocytosis capacities via different pathways that depend on the physical size and biological nature of the engulfed objects.