Rescuing effects of periostin in advanced glycation end-products (AGEs) caused osteogenic and oxidative damage through AGE receptor mediation and DNA methylation of the CALCA promoter.

An in vitro model was established to simulate a diabetes-type environment by treating human periodontal stem cells with advanced glycation end-products (AGEs). Periostin (POSTN) plays a crucial role in maintaining the integrity of periodontal tissues. However, the role of POSTN in human periodontal stem cells stimulated by AGEs remains unknown. Diabetes mellitus is considered a metabolic disease, and DNA methylation of CpG islands is a biomarker of metabolic syndromes. Diabetes has been found to be closely related to the DNA methylation of certain genes. Here, we investigated the protective mechanism and effect of POSTN on osteogenesis and oxidative stress in the AGE environment, and further explored the CpG island methylation of specific genes potentially mediated by POSTN. The optimal concentration of AGEs was screened using CCK8. AGEs were found to contribute to oxidative stress. Conversely, reactive oxygen species production and malondialdehyde and superoxide activity indicated that the AGE + POSTN group decreased oxidative injury. According to an alkaline phosphatase assay, Alizarin Red S staining, and the expression of key genes and proteins involved in osteogenesis, POSTN mitigated the inhibitory effects of AGE on cell proliferation and osteogenic differentiation potential during osteogenic differentiation. In contrast, the growth and osteogenesis of human periodontal stem cells were notably suppressed by POSTN knockdown. Bisulfite sequencing PCR was used to evaluate the DNA methylation status. Moreover, AGE elevated the expression of DNA methyltransferas 1 (DNMT1) and inhibited the activation of CALAL promoter methylation, which was rescued by the addition of POSTN and 5-Azacytidine (5-AZA). In conclusion, POSTN attenuated the AGE-induced inhibition of osteogenesis in periodontal ligament stem cells by reducing AGE receptor levels and DNA methylation of the calcitonin-related polypeptide α (CALCA) promoter. Thus, POSTN is a promising candidate for dental bone regeneration, representing a novel therapeutic agent for diabetic patients. The mechanism underlying these processes may provide new insights into novel therapeutic targets for improving abnormal bone metabolism in patients with diabetes.

[A clinical analysis of screw-retained implant-supported casted integrated abutment crowns in the molar region with limited interocclusal space].

PURPOSE: To observe the clinical effects of screw-retained implant-supported casted abutment integrated crowns (IACs) in the molar region with limited interocclusal space. METHODS: This study involved 507 implants in 376 patients with limited interocclusal space in the molar region. All implants were inserted to the jaw by standard one-stage protocol. Screw-retained IACs were used as the final prosthesis. With 6 to 24 months follow-up, the clinical effects of screw-retained IACs were recorded and analyzed using SPSS 17.0 software package. RESULTS: During 6 to 24 months of follow-up, the implant survival rate was 99.61%. 37 patients had ceramic fracture which mainly happened in the group with 3-4 mm interocclusal space. In each group, porcelain fused to metal (PFM) prosthesis had ceramic fracture more easily than PFM prosthesis without porcelain on occlusal surface(P<0.05). As the interocclusal space became smaller, the probability of collapsing porcelain increased(P<0.05).13 patients had screw loosening. 13 patients suffered from gingival swelling and bleeding, they were given periodontal treatment and oral hygiene instruction. Patients were satisfied with the restoration results. CONCLUSIONS: Screw-retained IACs can be used to repair missing teeth in the molar region with limited interocclusal space.

[Application of one-piece implant-supported detachable telescope retained fixed bridge in edentulous cases].

PURPOSE: To evaluate the clinical effectiveness of one-piece implant-supported detachable telescopic fixed bridge in edentulous patients. METHODS: Seventeen patients were treated with one-piece implant-supported detachable telescopic fixed bridge. A total of 18 prostheses were fabricated with 8 in the upper jaws and 10 in the lower jaws.Fixed bridges retained by telescopic crowns were used as final prostheses, with milling titanium or all-ceramic abutments as primary crowns, gold-electroforming crowns as secondary crowns. Surveys about clinical and radiographic examination, satisfaction and prosthetic complications were conducted after 3 months,1 year, 2 years, 3 years after final rehabilitation. Data analysis was performed using SPSS 17.0 software package. RESULTS: Radiography showed stable bone levels for all implants except 2 implants, which were observed slight marginal bone resorption. The results of one-way ANOVA showed that no significant difference in modified plaque index or modified sulcus blooding index was found during the follow-up period (P>0.05). The probing attachment level deteriorated by 1.5 mm during the first 3 years (P<0.05). Eighteen restoration provided sufficient fixation and stability. Two porcelain fractures occured but had no influence on restoration. The patients were highly satisfied with the outcomes. The frequency of prosthetic maintenance per patient per year was 0.11. CONCLUSIONS: One-piece implant-supported detachable telescopic fixed bridge is an effective method with satisfactory long-term aesthetic and stable outcomes in edentulous patients.