Quantitative analysis of the color in six CAD-CAM dental materials of varied thickness and surface roughness: An in vitro study.

STATEMENT OF PROBLEM: Computer-aided design and computer-aided manufacturing (CAD-CAM) monochromatic restorative materials are gaining popularity because of their convenience and efficiency. However, studies that quantitatively analyzed color change associated with thickness and surface roughness are sparse. PURPOSE: The purpose of this in vitro study was to quantitatively evaluate the color of 6 CAD-CAM monochromatic materials of different thickness and surface roughness using the CIELab color system. MATERIAL AND METHODS: A total of 150 12×12-mm square specimens of 6 different CAD-CAM monochromatic materials (VITA Enamic HT [VE], IPS e.max CAD HT [LS], LAVA Ultimate HT [LU], Telio CAD HT [TE], VITA Suprinity HT [VS], and Celtra Duo HT [CD]) in shade A2 and 5 different thicknesses (from 0.5 mm to 2.5 mm, with 0.5-mm increments) were fabricated (n=5). After 3 different surface treatments (polished, roughened by SiC P800-grit, and P300-grit), CIELab color parameters (L*, a* and b*) were measured using a spectrophotometer (VITA Easyshade V), and surface roughness was measured with a profilometer (VK-X200). Color variation was quantified by ΔE00 and 50:50% acceptability and perceptibly thresholds. Data analyses were performed using MANOVA, 2-way ANOVA, post hoc Tukey-Kramer test, and the 1-sample t test (α=.05). RESULTS: The L*, a*, and b* of the monochromatic specimens were significantly influenced by material type, thickness, and surface roughness (P<.001). An overall increase in the L* (from 61.90 to 82.2), a* (from -4.22 to 1.16), and b* (from 5.48 to 43.22) of the specimens was observed with increased thickness. The roughened specimens exhibited lower L* and higher a* and b* than the polished ones (P<.001). The use of P300-grit for roughening resulted in greater ΔE00 compared with P800-grit (P<.001). As thickness decreased or surface roughness increased, the ΔE00 increased and exceeded the acceptability and perceptibly thresholds for color difference. CONCLUSIONS: Material type, thickness, and surface roughness were major factors affecting the color of CAD-CAM monochromatic materials. Variations in thickness of 0.5 mm or more, as well as roughening treatments, may lead to clinically unacceptable color changes.

Screw-retained ceramic-veneered/monolithic zirconia partial implant-supported fixed dental prostheses: A 5 to 10-year retrospective study on survival and complications.

PURPOSE: To assess the clinical performance of screw-retained, ceramic-veneered, monolithic zirconia partial implant-supported fixed dental prostheses (ISFDP) over 5-10 years and to evaluate implant- and prosthesis-related factors influencing treatment failure and complications. MATERIALS AND METHODS: Partially edentulous patients treated with screw-retained all-ceramic ISFDPs with 2-4 prosthetic units with a documented follow-up of ≥5 years after implant loading were included in this retrospective study. The outcomes analyzed included implant/prosthesis failure and biological/technical complications. Possible risk factors were identified using the mixed effects Cox regression analysis. RESULTS: A screened sample of 171 participants with 208 prostheses (95% of the restorations were splinted crowns without a pontic) supported by 451 dental implants were enrolled in this study. The mean follow-up duration after prosthesis delivery was 82.4 ±17.2 months. By the end of the follow-up period, 431 (95.57%) of the 451 implants remained functional at the implant level. At the prosthesis level, 185 (88.94%) of the 208 partial ISFDPs remained functional. Biological complications were observed in 67 implants (14.86%), and technical complications were observed in 62 ISFDPs (29.81%). Analysis revealed only emergence profiles (over-contoured) as a significant risk factor for implant failure (P<0.001) and biological complications (P<0.001). Full-coverage ceramic-veneered zirconia prostheses had a significantly greater chance of chipping (P<0.001) compared with buccal-ceramic-veneered or monolithic zirconia prostheses. CONCLUSIONS: Screw-retained ceramic-veneered, monolithic partial ISFDPs have a favorable long-term survival rate. Over-contoured emergence profile is a significant risk factor associated with implant failure and biological complications. Buccal-ceramic-veneered and monolithic zirconia partial ISFDPs lower the initial prevalence of chipping compared with a full-coverage veneered design.

Clinical evaluation and quantitative occlusal change analysis of posterior implant-supported all-ceramic crowns: A 3-year randomized controlled clinical trial.

OBJECTIVES: To compare the survival and complication rates of posterior screw-retained monolithic lithium disilicate (LS2 )/veneered zirconia (ZrO2 ) single implant crowns (SICs), as well as analyze the occlusal changes observed during a 3-year follow-up period. MATERIALS AND METHODS: Thirty-three patients were included and randomly divided into two groups. The test group consisted of 17 patients who received monolithic-LS2 -SIC, while the control group consisted of 16 patients who received veneered-ZrO2 -SIC. Implant/prosthesis survival rates, technical complications, peri-implant soft tissue conditions, and quantitative occlusal changes of SIC (obtained by the intra-oral scanner and analyzed in reverse software Geomagic Control 2015) were assessed at 1- and 3-year follow-ups. Bone loss and Functional Implant Prosthodontic Score (FIPS) were evaluated at a 3-year follow-up. RESULTS: After a 3-year follow-up period, one patient dropped out of the follow-up. No implant loss was observed. One crown was fractured, resulting in prosthesis survival rates of 93.75% for the monolithic group and 100% for the veneered group. A technical complication rate of 25% (4/16) was observed in the veneered group (p = .333). No significant differences in the marginal bone loss were observed at the 3-year follow-up (0.00 (-0.22, 0.17) mm versus 0.00 (-0.12, 0.12) mm, p = .956). The total FIPS scores for the test group were 9.0 (9.0, 9.0), while the control group received scores of 9.0 (8.0, 10.0) (p = .953). The changes in mean occlusal clearance were 0.022 ± 0.083 mm for the test and 0.034 ± 0.077 mm for the control group (at 3 years, p = .497). The changes in occlusal contact area were 1.075 ± 2.575 mm2 for the test and 1.676 ± 2.551 mm2 for the control group (at 3 years, p = .873). CONCLUSION: After a 3-year follow-up, screw-retained monolithic LS2 and veneered ZrO2 SIC demonstrated similar survival rates. The occlusal performance of implant prostheses needs to be closely examined during follow-up, and appropriate occlusal adjustments need to be considered.

Effects of thickness and polishing treatment on the translucency and opalescence of six dental CAD-CAM monolithic restorative materials: an in vitro study.

BACKGROUND: Computer-aided design and computer-aided manufacturing (CAD-CAM) materials for prosthetic is gaining popularity in dentistry. However, limited information exists regarding the impact of thickness and roughening treatment on the optical properties of contemporary CAD-CAM restorative materials. This study aimed to quantitatively evaluate the translucency and opalescence of six dental CAD-CAM materials in response to different thicknesses and roughening treatments. METHODS: Six dental CAD-CAM materials, lithium disilicate glass-ceramic (IPS e.max CAD, LS), polymer-infiltrated ceramic (VITA Enamic, VE), resin-nano ceramic glass-ceramic (LAVA Ultimate, LU), polymethyl methacrylate (Telio CAD, TE), and two zirconia reinforced lithium silicate (VITA Suprinity, VS, and Celtra Duo, CD), in shade A2 were prepared as 12 × 12mm2 specimens of four thicknesses (0.5mm, 1.0mm, 1.5mm, and 2.0mm) (N = 240, n = 10). After three different treatments (polished, roughened by SiC P800-grit, and SiC P300-grit), the translucency parameter (TP00) and opalescence parameter (OP) were measured with a spectrophotometer (VITA Easyshade V). The surface roughness was analyzed with a shape measurement laser microscope. The data were analyzed using a MANOVA, post hoc Tukey-Kramer test, the t test, and regression analysis (α = .05). RESULTS: The TP00 and OP were significantly influenced by material type, thickness and roughening treatment (P < .05). TP00 showed a continues decline with increasing thicknesses, while the variations of OP were material-dependent. TP00 ranged from 37.80 (LS in 0.5mm) to 5.66 (VS in 2.0mm), and OP ranged from 5.66 (LU in 0.5mm) to 9.55 (VS in 0.5mm). The variations in TP00 of all materials between adjacent thicknesses ranged from 2.10 to 15.29, exceeding the acceptable translucency threshold except for LU. Quadratic and logarithmic regression curves exhibited the best fit for TP00 among the materials. Compared to polished specimens, rougher specimens exhibited lower TP00 and higher OP in all materials except for LS (P < 0.05). Roughening with P300-grit decreased TP00 and OP by an average of 2.59 and 0.43 for 0.5mm specimens, and 1.26 and 0.25 for 2.0mm specimens, respectively. CONCLUSIONS: Variations in translucency caused by thickness and roughening treatment were perceptible and may be clinically unacceptable. Careful consideration should be given to the selection of CAD-CAM materials based on their distinct optical properties.

Aminopeptidase N-Responsive Conjugates with Tunable Charge-Reversal Properties for Highly Efficient Tumor Accumulation and Penetration.

Tumor enzyme-responsive charge-reversal carriers can induce efficient transcytosis and lead to efficient tumor infiltration and potent anticancer efficacy. However, the correlations of molecular structure with charge-reversal property, tumor penetration, and drug delivery efficiency are unknown. Herein, aminopeptidase N (APN)-responsive conjugates were synthesized to investigate these correlations. We found that the monomeric unit structure and the polymer chain structure determined the enzymatic hydrolysis and charge-reversal rates, and accordingly, the transcytosis and tumor accumulation and penetration of the APN-responsive conjugates. The conjugate with moderate APN responsiveness balanced the in vitro transcytosis and in vivo overall drug delivery process and achieved the best tumor delivery efficiency, giving potent antitumor efficacy. This work provides new insight into the design of tumor enzyme-responsive charge-reversal nanomedicines for efficient cancer drug delivery.

LRG-1 promotes fat graft survival through the RAB31-mediated inhibition of hypoxia-induced apoptosis.

Autologous adipose tissue is an ideal soft tissue filling material, and its biocompatibility is better than that of artificial tissue substitutes, foreign bodies and heterogeneous materials. Although autologous fat transplantation has many advantages, the low retention rate of adipose tissue limits its clinical application. Here, we identified a secretory glycoprotein, leucine-rich-alpha-2-glycoprotein 1 (LRG-1), that could promote fat graft survival through RAB31-mediated inhibition of hypoxia-induced apoptosis. We showed that LRG-1 injection significantly increased the maintenance of fat volume and weight compared with the control. In addition, higher fat integrity, more viable adipocytes and fewer apoptotic cells were observed in the LRG-1-treated groups. Furthermore, we discovered that LRG-1 could reduce the ADSC apoptosis induced by hypoxic conditions. The mechanism underlying the LRG-1-mediated suppression of the ADSC apoptosis induced by hypoxia was mediated by the upregulation of RAB31 expression. Using LRG-1 for fat grafts may prove to be clinically successful for increasing the retention rate of transplanted fat.

AIE-Active, Stimuli-Responsive Fluorescent 2D Block Copolymer Nanoplatelets Based on Corona Chain Compression.

Aggregation-induced emission (AIE) represents a powerful tool in nanoscience as a result of enhanced luminescence in the condensed state. Although AIEgenic materials have been utilized in a wide range of applications, well-defined self-assembled nanoparticles with tailorable and uniform dimensions and morphology remain challenging to access. Herein, we use the seeded growth, living crystallization-driven self-assembly (CDSA) method to prepare size-tunable and uniform AIE-active 2D nanoplatelets from amphiphilic block copolymer (BCP) precursors with a crystallizable core-forming block and a corona-forming block to which tetraphenylethene (TPE) groups were covalently grafted as AIE-active pendants. The nanoplatelets were formed as a result of a solvophobicity-induced 1D to 2D morphology preference change, which accompanied the seeded growth of a BCP with a quaternized corona-forming block bearing the TPE luminogen. The 2D nanoplatelets exhibited a solvent-responsive fluorescent emission, and examples with coronas containing homogeneously distributed AIE-active TPE groups and Hg(II)-capturing thymine units exhibited excellent performance as proof-of-concept "turn-on" sensors for Hg(II) detection with a rapid response, high selectivity, and a low detection limit (5-125 × 10-9 M, i.e., 1-25 ppb). The fluorescence intensity was found to be nonlinear with respect to analyte concentration and to increase with the area of the nanoplatelet. This behavior is consistent with a cooperative mechanism based on changes in the steric compression of the corona chains, which gives rise to a restriction of the intramolecular motion (RIM) effect.

Enzymatic Crosslinked Silk Fibroin Hydrogel for Biodegradable Electronic Skin and Pulse Waveform Measurements.

The development of a portable, controllable, and environmentally friendly electronic skin (e-skin) is highly desirable; however, it presents a major challenge. Herein, a biocompatible, biodegradable, and easily usable hydrogel was designed and fabricated as e-skin to enable the transmission of information regarding the spatial pressure distribution. Silk fibroin (SF) was used as the hydrogel skeleton, which endowed the hydrogel with intelligent mechanical sensitivity. During its conditioning in weakly acidic media, the density of the enzymatic crosslink increased and a dense network was formed due to the formation of covalent/hydrogen bonds. Additionally, a conductive SF/polyvinyl alcohol (PVA) hybrid film was molded as a flexible electrode after graphite deposition. The above SF sensing unit based on SF hydrogels and SF/PVA hybrid films showed high strain sensitivity (4.78), fast responsiveness (<0.1 s), good cycling stability (≥10,000), excellent biocompatibility, and biodegradability. Importantly, a coplanar 8 × 8 pixel SF-based e-skin array was successfully fabricated and applied for 3D signal transmission of the object. The SF-based e-skin was capable of precisely tracking the changes in the pulse pressure, the movement of the finger joint, and the vibrations of the vocal cord. Therefore, the current findings provide a solid foundation for future studies exploring the next generation of electronic devices.

The protective role of Ephrin-B2/EphB4 signaling in osteogenic differentiation under inflammatory environment.

Inflammation and alveolar bone destruction constitute the main pathological process of periodontitis. However, the molecular mechanisms of bone destruction under the inflammation environment remain unclear. This study aims to explore the role of Ephrin-B2/EphB4 signaling in osteogenic differentiation under the inflammation environment. Mouse pre-osteoblasts MC3T3-E1 were pretreated with lipopolysaccharide of Porphyromonas gingivalis (Pg-LPS). The Ephrin-B2/EphB4 signaling was activated, and the osteogenic differentiation of cells was examined. The results showed that activation of Ephrin-B2/EphB4 signaling promoted the expression levels of osteogenic differentiation-related genes, and also relieved the inhibitory effect of Pg-LPS on osteogenesis. Noticeably, the effect of Ephrin-B2/EphB4 signaling might be related to the mitogen-activated protein kinase (MAPK) pathway. While applying Ephrin-B2-Fc and EphB4-Fc to periodontitis mice, we observed the reduction of alveolar crest destruction. The current study revealed the possible role of Ephrin-B2/EphB4 signaling in reducing bone destruction in periodontitis and suggested its potential values for further research.

Hand-Foot-and-Mouth Disease-Associated Enterovirus and the Development of Multivalent HFMD Vaccines.

Hand-foot-and-mouth disease (HFMD) is an infectious disease of children caused by more than 20 types of enteroviruses, with most cases recovering spontaneously within approximately one week. Severe HFMD in individual children develops rapidly, leading to death, and is associated with other complications such as viral myocarditis and type I diabetes mellitus. The approval and marketing of three inactivated EV-A71 vaccines in China in 2016 have provided a powerful tool to curb the HFMD epidemic but are limited in cross-protecting against other HFMD-associated enteroviruses. This review focuses on the epidemiological analysis of HFMD-associated enteroviruses since the inactivated EV-A71 vaccine has been marketed, collates the progress in the development of multivalent enteroviruses vaccines in different technical routes reported in recent studies, and discusses issues that need to be investigated for safe and effective HFMD multivalent vaccines.

Customized Utilization Strategies of Industrial Lignin to Produce Adsorbents and Flocculants Based on Fractionation and Adequate Structural Interpretation.

Lignin, a by-product of pulping and biorefinery, has great potential to replace petrochemical resources for wastewater purification. However, the defects of lignin, such as severe heterogeneity, inferior reactivity and poor solubility, characterize the production process of lignin-based products by high energy consumption and serious pollution. In this study, several lignin fractions with relatively homogeneous structure were first obtained by organic solvent fractionation, and their structures were fully deciphered by various characterization techniques. Subsequently, each lignin component was custom-valued for wastewater purification based on their structural characteristics. Benefiting from the high reactivity and reaction accessibility, the lignin fraction (lignin-1) refined by dissolving in ethanol and n-butanol could been used as a raw material to produce cationic lignin-based flocculant (LBF) in a copolymerization system using green, cheap and recyclable ethanol as solvent. The lignin fraction (lignin-2) extracted by methanol and dioxane showed low reactivity and high carbon content, which was used to produce lignin-based activated carbon (LAC) with phosphoric acid as activator. Moreover, the influences of synthetic factors on the purification capacity were discussed, and the LBF and LAC produced under the optimal conditions showed distinguished purification effect on kaolin suspension and heavy metal wastewater, respectively. Furthermore, the corresponding purification mechanism and external factors were also elaborated. It is believed that this cleaner production strategy is helpful for the valorization of lignin in wastewater resources.

Finite element analysis of maxillary first molar with a 4-wall defect and 1.5-mm-high ferrule restored with fiber-reinforced composite resin posts and resin core: The number and placement of the posts.

STATEMENT OF PROBLEM: Whether fiber-reinforced composite (FRC) posts should be inserted in root canals to restore teeth with multiple roots remains unclear. PURPOSE: The purpose of this finite element analysis (FEA) study was to determine the optimal use of FRC posts in an endodontically treated maxillary first molar with a 4-wall defect and 1.5-mm-high ferrule. MATERIAL AND METHODS: Eight different models of a maxillary first molar were established: no post (NP), post in palatal root (P), post in distobuccal root (DB), post in mesiobuccal root (MB), posts in palatal root and distobuccal root (P+DB), posts in palatal root and mesiobuccal root (P+MB), posts in 2 buccal roots (DB+MB), and posts in all roots (P+DB+MB). Two types of loading were applied: a force of 800 N parallel to the long axis of the tooth to simulate the vertical masticatory force and another force of 225 N at 45 degrees to the long axis of the tooth to simulate the lateral masticatory force. The equivalent stresses on the external surfaces of the tooth tissue, the internal surfaces of the root canals and in the posts, as well as the maximal shear stresses on the post-core interface and the core-dentin interface, were calculated with FEA. RESULTS: All the models showed similar maximal equivalent stress values on the external surfaces of the tooth tissue, and stress concentrations were found at the cervical and furcation area. On the internal surfaces of root canals, an increase of equivalent stress at the middle third of the canals with posts and a decrease at the cervical third were observed. Under vertical loading, the P+DB+MB group showed the largest equivalent stress in the post (76.45 MPa in the palatal post), the DB+MB group showed the largest shear stress on the post-core interface (19.02 MPa), and the MB group showed the largest shear stress on the core-dentin interface (12.07 MPa). Under lateral loading, the P+DB+MB group showed the largest equivalent stress in the post (60.11 MPa in the mesiobuccal post) and the largest shear stress on the post-core interface (13.48 MPa) and the DB group showed the largest shear stress on the core-dentin interface (21.03 MPa). CONCLUSIONS: One post in the palatal canal was found to be appropriate for the FRC post and resin core restoration of a maxillary first molar with a 4-wall defect and 1.5-mm-high ferrule. An additional post in the mesiobuccal canal could help disperse lateral occlusal force and improve retention of the restoration.

Diagnosis of in vivo vertical root fracture using deep learning on cone-beam CT images.

OBJECTIVES: Evaluating the diagnostic efficiency of deep learning models to diagnose vertical root fracture in vivo on cone-beam CT (CBCT) images. MATERIALS AND METHODS: The CBCT images of 276 teeth (138 VRF teeth and 138 non-VRF teeth) were enrolled and analyzed retrospectively. The diagnostic results of these teeth were confirmed by two chief radiologists. There were two experimental groups: auto-selection group and manual selection group. A total of 552 regions of interest of teeth were cropped in manual selection group and 1118 regions of interest of teeth were cropped in auto-selection group. Three deep learning networks (ResNet50, VGG19 and DenseNet169) were used for diagnosis (3:1 for training and testing). The diagnostic efficiencies (accuracy, sensitivity, specificity, and area under the curve (AUC)) of three networks were calculated in two experiment groups. Meanwhile, 552 teeth images in manual selection group were diagnosed by a radiologist. The diagnostic efficiencies of the three deep learning network models in two experiment groups and the radiologist were calculated. RESULTS: In manual selection group, ResNet50 presented highest accuracy and sensitivity for diagnosing VRF teeth. The accuracy, sensitivity, specificity and AUC was 97.8%, 97.0%, 98.5%, and 0.99, the radiologist presented accuracy, sensitivity, and specificity as 95.3%, 96.4 and 94.2%. In auto-selection group, ResNet50 presented highest accuracy and sensitivity for diagnosing VRF teeth, the accuracy, sensitivity, specificity and AUC was 91.4%, 92.1%, 90.7% and 0.96. CONCLUSION: In manual selection group, ResNet50 presented higher diagnostic efficiency in diagnosis of in vivo VRF teeth than VGG19, DensenNet169 and radiologist with 2 years of experience. In auto-selection group, Resnet50 also presented higher diagnostic efficiency in diagnosis of in vivo VRF teeth than VGG19 and DensenNet169. This makes it a promising auxiliary diagnostic technique to screen for VRF teeth.

Dendritic Micelles with Controlled Branching and Sensor Applications.

Although micelles derived from the solution self-assembly of amphiphilic molecules and polymers have been prepared with a wide variety of shapes, examples with well-defined branched structures have remained elusive. We describe a divergent, directed self-assembly approach to low dispersity dendritic micelles with a high degree of structural perfection and tailorable branch numbers and generations. We use block copolymer amphiphiles as precursors and a crystallization-driven seeded growth approach whereby the termini of fiber-like micelles function as branching sites. Different dendrimeric generations are accessible by adjusting the ratio of added unimers to pre-existing seed micelles where the branch positions are determined by the reduced coronal chain grafting density on the surface of the micelle crystalline core. We demonstrate the spatially defined decoration of the assemblies with emissive nanoparticles and utility of the resulting hybrids as fluorescent sensors for anions where the dendritic architecture enables ultrahigh sensitivity.

A capacitive humidity sensor based on all-protein embedded with gold nanoparticles @ carbon composite for human respiration detection.

Wool and silk fiber are the most extensive resources of protein fibers and have been used in the textile field for many years. The extracted biocompatible proteins are more and more widely used in flexible devices, sensors, tissue engineering, etc. Here, a fully biomaterial based flexible humidity sensor has been successfully fabricated for the first time. Interdigital electrodes of humidity sensor are printed on a transparent sensor substrate made of silk protein by inkjet printing. The humidity sensitive material is gold nanoparticles hosted nitrogen doped carbon (AuNPs@NC), which is fabricated by in situ dispersion of gold nanoparticles in a wool keratin assisted porous carbon precursor. The best treatment condition of the sensitive materials is obtained by comparing the sensitivity of humidity response. Moreover, the as-prepared biocompatible flexible sensor was successfully used to detect human respiration.

Effect of periodontal treatments on blood pressure.

BACKGROUND: An association has been hypothesized between periodontitis and hypertension. Periodontal therapy is believed to reduce systemic inflammatory mediators and increase endothelial function, thus having the potential to prevent and treat hypertension. OBJECTIVES: To assess the effect and safety of different periodontal treatment modalities on blood pressure (BP) in people with chronic periodontitis. SEARCH METHODS: The Cochrane Hypertension Information Specialist searched for randomized controlled trials (RCTs) up to November 2020 in the Cochrane Hypertension Specialised Register, CENTRAL, MEDLINE, Embase, seven other databases, and two clinical trials registries. We contacted the authors of relevant papers regarding further published and unpublished work. SELECTION CRITERIA: RCTs and quasi-RCTs aiming to detect the effect of periodontal treatment on BP were eligible. Participants should have been diagnosed with chronic periodontitis and hypertension (or no hypertension if the study explored the preventive effect of periodontal treatment). Participants in the intervention group should have undergone subgingival scaling and root planing (SRP) and any other type of periodontal treatments, compared with either no periodontal treatment or alternative periodontal treatment in the control group. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane for study identification, data extraction, and risk of bias assessment. We used a formal pilot-tested data extraction form for data extraction, and the Cochrane risk of bias tool for risk of bias assessment. We planned the meta-analysis, test for heterogeneity, sensitivity analysis, and subgroup analysis. We assessed the certainty of evidence using GRADE. The primary outcome was change in systolic BP (SBP) and diastolic BP (DBP). MAIN RESULTS: We included eight RCTs. Five had low risk of bias, one had unclear risk of bias, and two had high risk of bias. Four trials compared periodontal treatment with no treatment. We found no evidence of a difference in the short-term change of SBP and DBP for people diagnosed with periodontitis and other cardiovascular diseases except hypertension (very low-certainty evidence). We found no evidence of a difference in long-term changes in SBP (mean difference [MD] -2.25 mmHg, 95% confidence interval [CI] -9.41 to 4.92; P = 0.54; studies = 2, participants = 108; low-certainty evidence) and DBP (MD -2.55 mmHg, 95% CI -6.90 to 1.80; P = 0.25; studies = 2, participants = 103; low-certainty evidence). Concerning people diagnosed with periodontitis, in the short term, two studies of low certainty reported no changes in SBP (MD -0.14 mmHg, 95% CI -4.05 to 3.77; P = 0.94; participants = 294) and DBP (MD -0.15 mmHg, 95% CI -2.47 to 2.17; P = 0.90; participants = 294), and we found no evidence of a difference in SBP and DBP over a long period based on low certainty of evidence. Three studies compared intensive periodontal treatment with supra-gingival scaling. We found no evidence of a difference in changes in SBP and DBP for any length of time in people diagnosed with periodontitis (very low-certainty evidence). In people diagnosed with periodontitis and hypertension, we found one study reporting a significant reduction in the short term in SBP (MD -11.20 mmHg, 95% CI -15.40 to -7.00; P < 0.001; participants = 101; moderate-certainty evidence) and DBP (MD -8.40 mmHg, 95% CI -12.19 to -4.61; P < 0.0001; participants = 101; moderate-certainty evidence). AUTHORS' CONCLUSIONS: We found no evidence of a difference of an impact of periodontal treatments on BP in most comparisons assessed in this review, and given the low certainty of evidence and the lack of relevant studies we could not draw conclusions about the effect of periodontal treatment on BP in people with chronic periodontitis. We found only one study suggesting that periodontal treatment may reduce SBP and DBP over a short period in people with hypertension and chronic periodontitis, but the certainty of evidence was moderate.

Enhanced exopolysaccharide production in submerged fermentation of Ganoderma lucidum by Tween 80 supplementation.

Bioactive polysaccharides extracted from Ganoderma lucidum (G. lucidum) have been widely applied in food and medicine for their multiple functions. In this study, G. lucidum exopolysaccharide (EPS) production in submerged fermentation was stimulated by Tween 80. The addition of 0.25% Tween 80 on day 3 gave a maximum production of mycelial biomass and EPS, with an increase of 19.76 and 137.50%, respectively. Analysis of fermentation kinetics showed that glucose was consumed faster after adding Tween 80, while the expression of EPS biosynthesis-related genes and ATP generation were greatly improved. Moreover, Tween 80 resulted in the significant accumulation of reactive oxygen species and increased cell membrane and cell wall permeability. The EPS from Tween 80-containing medium had higher contents of carbohydrate and uronic acid, lower molecular weight, and higher antioxidant activity against 2,2-diphenyl-1-picrylhydrazyl (DPPH) radicals than those of EPS produced in the absence of Tween 80. This study provides further evidence to clarify the stimulatory effects of Tween 80 in fermentation and provides a guide for the production of bioactive G. lucidum EPS.

Photocurable Hyperbranched Polymer Medical Glue for Water-Resistant Bonding.

Medical glue represents a suitable tool to stop wound bleeding, seal wounds, bond tissues, or implant materials. However, the development of a medical glue for durable underwater bonding remains a challenge. Herein, we developed a hydrophobic hyperbranched polymer-based medical glue with water-resistant bonding ability. Specifically, the hyperbranched polythioether (HBPTE) with abundant terminal thiol groups was first prepared through a simple one-pot thiol-Michael polyaddition reaction. Due to the hyperbranched molecular structure, HBPTE is a liquid material under room temperature, thus enabling the manufacturing of a photocurable HBPTE glue by the direct addition of poly(ethylene glycol) dimethacrylate and a photoinitiator without introduction of a solvent. This solventless HBPTE glue exhibited a maximum underwater adhesive strength of 36 kPa on porcine skin compared to only <10 kPa of the commercial fibrin glue and cyanoacrylate glue. Moreover, since the hydrophobic cross-linked network resists penetration of water, the HBPTE glue minimally swelled (2-10%) and could maintain a glass sheet structure bonded together even after 2 weeks underwater. Furthermore, an in vitro cytotoxicity test showed that the HBPTE glue did not leak any cytotoxic substances and allowed for proliferation of L929 cells on its surface. Moreover, hemocompatibility tests indicated that the HBPTE glue was nonhemolytic and did not induce thrombosis. This HBPTE glue exhibited promising characteristics to potentially find use as an underwater soft tissue adhesive or sealant.

Programing Performance of Silk Fibroin Superstrong Scaffolds by Mesoscopic Regulation among Hierarchical Structures.

To design higher-strength natural scaffold materials, wool keratin (WK) rich in α-helix structures is used as a well-defined foreign substrate, which induces the formation of ß-crystallites in silk fibroin (SF). Consequently, the macroscopic properties of silk materials (such as the rheological properties of SF hydrogels and the mechanical properties of stents) can be manipulated by governing the change in the hierarchical mesoscopic structure of silk materials. In this work, by monitoring the structure and morphology in the SF gel process, the mechanism of the effect of keratin on SF network formation was speculated, which was further used to design ultra-high-strength protein scaffolds. It has been confirmed that WK accelerates the gelation of SF by reducing the multistep nucleation barrier and increasing the primary nucleation sites, and then establishing a high-density SF domain network. The modulus of the protein composite scaffold prepared by this facile strategy can reach 11.55 MPa, and the MC-3T3 cells can grow well on the scaffold surface. The results suggest that freeze-dried biocompatible SF-based scaffolds are potential candidates for bone tissue engineering.

Minimally invasive procedures for deficient interdental papillae: A review.

OBJECTIVE: Deficient interdental papillae cause a series of problems, including food impaction, phonetic difficulties, and esthetic concerns. The purpose of this article is to provide valid clinical recommendations for clinicians to address these problems in a predictable and less invasive way. OVERVIEW: Numerous treatments are available for interdental papillae reconstruction, but most of them involve surgery and yield unpredictable outcomes. Minimally invasive treatments have the advantages of being effective, predictable, and involving only slight injury as compared to surgical treatments. We included 66 studies obtained after searching for relevant papers in PubMed and Web of Science. The etiology and classification of deficient interdental papillae are explained and minimally invasive procedures for deficient interdental papillae reconstruction are summarized. CONCLUSIONS: Minimally invasive procedures are promising ways to reconstruct deficient interdental papillae, and have the advantages of slight pain and rapid recovery. It should be noticed that some of the minimally invasive treatments still require further long-term observation to confirm their efficacy. CLINICAL SIGNIFICANCE: Familiarity with etiology and classification of deficient interdental papillae can help clinicians to choose the appropriate minimally invasive approach as well as help with case collection to enhance esthetics status in patients with deficient interdental papillae.