Comparing the Bone Healing After Cold Ablation Robot-Guided Er:YAG Laser Osteotomy and Piezoelectric Osteotomy-A Pilot Study in a Minipig Mandible.

BACKGROUND AND OBJECTIVE: To take major advantage of erbium-doped yttrium aluminium garnet (Er:YAG) lasers in osteotomy-like freedom of cutting geometries and high accuracy-the integration and miniaturization of the robot, laser, and navigation technology was tried and applied to minipigs. The investigators hypothesized laser osteotomy would render acceptable bone healing based on the intraoperative findings and postoperative cut surface analysis. STUDY DESIGN/MATERIALS AND METHODS: We designed and implemented a comparative bone-cutting surgery in the minipig mandible with a cold ablation robot-guided Er:YAG laser osteotome (CARLO) and a piezoelectric (PZE) osteotome. The sample was composed of different patterns of defects in the mandibles of six grown-up female Goettingen minipigs. The predictor variable was Er:YAG osteotomy and PZE osteotomy. The outcome variable was the cut surface characteristics and bone healing at 4 and 8 weeks postoperatively. Descriptive and qualitative comparison was executed. RESULTS: The sample was composed of four kinds of bone defects on both sides of the mandibles of six minipigs. We observed more bleeding during the operation, open-cut surfaces, and a faster healing pattern with the laser osteotomy. There was a possible association between the intraoperative findings, postoperative cut surface analysis, and the bone healing pattern. CONCLUSIONS: The results of this study suggest that characteristic open-cut surfaces could explain favorable bone healing after laser osteotomy. Future studies will focus on the quantification of the early healing characteristics after laser osteotomy, its diverse application, and the safety feature. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.

Image analysis of immediate full-arch prosthetic rehabilitations guided by a digital workflow: assessment of the discrepancy between planning and execution.

BACKGROUND: A dentition with adequate function and esthetics is essential for the well-being and quality of life. A full implant-retained fixed prosthetics is an ideal solution for fully edentulous arch, however requires complex planning, surgical, and prosthetic procedure. With the help of digital workflow, it becomes a predictable and fast solution for the dentists and the patients. This retrospective study analyzed the most advanced surgical approach in full-arch rehabilitation with dental implants and immediate loading using digital workflow. METHODS: Patient records of fully edentulous jaws treated in four clinical centers in Warsaw, Poland, were evaluated. Computer-assisted planning and surgical template fabrication were done using the planning software coDiagnostiX™, based on a pre-op cone beam computed tomography (CBCT) and scanned data of a plaster model. A post-op CBCT was acquired after the placement of four to six implants by the guided system. The influence of different surgical variables on the discrepancy between planning and execution was analyzed, together with the biomechanical indices. RESULTS: A total of nine patient records were selected of 12 edentulous jaws treated with 62 implants. The overall mean three-dimensional (3D) offset at the implant base was 1.60 mm, at the tip 1.86 mm. The mean angle of deviation was 4.89°, the mean implant stability quotient (ISQ) 70.42, and the insertion torque 35.58 Ncm. The 3D offsets were influenced by the gender of the patient, treated jaw, the diameter, and length of the implant. The angle of deviation was affected only by the treated jaw. Insertion torque was influenced by the treated jaw, the age of the patient, the length of the implant, tooth type, and the side of the jaw. DISCUSSION: Bone quality of the patient and implant preparation procedure influenced the discrepancy between the planning and the execution of the digitally guided implant placement. Dense bone-mandible, posterior area, young age, and man-and multiple preparations of the implant bed-wider and longer implant-could be suggested as risk factors. CONCLUSION: Digital workflow successfully enabled the immediate full-arch rehabilitation with a predictable outcome by different surgeons in multiple centers.

Simultaneous intrinsic and extrinsic calibration of a laser deflecting tilting mirror in the projective voltage space.

PURPOSE  : During the past five decades, laser technology emerged and is nowadays part of a great number of scientific and industrial applications. In the medical field, the integration of laser technology is on the rise and has already been widely adopted in contemporary medical applications. However, it is new to use a laser to cut bone and perform general osteotomy surgical tasks with it. In this paper, we describe a method to calibrate a laser deflecting tilting mirror and integrate it into a sophisticated laser osteotome, involving next generation robots and optical tracking. METHODS  : A mathematical model was derived, which describes a controllable deflection mirror by the general projective transformation. This makes the application of well-known camera calibration methods possible. In particular, the direct linear transformation algorithm is applied to calibrate and integrate a laser deflecting tilting mirror into the affine transformation chain of a surgical system. RESULTS  : Experiments were performed on synthetic generated calibration input, and the calibration was tested with real data. The determined target registration errors in a working distance of 150 mm for both simulated input and real data agree at the declared noise level of the applied optical 3D tracking system: The evaluation of the synthetic input showed an error of 0.4 mm, and the error with the real data was 0.3 mm.

A comparative investigation of bone surface after cutting with mechanical tools and Er:YAG laser.

BACKGROUND AND OBJECTIVES: Despite of the long history of medical application, laser ablation of bone tissue became successful only recently. Laser bone cutting is proven to have higher accuracy and to increase bone healing compared to conventional mechanical bone cutting. But the reason of subsequent better healing is not biologically explained yet. In this study we present our experience with an integrated miniaturized laser system mounted on a surgical lightweight robotic arm. STUDY DESIGN/MATERIALS AND METHODS: An Erbium-doped Yttrium Aluminium Garnet (Er:YAG) laser and a piezoelectric (PZE) osteotome were used for comparison. In six grown up female Göttingen minipigs, comparative surgical interventions were done on the edentulous mandibular ridge. Our laser system was used to create different shapes of bone defects on the left side of the mandible. On the contralateral side, similar bone defects were created by PZE osteotome. Small bone samples were harvested to compare the immediate post-operative cut surface. RESULTS: The analysis of the cut surface of the laser osteotomy and conventional mechanical osteotomy revealed an essential difference. The scanning electron microscopy (SEM) analysis showed biologically open cut surfaces from the laser osteotomy. The samples from PZE osteotomy showed a flattened tissue structure over the cut surface, resembling the "smear layer" from tooth preparation. CONCLUSIONS: We concluded that our new finding with the mechanical osteotomy suggests a biological explanation to the expected difference in subsequent bone healing. Our hypothesis is that the difference of surface characteristic yields to different bleeding pattern and subsequently results in different bone healing. The analyses of bone healing will support our hypothesis.

PKR-dependent mechanisms of interferon-α for inhibiting hepatitis B virus replication.

Interferon-α (IFN-α) inhibits the replication of hepatitis B virus (HBV) in vivo and in vitro, but the molecular mechanism of this inhibition has been elusive. We found that while HBV replication in transfected human hepatoma Huh-7 cell was severely inhibited by IFN-α treatment as reported previously, this inhibition was markedly impaired in the cell in which the expression of IFN-inducible, double-stranded RNA-dependent protein kinase (PKR) was stably and specifically suppressed through RNA-interference. Intracellular level of viral capsids was down-regulated likewise in a PKR-dependent manner, whereas that of HBV transcripts including the viral RNA pregenome was not affected by IFN-α treatment. Ectopic expression of PKR also resulted in the reduction of viral capsids with concomitant increase of phosphorylated eIF2α. These results suggested that PKR functions as a key mediator of IFN-α in opposing HBV replication, most likely through the inhibition of protein synthesis.

Dental caries prevalence of medieval Korean people.

OBJECTIVES: Prevalence and distribution of dental caries in medieval Korean society were evaluated. MATERIALS AND METHODS: Two thousand and nine hundred teeth samples of 126 individuals collected from 16th to 18th century Korean tombs. RESULTS: Preservation status of sample was good. The prevalence of ante- and postmortem tooth loss was 4.4% and 14.2%, respectively. The total caries prevalence was 3.9%. The tooth surface most frequently affected by dental caries was occlusal (4.5%), followed by approximal (2.1%), buccal (1.5%), and lingual (1.1%) surfaces. DISCUSSION: The prevalence of dental caries in Joseon Dynasty skeleton collection was lower than have been found in other collections of similar chronology. The low consumption of refined sugar in medieval Korean society might be a possible explanation, though the technical limitations inherent in such comparison studies preclude definitive conclusions.

The associations of coping mechanism with arterial stiffness in hwa-byung patients.

OBJECTIVE: The goal of this study is to assess the relationship between stress coping mechanisms and the risk of atherosclerosis in patients with Hwa-Byung. METHODS: The Korean version of the Ways of Coping Checklist (WOCC) was administered to 50 patients with Hwa-Byung (49.1+/-10.1 years, 6 males). Brachial-ankle pulse wave velocity (baPWV) and serum cholesterol level were assessed in all participants. RESULTS: After controlling for age, sex, diagnosis of hypertension, Body Mass Index (BMI), and serum cholesterol level, the score of seeking social support in coping strategies was negatively correlated with right and left baPWV (r=-0.356, p=0.016; r=-0.373, p=0.012, respectively). In addition, the score of active coping mechanism was negatively correlated with both sides of baPWV (r=-0.383, p=0.009; r=-0.389, p=0.008, respectively). CONCLUSION: The seeking social support and active coping mechanism were inversely related to the severity of arterial stiffness in Hwa-Byung patients. Therefore, our result may suggest a possibility that coping strategies in Hwa-Byung patients are associated with the risk of atherosclerosis.

Turnover of hepatitis B virus X protein is facilitated by Hdj1, a human Hsp40/DnaJ protein.

Hepatitis B virus X (HBX) protein is required for the productive infection of hepatitis B virus (HBV) in vivo and implicated in the development of hepatocellular carcinoma. We have previously shown that hTid-1 and Hdj1, the human Hsp40/DnaJ chaperone proteins, bind the HBV core protein and inhibit viral replication in cell culture system. Here, we report evidences to suggest that HBX is the major target of Hdj1 in the inhibition of HBV replication. Expression of Hdj1 in cultured human hepatoma HepG2 cells facilitated degradation of HBX by the proteasome pathway, and thereby inhibited replication of the wild-type HBV as well as that of the HBX-deficient mutant virus rescued by HBX supplied in trans. Mutational analyses indicated that J domain of Hdj1 is required for the process. These results might provide a molecular basis for the antiviral effect of cellular chaperones.