ABSTRACT
To address the problem of insufficient bone mass in the implant area, we focused on the vertical increment of the posterior mandibular area to increase bone mass with the aid of a healing abutment. Data of patients with insufficient vertical bone height in the posterior mandibular area were collected, and vertical increment of alveolar bone operations was performed with the aid of a healing abutment. Preoperative residual alveolar bone height, immediate postoperative alveolar bone height, and 6-month postoperative alveolar bone height were recorded, with peri-implant soft tissue results 6 months after surgery using the modified plaque index and sulcus bleeding index. Twelve patients, aged 42-73 years, with an average age of 55.91 ± 11.58 years, received vertical bone augmentation in the posterior mandibular region supported by implant healing abutments. Fifteen SLA TSIII OSSTEM implants were utilized in the 12 patients; one patient failed in vertical bone augmentation at one site (H0 = 0 mm). The vertical bone augmentation effect of two patients at two sites was 0 mm < H0 < 1 mm, and the vertical bone augmentation effect of 12 sites in nine patients was H0 ≥ 1 mm. The implant success rate was 93.3%, and the mean vertical bone gain was 2.91 mm. Peri-implant soft tissue parameters are as follows: mean modified plaque index, 1.92; mean modified sulcus bleeding index, 1.21; and mean probing depth, 3.18. No clinically observable complications occurred. Bone augmentation supported by the implant healing abutment showed the characteristics of "platform transfer", with good formation of the implant-bone interface. The bone augmentation surgery was completed at the same time as the implant placement, which reduced the pain of multiple operations and shortened waiting times. We provide a novel idea to solve the problem of insufficient vertical bone height in the posterior mandibular region.
Subject(s)
Alveolar Bone Loss , Humans , Adult , Middle Aged , Aged , Alveolar Bone Loss/etiology , Mandible/surgery , Prostheses and Implants/adverse effectsABSTRACT
Tumor necrosis factorrelated apoptosisinducing ligand (TRAIL) is known to induce cell apoptosis in many types of cancer cells. However, some malignant cells still exhibit antiapoptosis features induced by TRAIL; thus the underlying mechanisms that regulate sensitivity and resistance of tumor cells to TRAILinduced apoptosis remain unclear. Human telomerase reverse transcriptase (hTERT) is overexpressed in most types of human tumors and is mostly inactive in somatic cells. The present study aimed to investigate the endogenous effects and mechanisms of hTERT inhibition and TRAIL overexpression on TRAILinduced apoptosis of human oral squamous cell carcinoma (OSCC) cells. The effects of adenoassociated virus (AAV)mediated TRAIL and hTERT gene silencing by RNA interference were investigated on the proliferation and apoptosis of human OSCC cells in vitro and in vivo. The present results suggest that knockdown of hTERT expression accelerated TRAILresistant OSCC cells to TRAILinduced apoptosis and impaired OSCC cell proliferation. In addition, this process is accompanied by the upregulation of caspase3, caspase8 and caspase9, and downregulation of B cell lymphoma2. Additionally, the possible mechanisms underlying the association between TRAIL expression and hTERT silencing were explored. The results demonstrated that TRAIL expression levels were elevated when the hTERT gene was silenced, and notable antitumor effects were observed when TRAIL upregulation and hTERT gene silencing were carried out simultaneously. The present findings provide experimental evidence for the combined use of TRAIL and hTERT as a possible gene therapy strategy in oral cancer.