The effect of nicotine-containing products on peri-implant tissues: A systematic review and network meta-analysis.

INTRODUCTION: Smokers have a higher chance of developing peri-implant diseases and are therefore considered an at-risk population. Our aim was to compare peri-implant characteristics in users of electronic cigarettes (EC), waterpipes (WP), cigarettes (CS), smokeless tobacco (ST), and non-smokers (non-users of any nicotine and tobacco product; NS). METHODS: A systematic search of four electronic databases (PubMed, EMBASE, Web of Science, CENTRAL) was performed until April 2023, restricted to English language. Thirty-nine observational studies were included in the qualitative synthesis, of which 32 studies were included in a Bayesian network meta-analysis. Using a predesigned form, two researchers independently collected data about marginal bone loss (MBL), probing pocket depth (PPD), plaque index (PI), bleeding on probing (BOP), modified plaque index (mPI), probing pocket depth > 4mm (PPD>4), gingival index (GI), peri-implant sulcular fluid (PISF) volume, and TNF-α and IL-1ß levels. QUIPS and CINeMA were used to evaluate the risk of bias and certainty of evidence. RESULTS: NS had the smallest MBL. Most nicotine-containing product users had significantly higher MBL (CS, MD:1.34 CrI: 0.85, 1.79; WP, MD:1.58 CrI: 0.84, 2.35; ST, MD:2.53, CrI: 1.20, 3.87) than NS. EC did not show significant difference compared to NS (MD:0.52 CrI: -0.33, 1.36). In secondary outcomes NS were ranked in first place. Subset analysis based on smoking habit, implant duration, and maintenance control revealed no differences in ranking probability. CONCLUSION: Most nicotine-containing product users presented worse peri-implant parameters compared to non-smokers, while EC users did not show significant differences to NS in many outcomes. IMPLICATION: Alternative nicotine-containing products are gaining popularity and are often considered less harmful by the general public compared to traditional cigarettes. This is the first network meta-analysis comparing users of four nicotine-containing products and non-smokers. This study shows that CS, WP and ST have a detrimental effect on the overall health of peri-implant tissues. EC users also presented inferior parameters compared to NS, however, the difference was not significant in many outcomes. It is essential to educate patients who are using nicotine-containing products, and to provide proper maintenance and appropriate cessation support. Well-designed multi-armed studies are needed for direct comparison of different products, including heated tobacco products. Greater transparency of confounding factors is needed regarding smoking habit and oral hygiene.

Aromatase Inhibitors and Plasma Lipid Changes in Postmenopausal Women with Breast Cancer: A Systematic Review and Meta-Analysis.

Background: Women are typically diagnosed with estrogen receptor-positive breast cancer around the postmenopausal period when declining estrogen levels initiate changes in lipid profiles. Aromatase inhibitors (AI) are used to prevent the progression of cancer; however, a further reduction in estrogen levels may have detrimental effects on lipid levels, which was our working hypothesis. Methods: Our meta-analysis was conducted on the lipid profiles of postmenopausal breast cancer patients at baseline and at different treatment time points. Results: We identified 15 studies, including 1708 patients. Studies using anastrozole (ANA), exemestane (EXE), letrozole (LET), and tamoxifen (TMX) were involved. Subgroup analyses revealed that 3- and 12-month administrations of LET and EXE lead to negative changes in lipid profiles that tend to alter the lipid profile undesirably, unlike ANA and TMX. Conclusions: Our results suggest that, despite statistically significant results, EXE and LET may not be sufficient to cause severe dyslipidemia in patients without cardiovascular comorbidities according to the AHA/ACC Guideline on the Management of Blood Cholesterol. However, the results may raise the question of monitoring the effects of AIs in patients, especially those with pre-existing cardiovascular risk factors such as dyslipidemia.

Isomorphic Insertion of Ce(III)/Ce(IV) Centers into Layered Double Hydroxide as a Heterogeneous Multifunctional Catalyst for Efficient Meerwein-Ponndorf-Verley Reduction.

The development of highly active acid-base catalysts for transfer hydrogenations of biomass derived carbonyl compounds is a pressing challenge. Solid frustrated Lewis pairs (FLP) catalysis is possibly a solution, but the development of this concept is still at a very early stage. Herein, stable, phase-pure, crystalline hydrotalcite-like compounds were synthesized by incorporating cerium cations into layered double hydroxide (MgAlCe-LDH). Besides the insertion of well-isolated cerium centers surrounded by hydroxyl groups, the formation of hydroxyl vacancies near the aluminum centers, which were formed by the insertion of cerium centers into the layered double hydroxides (LDH) lattice, was also identified. Depending on the initial cerium concentration, LDHs with different Ce(III)/Ce(IV) ratios were produced, which had Lewis acidic and basic characters, respectively. However, the acid-base character of these LDHs was related to the actual Ce(III)/Ce(IV) molar ratios, resulting in significant differences in their catalytic performance. The as-prepared structures enabled varying degrees of transfer hydrogenation (Meerwein-Ponndorf-Verley MPV reduction) of biomass-derived carbonyl compounds to the corresponding alcohols without the collapse of the original lamellar structure of the LDH. The catalytic markers through the test reactions were changed as a function of the amount of Ce(III) centers, indicating the active role of Ce(III)-OH units. However, the cooperative interplay between the active sites of Ce(III)-containing specimens and the hydroxyl vacancies was necessary to maximize catalytic efficiency, pointing out that Ce-containing LDH is a potentially commercial solid FLP catalysts. Furthermore, the crucial role of the surface hydroxyl groups in the MPV reactions and the negative impact of the interlamellar water molecules on the catalytic activity of MgAlCe-LDH were demonstrated. These solid FLP-like catalysts exhibited excellent catalytic performance (cyclohexanol yield of 45%; furfuryl alcohol yield of 51%), which is competitive to the benchmark Sn- and Zr-containing zeolite catalysts, under mild reaction conditions, especially at low temperature (T = 65 °C).

Reduction of intracellular oxidative stress with a copper-incorporated layered double hydroxide.

Biocompatible Cu(II)-doped layered double hydroxide (CMA) nanoparticles were developed to combat reactive oxygen species. The 2-dimensional nanozymes showed both superoxide dismutase- and catalase-like activities in chemical assays, while proving as efficient antioxidants in the reduction of intracellular oxidative stress. The results indicate the great promise of CMA in antioxidant therapies.

Current status of optical scanning in facial prosthetics: A systematic review and meta-analysis.

Purpose To assess the accuracy of scanning technologies for constructing facial prostheses on human faces.Study selection Our systematic search was performed on five databases. Studies reporting on human volunteers (P) whose faces were scanned with a scanning technology were eligible. The anthropometrical interlandmark distances (ILDs) were used as indicators of accuracy; the ILDs are measured on the virtual models (I) and directly on the faces (C). The virtual models deviated from their true values (O). Studies reporting the measurements on patients with or without facial deformities were included, but cadavers or inanimate objects were reasons for exclusion. We performed a mean difference (MD) / standardized MD analysis with a random effect model. The difficulties regarding the scanning procedure mentioned in the articles were also assessed.Results We found 3723 records after duplicate removal. Twenty five articles were eligible for the qualitative review, and ten articles were included in the quantitative synthesis. Eight different ILDs were compared in MD analyses. The differences were between -0.54-0.43 mm. We also performed a regional three-dimensional analysis to compare scanning technologies in each major region. No significant differences were found in any of the regions and axes. The most mentioned difficulties were artifacts due to motion or blinking.Conclusions The results suggest no systematic skew in linear dimensions neither between direct caliper measurements nor between measurements on the scanned models, scanning technologies, or facial regions.

Combined Casein Phosphopeptide-Amorphous Calcium Phosphate and Fluoride Is Not Superior to Fluoride Alone in Early Carious Lesions: A Meta-Analysis.

There is a growing need for effective methods in the management of early stage carious lesions. Therefore, the aim of this study was to evaluate the effect of combined casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride on white spot lesions (WSLs) compared to fluoride-only interventions. This meta-analysis was performed according to PRISMA guidelines and registered in PROSPERO (CRD42021286245). The Medline, Embase, and Cochrane Central databases were searched until October 17, 2022. Eligible studies were randomized controlled trials. Outcome variables included laser fluorescence (LF), quantitative light-induced fluorescence (QLF), and lesion area scores. The random-effects model was used for analysis, and results were given as standardized mean difference (SMD) and mean difference (MD) with a 95% confidence interval. Risk of bias was assessed using the RoB 2 tool, and the level of evidence with GRADE. Our systematic search yielded 973 records after duplicate removal, 21 studies were included for qualitative synthesis, and 15 studies were eligible for quantitative analysis. No significant difference was found between CPP-ACP and fluoride versus fluoride alone in LF at 1, 3, and 6 months of use: SMD -0.30 (-0.64; 0.04); SMD -0.47 (-1.02; 0.07); SMD -0.49 (-1.13; 0.15), respectively. For QLF, the analysis did not demonstrate significant differences between these two kinds of treatment at 1 and 6 months of use: MD 0.21 (-0.30;0.71); MD 0.60 (-1.70;2.90), but at 3 months, higher QLF values were found in the fluoride-only group compared to the CPP-ACP and fluoride combination was shown regarding the WSLs: MD 0.58 (0.25;0.91). On the contrary, data showed a small but statistically significant decrease in the lesion area in favor of the CPP-ACP plus fluoride versus fluoride alone at 6 months MD -0.38 (-0.72; -0.04). None of these observed changes indicated substantial clinical relevance. The combination of CPP-ACP and fluoride did not overcome the effect of fluoride given alone. Our data suggest that fluoride itself is effective in improving WSLs. However, the certainty of evidence was very low. These results indicate that further studies and future development of more effective products than CPP-ACP are needed in addition to fluoride to achieve robust amelioration of WSLs.

Comparative analysis of surgical and prosthetic rehabilitation in maxillectomy: A systematic review and meta-analysis on quality-of-life scores and objective speech and masticatory measurements.

STATEMENT OF PROBLEM: Patients with oro-antral communication, whether from trauma, disease, or congenital anomalies, have options for surgical reconstruction or prosthetic obturation, but guiding interdisciplinary protocols are lacking. PURPOSE: The purpose of this systematic review and meta-analysis was to compare surgical reconstruction and prosthetic obturation, identifying correlations with baseline characteristics to determine the most effective approach for specific patients. MATERIAL AND METHODS: A systematic search was conducted in 4 databases. Searching, screening, data extraction, and risk of bias assessment were performed by 2 reviewers. Eligible studies focused on patients with palatomaxillary defects from cancer-related maxilla surgeries. Traumatic or congenital defects were excluded. The study compared prosthetic restoration (either with surgical or definitive obturators) to surgical reconstruction using flaps or grafts. Patients with surgical restoration after tooth extraction were excluded. Both subjective and objective outcomes were used for comparison. RESULTS: Thirteen articles were included in the qualitative synthesis and 9 in the meta-analysis. Patient scores on quality-of-life questionnaires, objective speech, and masticatory ability evaluations were compared. The number of patients who underwent surgical reconstruction was 206, whereas 260 patients received prosthetic obturators. Results showed no significant differences. In the "activity" domain of the University of Washington QoL questionnaire, however, the 1.92 (0.45, 3.40) score difference was not clinically relevant. However, the heterogeneity of trials, the transient nature of subjective evaluations, the low number of participants, and major confounding biases did not allow a solid conclusion to be drawn. CONCLUSIONS: The growing number of maxillectomy patients demands firm evidence on which rehabilitation to choose and when it should be done. The result suggests that obturator devices and surgical reconstruction have similar effects on quality of life and health outcomes. A multicentric registry in which patient strata could be analyzed separately by age, adjuvant therapies, defect sizes, and remaining dentition is advocated.

Effect of Chitosan on the Number of Streptococcus mutans in Saliva: A Meta-Analysis and Systematic Review.

We conducted a meta-analysis and systematic review to investigate the efficacy of chitosan-containing chewing gums, and to test their inhibitory effects on Streptococcus mutans. The systematic search was performed in three databases (Cochrane Library, EMBASE, and PubMed) and included English-language randomized-controlled trials to compare the efficacy of chitosan in reducing the number of S. mutans. To assess the certainty of evidence, the GRADE tool was used. Mean differences were calculated with a 95% confidence interval for one outcome: bacterial counts in CFU/mL. The protocol of the study was registered on PROSPERO, registration number CRD42022365006. Articles were downloaded (n = 6758) from EMBASE (n = 2255), PubMed (n = 1516), and Cochrane (n = 2987). After the selection process, a total of four articles were included in the qualitative synthesis and three in the quantitative synthesis. Our results show that chitosan reduced the number of bacteria. The difference in mean quantity was -4.68 × 105. The interval of the random-effects model was [-2.15 × 106; 1.21 × 106] and the prediction interval was [1.03 × 107; 9.40 × 106]. The I2 value was 98% (p = 0.35), which indicates a high degree of heterogeneity. Chitosan has some antibacterial effects when used as a component of chewing gum, but further studies are needed. It can be a promising antimicrobial agent for prevention.

Advancing accuracy in guided implant placement: A comprehensive meta-analysis: Meta-Analysis evaluation of the accuracy of available implant placement Methods.

OBJECTIVES: This meta-analysis aimed to determine the accuracy of currently available computer-assisted implant surgery (CAIS) modalities under in vitro conditions and investigate whether these novel techniques can achieve clinically acceptable accuracy. DATA: In vitro studies comparing the postoperative implant position with the preoperative plan were included. Risk of bias was assessed using the Quality Assessment Tool For In Vitro Studies (QUIN Tool) and a sensitivity analysis was conducted using funnel plots. SOURCES: A systematic search was performed on April 18, 2023, using the following three databases: MEDLINE (via PubMed), EMBASE, and Cochrane Central Register of Controlled Trials. No filters or restrictions were applied during the search. RESULTS: A total of 5,894 studies were included following study selection. Robotic- and static CAIS (sCAIS) had the most accurate and clinically acceptable outcomes. sCAIS was further divided according to the guidance level. Among the sCAIS groups, fully guided implant placement had the greatest accuracy. Augmented reality-based CAIS (AR-based CAIS) had clinically acceptable results for all the outcomes except for apical global deviation. Dynamic CAIS (dCAIS) demonstrated clinically safe results, except for horizontal apical deviation. Freehand implant placement was associated with the greatest number of errors. CONCLUSIONS: Fully guided sCAIS demonstrated the most predictable outcomes, whereas freehand sCAIS demonstrated the lowest accuracy. AR-based and robotic CAIS may be promising alternatives. CLINICAL SIGNIFICANCE: To our knowledge, this is the first meta-analysis to evaluate the accuracy of robotic CAIS and investigate the accuracy of various CAIS modalities.

Less marginal bone loss around bone-level implants restored with long abutments: A systematic review and meta-analysis.

The aim of this study was to investigate the biological outcomes of bone-level implants restored with long vs. short abutments, with regard to the 'one abutment at one time' protocol. The systematic search was performed in five databases: MEDLINE (PubMed), EMBASE, Web of Science, Scopus, and CENTRAL for randomized controlled trials up to January 14, 2023. Data were collected for marginal bone loss, bleeding on probing, and probing pocket depth by two reviewers. As effect size measure, mean difference (MD), and risk ratio (RR) were used for continuous and categorical outcomes, R-statistics software was used for conducting statistical analyses. For quality and certainty assessment, Risk of Bias Tool 2, ROBINS-I, and GRADE approach were used. The search resulted in 4055 records without any duplicates. After title, abstract, and full-text analysis, eight articles were found eligible for inclusion. Bone-level and platform-switched implants presented less marginal bone loss after 6 months and 1 year as well, when long abutments were used (MD 0.63, 95% CI: [-0.16; 1.42]) and (MD 0.26, 95% CI: [-0.02; 0.53]). However, subgroup analysis revealed no difference in marginal bone loss when applying 'one abutment at one time' protocol (p = 0.973). Bleeding on probing and probing pocket depth presented similarly good results in both groups without almost any differences (RR 0.97, 95% CI: [0.76; 1.23]) and (MD -0.05, 95% CI: [-1.11; 1.01]). Longer abutments on bone-level implants seem to be a favorable choice for decreasing early marginal bone loss, irrespective of connection timing.

ORGANOLEPTIC AND HALITOMETRIC ASSESSMENTS DO NOT CORRELATE WELL IN INTRA-ORAL HALITOSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS.

BACKGROUND: The gold standard method for diagnosing oral halitosis is the subjective organoleptic measurement. Device-supported methods are also widespread worldwide. The challenges and safety concerns around performing organoleptic measurements during pandemics and the diversity of measuring device alternatives raised our clinical question: which halitometer is the most suitable for diagnosing halitosis? METHODS: This systematic review was registered in PROSPERO (ID CRD42022320024). The search was performed on March 23, 2022 in the following electronic databases: MEDLINE, Embase, Scopus, Web of Science, and CENTRAL. Adult populations with or without halitosis were included, and patients with systemic diseases were excluded. Organoleptic (subjective) measurement and the device-supported (objective) methods were compared; the primary outcome was the correlation coefficient, and the secondary was the specificity and sensitivity of the devices. QUADAS-2 and QUADAS-C were used to evaluate the risk of bias in the studies. Random-effects meta analyses were performed on the outcomes, and the secondary outcomes were plotted on a common ROC plot. RESULTS: A total of 1231 records were found in the 5 databases. After the selection process, 76 articles were eligible for the systematic review, and 14,635 patients were involved in the qualitative analysis. The pooled Spearman's correlation coefficient (c.c.) for sulfide monitors was 0.65; 95% CIs: [0.53-0.74]; I2 = 95%, P < .01. The pooled Spearman's c.c. for portable gas chromatographs was 0.69; 95% CIs: [0.63-0.74]; I2 = 12%, P < .01. The pooled Spearman's c.c. for gas chromatographs was 0.76; 95% CIs: [0.67-0.83]; I2 = 0%, P < .01. DISCUSSION: None of the most commonly used halitometers proved to be significantly superior to the others. Halimeter and OralChroma measurements did not correlate well with the organoleptic level of oral halitosis in adults. Therefore, better halitometers need to be developed as an alternative to organoleptic measurements.

The use of autogenous tooth bone graft is an efficient method of alveolar ridge preservation - meta-analysis and systematic review.

BACKGROUND: Ridge resorption following tooth extraction may be reduced by alveolar ridge preservation (ARP). Previous randomized clinical trials and systematic reviews have suggested that autogenous tooth bone graft (ATB) can be an effective alternative material for ARP. However, the results are heterogeneous. Therefore, our research aimed to evaluate the efficacy of ATB in ARP. METHODS: A systematic search was conducted in Cochrane Library, Embase, MEDLINE and Scopus for studies published from inception to 31 November 2021. We searched searched for randomized, non-randomized controlled trials and case series reporting on ATB use for ARP. The primary outcome was the ridge width difference pre- and post-surgery, measured in millimetres (mm) measured on CBCT (cone beam computed tomography). The secondary outcomes were the histological results. We followed the PRISMA2020 recommendations for reporting our systematic review and meta-analysis. RESULTS: The analysis included eight studies for the primary and six for the secondary outcomes. The meta-analysis revealed a positive ridge preservation effect with a pooled mean difference ridge width change of -0.72 mm. The pooled mean residual graft proportion was 11.61%, and the newly formed bone proportion was 40.23%. The pooled mean of newly formed bone proportion was higher in the group where ATB originated from both the root and crown of the tooth. CONCLUSIONS: ATB is an effective particulate graft material in ARP. Complete demineralization of the ATB tends to decrease the proportion of newly formed bone. ATB can be an attractive option for ARP. TRIAL REGISTRATION: The study protocol was registered on PROSPERO (CRD42021287890).

Clear guidance to select the most accurate technologies for 3D printing dental models - A network meta-analysis✰.

OBJECTIVES: Thus far, the findings of numerous studies conducted on the accuracy of three-dimensional (3D) printed dental models are conflicting. Therefore, the aim of the network meta-analysis (NMA) is to determine the accuracy of 3D printed dental models compared with digital reference models. DATA: Studies comparing the accuracy of 3D printed full-arch dental models manufactured using different printing techniques to initial STL files were included. SOURCES: This study was registered in PROSPERO (CRD42021285863). An electronic search was performed across four databases in November 2021, and search was restricted to the English language. STUDY SELECTION: A systematic search was conducted based on a prespecified search query. 16,303 articles were pooled after the removal of the duplicates. Following study selection and data extraction, 11 eligible studies were included in the NMA in 6 subgroups. The outcomes were specified as trueness and precision and expressed as root mean square (RMS) and absolute mean deviation values. Seven printing technologies were analyzed: stereolithography (SLA), digital light processing (DLP), fused deposition modeling/fused filament fabrication (FDM/FFF), MultiJet, PolyJet, continuous liquid interface production (CLIP), and LCD technology. The QUADAS-2 and GRADE were used to evaluate the risk of bias and certainty of evidence. CONCLUSIONS: SLA, DLP, and PolyJet technologies were the most accurate in producing full-arch dental models. CLINICAL SIGNIFICANCE: The findings of the NMA suggest that SLA, DLP, and PolyJet technologies are sufficiently accurate for full-arch dental model production for prosthodontic purposes. In contrast, FDM/FFF, CLIP, and LCD technologies are less suitable for manufacturing dental models.

Characterization of Electrospun Polysuccinimide-Dopamine Conjugates and Effect on Cell Viability and Uptake.

Biocompatible nanofibrous systems made by electrospinning have been studied widely for pharmaceutical applications since they have a high specific surface and the capability to make the entrapped drug molecule amorphous, which increases bioavailability. By covalently conjugating drugs onto polymers, the degradation of the drug as well as the fast clearance from the circulation can be avoided. Although covalent polymer-drug conjugates have a lot of advantages, there is a lack of research focusing on their nano-formulation by electrospinning. In this study, polysuccinimide (PSI) based electrospun fibrous meshes conjugated with dopamine (DA) are prepared. Fiber diameter, mechanical properties, dissolution kinetics and membrane permeability are thoroughly investigated, as these are crucial for drug delivery and implantation. Dopamine release kinetics prove the prolonged release that influenced the viability and morphology of periodontal ligament stem cells (PDLSCs) and SH-SY5Y cells. The presence of dopamine receptors on both cell types is also demonstrated and the uptake of the conjugates is measured. According to flow cytometry analysis, the conjugates are internalized by both cell types, which is influenced by the chemical structure and physical properties. In conclusion, electrospinning of PSI-DA conjugates alters release kinetics, meanwhile, conjugated dopamine can play a key role in cellular uptake.

Daily use of chlorine dioxide effectively treats halitosis: A meta-analysis of randomised controlled trials.

OBJECTIVES: We aimed to conduct a systematic review on published data in order to investigate the efficacy of mouthwash products containing chlorine dioxide in halitosis. STUDY DESIGN: Systematic review and meta-analysis. METHODS: Our search was conducted on 14th October 2021. We searched the following electronic databases: MEDLINE, Embase, Scopus, Web of Science, and CENTRAL. We analysed data on adults with halitosis, included only randomised controlled trials and excluded in vitro and animal studies. The interventional groups used chlorine dioxide, and the comparator groups used a placebo or other mouthwash. Our primary outcomes were changes in organoleptic test scores (OLS) and Volatile Sulfur Compound (VSC) levels from baseline to the last available follow-up. RESULTS: We found 325 articles in databases. After the selection process, ten articles were eligible for qualitative synthesis, and 7 RCTs with 234 patients were involved in the meta-analysis. Our findings showed a significant improvement in the parameters of the chlorine dioxide group compared to the placebo group in OLS one-day data (mean difference (MD): -0.82; 95% confidence intervals (95% CIs): [-1.04 --0.6]; heterogeneity: I2 = 0%, p = 0.67); and one-week OLS data (MD: -0.24; 95% CIs: [-0.41 --0.07]; I2 = 0%, p = 0.52); and also changes in H2S one-day data (standardised mean difference (SMD): -1.81; 95% CIs: [-2.52 --1.10]); I2 = 73.4%, p = 0.02). CONCLUSION: Our data indicate that chlorine dioxide mouthwash may be a good supportive therapy in oral halitosis without known side effects.

The Wisdom in Teeth: Neuronal Differentiation of Dental Pulp Cells.

Mesenchymal stem/stromal cells (MSCs) are found in almost all postnatal organs. Under appropriate environmental cues, multipotency enables MSCs to serve as progenitors for several lineage-specific, differentiated cell types. In vitro expansion and differentiation of MSCs give the opportunity to obtain hardly available somatic cells, such as neurons. The neurogenic potential of MSCs makes them a promising, autologous source to restore damaged tissue and as such, they have received much attention in the field of regenerative medicine. Several stem cell pool candidates have been studied thus far, but only a few of them showed neurogenic differentiation potential. Due to their embryonic ontology, stem cells residing in the stroma of the dental pulp chamber are an exciting source for in vitro neural cell differentiation. In this study, we review the key properties of dental pulp stem cells (DPSCs), with a particular focus on their neurogenic potential. Moreover, we summarize the various presently available methods used for neural differentiation of human DPSCs also emphasizing the difficulties in reproducibly high production of such cells. We postulate that because DPSCs are stem cells with very close ontology to neurogenic lineages, they may serve as excellent targets for neuronal differentiation in vitro and even for direct reprogramming.

Molecular orientation rules the efficiency of immobilized antioxidants.

Tannic acid (TA) and glutathione (GSH) are important molecular antioxidants against reactive oxygen species. Their efficiency is limited by low solubility and high sensitivity, which may be solved by confinement in composite materials. Here, effect of immobilization of these antioxidants on their radical scavenging activity was investigated using layered double hydroxide (LDH) nanoparticles as hosts. Different preparation methods were applied to build composite systems leading to variations in the molecular orientation of both TA and GSH on the surface or among the layers of LDHs. Systematic combination of spectroscopy (FT-IR, Raman, UV-VIS-NIR-DRS), diffraction (XRD) and microscopy (SEM) methods revealed perpendicular or parallel orientation of TA on the surface of LDH depending on the preparation approach applied. Immobilization of GSH protected the antioxidant molecules from degradation. Radical scavenging tests evidenced that the activity of the antioxidants strongly depends on the molecular orientation. The LDH supported GSH and TA proved as durable and reusable antioxidant agents to be applied as radical scavengers in medical therapies or in industrial processes.

Clinical bracket failure rates between different bonding techniques: a systematic review and meta-analysis.

BACKGROUND: Bracket failure increases the treatment time of orthodontic therapy and burdens patients with unnecessary costs, increased chair time, and possible new appointments. OBJECTIVE: To compare the bond failures of different orthodontic materials based on the results of available clinical studies. SEARCH METHODS: A systematic search of clinical trials was performed in the Cochrane, Embase, and Pubmed databases with no limitations. The list of investigated techniques contained conventional acid-etch primer (CM-AEP), self-etch primer (SEP), self-cure resin (SCR), and simple or resin-modified glass ionomer (RM-GIC) materials and procedures. SELECTION CRITERIA: Clinical studies reporting the failure rate of bonded brackets after using direct adhesive techniques on buccal sites of healthy teeth were included. DATA COLLECTION AND ANALYSIS: Bracket failure rates from eligible studies were extracted by two authors independently. Risk ratios (RRs) were pooled using the random-effects model with DerSimonian-Laird estimation. RESULTS: Thirty-four publications, involving 1221 patients, were included. Our meta-analysis revealed no significant difference in the risk of bracket failures between SEP and CM-AEP. After 6, 12, and 18 months of bonding, the values of RR were 1.04 [95% confidence interval (CI), 0.67-1.61], 1.37 (95% CI, 0.98-1.92), and 0.93 (95% CI, 0.72-1.20), respectively. At 18 months, bracket failure was 4.9 and 5.2% for SEP and CM-AEP, respectively. Heterogeneity was good or moderate (I2 < 42.2%). The results of RM-GIC at 12 months indicated a 57% lower risk of bracket failure using SCR as compared with RM-GIC (RR: 0.38; 95% CI, 0.24-0.61). At 18 months, bracket failures for SCR and RM-GIC were 15.8 and 36.6%, respectively (RR: 0.44; 95% CI, 0.37-0.52, I2 = 78.9%), demonstrating three to six times higher failure rate than in the case of etching primer applications. LIMITATIONS: A major limitation of the present work is that the included clinical trials, with no exceptions, showed variable levels of risk of bias. Another possible problem affecting the outcome is the difference between the clustering effects of the split mouth and the parallel group bracket allocation methods. CONCLUSIONS AND IMPLICATIONS: The results revealed no significant difference between SEP and CM-AEP up to 18 months after application. RM-GIC had much worse failure rates than acid-etching methods; additionally, the superiority of SCR over RM-GIC was evident, indicating strong clinical relevance. REGISTRATION: Prospero with CRD42020163362.

Delamination of Layered Double Hydroxide in Ionic Liquids under Ambient Conditions.

Liquid phase delamination of layered materials into single- or few-layer nanosheets leads to stable nanoscale dispersions of 2D materials. The delamination of layered double hydroxide (LDH) to double hydroxide nanosheets was studied in two ionic liquids (ILs): ethylammonium nitrate (EAN) and 1-butyl-3-methylimidazolium thiocyanate (BMIMSCN). The as-prepared lamellar structure of LDH disappeared upon dispersing it in ILs due to delamination into 2D nanosheets confirmed by X-ray scattering and diffraction techniques and further evaluated by height profile assessment of the nanoparticles by atomic force microscopy. The results showed that both the thickness and lateral size of the dispersed particles decreased in the IL-based samples, indicating that cleavage of the LDH materials can be observed in addition to delamination. The findings prove the concept of delamination of layered materials by ILs under ambient conditions─an excellent way to prepare 2D double hydroxide nanosheet dispersions in one step using nonvolatile green solvents.

Patients with inflammatory bowel disease have a higher chance of developing periodontitis: A systematic review and meta-analysis.

Background and objective: Periodontitis affects up to one billion people worldwide, and has been proven to be associated with several systemic inflammatory conditions. This study investigates the specific relationship between two multifactorial diseases: Inflammatory bowel disease (IBD) and periodontitis. To thoroughly explore this issue, we investigated separately whether IBD patients have a higher chance of developing periodontitis, and equally, whether patients with periodontitis have a higher chance of developing IBD. Methods: The systematic search was performed in three databases: MEDLINE, Cochrane Trials, and Embase, up to 26 October 2021. The protocol was registered in PROSPERO. All eligible studies investigating the association between IBD and periodontitis from either direction were included. The Newcastle-Ottawa Scale was used to assess the risk of bias. As a primary outcome, we investigated the prevalence of IBD and periodontitis, and calculated the odds ratio (OR). Our secondary outcomes involved comparing the clinical periodontal outcomes of IBD patients to those of IBD-free patients. Results: The systematic search resulted in 1,715 records, 14 of which were eligible for qualitative synthesis and 8 for quantitative synthesis. On the basis of the results of the primary outcome, IBD diagnosis was associated with significantly higher odds of periodontitis: OR = 2.65 (CI: 2.09-3.36, I 2 = 0 (CI: 0-0.75)). For subgroup analysis, we investigated separately the odds in Crohn's disease (CD) patients: OR = 2.22 (CI: 1.49-3.31, I 2 = 0.05 (CI: 0-0.76)) and in ulcerative colitis (UC) patients: OR = 3.52 (CI: 2.56 to 4.83, I 2 = 0 (CI: 0-0.75)); the odds were significantly higher in all cases. Two studies investigated whether patients with periodontitis were more susceptible to IBD, and both found that periodontitis was significantly associated with the risk of subsequent UC, but not with subsequent CD. However, more studies are needed to prove an association. Conclusion: Our analysis confirmed that IBD patients have a higher chance of developing periodontitis, and are a higher risk population in dentistry. Both dentists and gastroenterologists should be aware of this relationship and should emphasize the importance of prevention even more than in the healthy population. Systematic review registration: [https://www.crd.york.ac.uk/prospero/], identifier [CRD42021286161].