Pharmacometabolomics applied to low-dose interleukin-2 treatment in amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a devastating motor neuron disease. The immunosuppressive functions of regulatory T lymphocytes (Tregs) are impaired in ALS, and correlate to disease progression. The phase 2a IMODALS trial reported an increase in Treg number in ALS patients following the administration of low-dose (ld) interleukin-2 (IL-2). We propose a pharmacometabolomics approach to decipher metabolic modifications occurring in patients treated with ld-IL-2 and its relationship with Treg response. Blood metabolomic profiles were determined on days D1, D64, and D85 from patients receiving 2 MIU of IL-2 (n = 12) and patients receiving a placebo (n = 12). We discriminated the three time points for the treatment group (average error rate of 42%). Among the important metabolites, kynurenine increased between D1 and D64, followed by a reduction at D85. The percentage increase of Treg number from D1 to D64, as predicted by the metabolome at D1, was highly correlated with the observed value. This study provided a proof of concept for metabolic characterization of the effect of ld-IL-2 in ALS. These data could present advances toward a personalized medicine approach and present pharmacometabolomics as a key tool to complement genomic and transcriptional data for drug characterization, leading to systems pharmacology.

Accuracy of conventional impressions and digital scans for implant-supported fixed prostheses in maxillary free-ended partial edentulism: An in vitro study.

OBJECTIVES: To evaluate the accuracy of conventional polyether impressions and digital scans produced by five intra-oral scanners (IOSs) in maxillary free-ended partial edentulism for long-span implant-supported prostheses. METHODS: This in vitro study involved the impression of a maxillary model with free-end partial edentulism, in which six implants were placed before digitization using a desktop scanner to generate a digital reference model. Conventional impressions (Impregum Penta Soft, 3M) and digital scans with five IOSs (Trios 3 and 4, 3Shape; Primescan, Dentsply-Sirona; CS 3600, Carestream Dental; and i-500, Medit) were obtained. Conventional impressions were digitized using the same desktop scanner. Each digital STL file of conventional or digital impressions was superimposed over the reference STL file to enable comparison. Trueness was assessed by calculating angles and distance deviations. For precision, dispersions of values around their means were also measured. RESULTS: The mean distance deviation was significantly higher for conventional impressions (454.24 ± 334.70 µm) than for IOSs (ranging from 160.98 ± 204.48 µm to 255.56 ± 395.89 µm) (p < 0.001). The mean angular deviation was high with conventional impressions (1.82 ± 1.51°), intermediate with CS 3600 (1.38 ± 1.42°), Primescan (1.37 ± 2.54°) and Trios 4 (1.30 ± 0.64°) scanners, and lower with I500 (0.97 ± 0.75°) and Trios 3 (1.01 ± 0.85°) scanners (p < 0.001). The dispersion of distance values around their means was lowest with Trios 3 and i-500, followed by CS3600, Primescan, and Trios 4, respectively, and higher for conventional impressions (p < 0.001). The dispersion of angular values was smallest with i-500, Trios 3, and Trios 4 compared with other groups and was highest with Primescan (p < 0.001). CONCLUSIONS: Within the limits of the current study, Trios 3 scanner exhibited the highest accuracy, followed by i-500, Trios 4, CS 3600, Primescan, and conventional impressions respectively. IOSs might be reliable for the fabrication of an implant-supported prosthesis. In vivo studies are required to confirm these findings. CLINICAL SIGNIFICANCE: Passive adaptation of the implant-supported framework is a challenge when rehabilitating patients with maxillary free-end partial edentulism. While Conventional impressions remain a reliable and validated technique, but IOSs demonstrated higher accuracy, suitable for the fabrication of long-span implant-supported prostheses in partially edentulous arch.

Oral implant rehabilitation under general anesthesia for patients with cognitive and physical disabilities: A 14-year cohort study.

STATEMENT OF PROBLEM: Oral rehabilitation with implants is an alternative to the provision of removable dentures in all patients for whom missing teeth require replacement. However, individuals with cognitive, mental health issues, and/or physical disabilities are often excluded from implant-supported prostheses because of the high perceived risk of failure linked to poor oral health, presence of parafunction, or systemic conditions. PURPOSE: The purpose of this cohort study was to describe the protocols, outcomes, and survival rates of oral rehabilitation with implant-supported prostheses in patients with cognitive and physical disabilities treated under general anesthesia (GA) in a French unit of Special Care Dentistry. MATERIAL AND METHODS: A retrospective cohort study was conducted on patient files. Data collected included demographics and information about the surgical and prosthetic phases of rehabilitation. Clinical and radiological reports were retrieved to establish the survival, success, and failure rates of implant placement according to the Health Scale for Dental Implants (HDSI) classification. RESULTS: A total of 298 dental implants had been placed under GA in 57 patients between January 2007 and August 2021. The prevalence of technical and biological postoperative complications was found to be 14% and 13% respectively. Thirty implants were determined to be failures. The estimated survival time in the population studied for loaded implants was 144.7 months [138.0; 151.3]. The cumulative survival rate was estimated to be 86% at 157 months. CONCLUSIONS: Implant-supported prostheses were found to be effective, and oral rehabilitation carried out under the conditions described was determined to be stable.

Accuracy of Conventional and Digital Impressions for Full-Arch Implant-Supported Prostheses: An In Vitro Study.

Both conventional and digital impressions aim to record the spatial position of implants in the dental arches. However, there is still a lack of data to justify the use of intraoral scanning over conventional impressions for full-arch implant-supported prostheses. The objective of the in vitro study was to compare the trueness and precision of conventional and digital impressions obtained with four intra-oral scanners: Trios 4 from 3Shape®, Primescan from Dentsply Sirona®, CS3600 from Carestream® and i500 from Medit®. This study focused on the impression of an edentulous maxilla in which five implants were placed for implant-supported complete prosthesis. The digital models were superimposed on a digital reference model using dimensional control and metrology software. Angular and distance deviations from the digital reference model were calculated to assess trueness. Dispersion of the values around their mean for each impression was also calculated for precision. The mean distance deviation in absolute value and the direction of the distance deviation were smaller for conventional impressions (p-value < 0.001). The I-500 had the best results regarding angular measurements, followed by Trios 4 and CS3600 (p < 0.001). The conventional and I-500 digital impressions showed the lowest dispersion of values around the mean (p-value < 0.001). Within the limitations of our study, our results revealed that the conventional impression was more accurate than the digital impression, but further clinical studies are needed to confirm these findings.

Comprehensive CAD/CAM Prosthetic Rehabilitation Management in a Young Patient with Agenesis: A Case Report.

With the advancement in ceramic restorations bonded to the tooth structure, the treatment has become a practicable and conservative option to restore teeth with shape alteration owing to the high demand for aesthetics, with minimum tooth preparation. This article describes the case of a 25-year-old man who was dissatisfied with his smile. After an assessment of the clinical situation, a decision was made to place a full-mouth prosthodontic rehabilitation (monolithic lithium disilicate glass-ceramic, IPS E-max CAD) with minimal tooth preparation, which figures as a conservative full-coverage approach. The restoration of an aesthetic smile resulted in the patient's satisfaction. Bonding of all monolithic veenerlay and crowns onto minimally prepared teeth figures as conservative treatment in cases of hypodontia.

Targeting Cellular Iron Homeostasis with Ironomycin in Diffuse Large B-cell Lymphoma.

Diffuse large B-cell lymphoma (DLBCL) is the most common hematological malignancy. Although more than half of patients with DLBCL achieve long-term remission, the majority of remaining patients succumb to the disease. As abnormal iron homeostasis is implicated in carcinogenesis and the progression of many tumors, we searched for alterations in iron metabolism in DLBCL that could be exploited to develop novel therapeutic strategies. Analysis of the iron metabolism gene expression profile of large cohorts of patients with DLBCL established the iron score (IS), a gene expression-based risk score enabling identification of patients with DLBCL with a poor outcome who might benefit from a suitable targeted therapy. In a panel of 16 DLBCL cell lines, ironomycin, a promising lysosomal iron-targeting small molecule, inhibited DLBCL cell proliferation at nanomolar concentrations compared with typical iron chelators. Ironomycin also induced significant cell growth inhibition, ferroptosis, and autophagy. Ironomycin treatment resulted in accumulation of DNA double-strand breaks, delayed progression of replication forks, and increased RPA2 phosphorylation, a marker of replication stress. Ironomycin significantly reduced the median number of viable primary DLBCL cells of patients without major toxicity for nontumor cells from the microenvironment and presented low toxicity in hematopoietic progenitors compared with conventional treatments. Significant synergistic effects were also observed by combining ironomycin with doxorubicin, BH3 mimetics, BTK inhibitors, or Syk inhibitors. Altogether, these data demonstrate that a subgroup of high-risk patients with DLBCL can be identified with the IS that can potentially benefit from targeting iron homeostasis. SIGNIFICANCE: Iron homeostasis represents a potential therapeutic target for high-risk patients with DLBCL that can be targeted with ironomycin to induce cell death and to sensitize tumor cells to conventional treatments.

Amyotrophic lateral sclerosis transcriptomics reveals immunological effects of low-dose interleukin-2.

Amyotrophic lateral sclerosis is a fatal neurodegenerative disease causing upper and lower motor neuron loss and currently no effective disease-modifying treatment is available. A pathological feature of this disease is neuroinflammation, a mechanism which involves both CNS-resident and peripheral immune system cells. Regulatory T-cells are immune-suppressive agents known to be dramatically and progressively decreased in patients with amyotrophic lateral sclerosis. Low-dose interleukin-2 promotes regulatory T-cell expansion and was proposed as an immune-modulatory strategy for this disease. A randomized placebo-controlled pilot phase-II clinical trial called Immuno-Modulation in Amyotrophic Lateral Sclerosis was carried out to test safety and activity of low-dose interleukin-2 in 36 amyotrophic lateral sclerosis patients (NCT02059759). Participants were randomized to 1MIU, 2MIU-low-dose interleukin-2 or placebo and underwent one injection daily for 5 days every 28 days for three cycles. In this report, we describe the results of microarray gene expression profiling of trial participants' leukocyte population. We identified a dose-dependent increase in regulatory T-cell markers at the end of the treatment period. Longitudinal analysis revealed an alteration and inhibition of inflammatory pathways occurring promptly at the end of the first treatment cycle. These responses are less pronounced following the end of the third treatment cycle, although an activation of immune-regulatory pathways, involving regulatory T-cells and T helper 2 cells, was evident only after the last cycle. This indicates a cumulative effect of repeated low-dose interleukin-2 administration on regulatory T-cells. Our analysis suggested the existence of inter-individual variation amongst trial participants and we therefore classified patients into low, moderate and high-regulatory T-cell-responders. NanoString profiling revealed substantial baseline differences between participant immunological transcript expression profiles with the least responsive patients showing a more inflammatory-prone phenotype at the beginning of the trial. Finally, we identified two genes in which pre-treatment expression levels correlated with the magnitude of drug responsiveness. Therefore, we proposed a two-biomarker based regression model able to predict patient regulatory T-cell-response to low-dose interleukin-2. These findings and the application of this methodology could be particularly relevant for future precision medicine approaches to treat amyotrophic lateral sclerosis.

Dental Trauma Management in a Young Teenager through Endodontics and Implantology: A Case Report.

Endodontic treatment is often the first-line procedure to manage the immediate or long-term aftermath of dental trauma, particularly in cases of luxation or avulsion. Failure to manage trauma in the short or medium term leads to significant functional or aesthetic consequences, especially in the adolescence period. Under this specific conditions, endodontic treatment could provide a temporary solution by keeping teeth with poor prognosis on the arch while waiting for better anatomical conditions for implantology. This clinical case aimed to describe the management of a maxilla-facial dental trauma and the following consequences in a 10-year-old male patient. Clinical and radiological examination showed complete extrusive luxation of 11 and 21 and intrusive luxation of 12 and 22. Endodontic treatment of 11 and 21 was performed six months after the trauma. Two years later, the patient was referred to the endodontic department because pink spot lesions appeared on 12 and 22 due to cervical invasive resorptions (class III for 12 and class II for 22). Endodontic treatment of 12 and filling with resin composite of 22 were performed. During the following two years, complication management finally led to placement of four OBI® (Euroteknika, Sallanches, France)-type mini-implants after avulsion of all four maxillary incisors. Palliative endodontic treatment helped maintain the prosthetic space and the volume of supporting tissue needed for future implant placement. The interest of using delaying procedures (palliative endodontic treatments and mini-implants) was to allow the patient to complete growth. Managing early treatment failure of trauma in adolescents has to be pluridisciplinary and should take into account the evaluation of the treatment's difficulty, the prognosis of the endodontic treatment, the available bone volume and the pubertal growth stage.

Repeated 5-day cycles of low dose aldesleukin in amyotrophic lateral sclerosis (IMODALS): A phase 2a randomised, double-blind, placebo-controlled trial.

BACKGROUND: Low-dose interleukin-2 (ld-IL-2) enhances regulatory T-cell (Treg) function in auto-inflammatory conditions. Neuroinflammation being a pathogenic feature of amyotrophic lateral sclerosis (ALS), we evaluated the pharmacodynamics and safety of ld-IL-2 in ALS subjects. METHODS: We performed a single centre, parallel three-arm, randomised, double-blind, placebo-controlled study. Eligibility criteria included age < 75 years, disease duration < 5 years, riluzole treatment > 3 months, and a slow vital capacity ≥ 70% of normal. Patients were randomised (1:1:1) to aldesleukin 2 MIU, 1 MIU, or placebo once daily for 5 days every 4 weeks for 3 cycles. Primary outcome was change from baseline in Treg percentage of CD4+ T cells (%Tregs) following a first cycle. Secondary laboratory outcomes included: %Treg and Treg number following repeated cycles, and plasma CCL2 and neurofilament light chain protein (NFL) concentrations as surrogate markers of efficacy. Safety outcomes included motor-function (ALSFRS-R), slow vital capacity (SVC), and adverse event reports. This trial is registered with ClinicalTrials.gov, NCT02059759. FINDINGS: All randomised patients (12 per group), recruited from October 2015 to December 2015, were alive at the end of follow-up and included in the intent-to-treat (ITT) analysis. No drug-related serious adverse event was observed. Non-serious adverse events occurred more frequently with the 1 and 2 MIU IL-2 doses compared to placebo, including injection site reactions and flu-like symptoms. Primary outcome analysis showed a significant increase (p < 0·0001) in %Tregs in the 2 MIU and 1 MIU arms (mean [SD]: 2 MIU: +6·2% [2·2]; 1 MIU: +3·9% [1·2]) as compared to placebo (mean [SD]: -0·49% [1·3]). Effect sizes (ES) were large in treated groups: 2 MIU ES=3·7 (IC95%: 2·3-4·9) and 1 MIU ES=3·5 (IC95%: 2·1-4·6). Secondary outcomes showed a significant increase in %Tregs following repeated cycles (p < 0·0001) as compared to placebo, and a dose-dependent decrease in plasma CCL2 (p = 0·0049). There were no significant differences amongst the three groups on plasma NFL levels. INTERPRETATION: Ld-IL-2 is well tolerated and immunologically effective in subjects with ALS. These results warrant further investigation into their eventual therapeutic impact on slowing ALS disease progression. FUNDING: The French Health Ministry (PHRC-I-14-056), EU H2020 (grant #633413), and the Association pour la Recherche sur la SLA (ARSLA).

A Retrospective Comparison of DLI and gDLI for Post-Transplant Treatment.

Donor lymphocyte infusion (DLI) is used to prevent or treat haematological malignancies relapse after allogeneic stem cell transplantation (allo-SCT). Recombinant human granulocyte colony-stimulated factor primed DLI (gDLI) is derived from frozen aliquots of the peripheral blood stem cell collection. We compared the efficacy and safety of gDLI and classical DLI after allo-SCT. We excluded haploidentical allo-SCT. Initial diseases were acute myeloblastic leukaemia (n = 45), myeloma (n = 38), acute lymphoblastic leukaemia (n = 20), non-Hodgkin lymphoma (n = 10), myelodysplasia (n = 8), Hodgkin lymphoma (n = 8), chronic lymphocytic leukaemia (n = 7), chronic myeloid leukaemia (n = 2) and osteomyelofibrosis (n = 1). Indications for DLI were relapse (n = 96) or pre-emptive treatment (n = 43). Sixty-eight patients had classical DLI and 71 had gDLI. The response rate was 38.2%, the 5-year progression-free survival (PFS) rate was 38% (29-48) and the 5-year overall survival (OS) rate was 37% (29-47). Graft versus host disease rate was 46.7% and 10.1% of patients died from toxicity. There were no differences between classical DLI and gDLI in terms of response (p = 0.28), 5-year PFS (p = 0.90), 5-year OS (p. 0.50), GvHD (p = 0.86), treated GvHD (p = 0.81) and cause of mortality (p. 0.14). In conclusion, this study points out no major effectiveness or toxicity of gDLI compared to classical DLI.

Correction to: Characterization of immortalized human islet stromal cells reveals a MSC-like profile with pancreatic features.

An amendment to this paper has been published and can be accessed via the original article.

Characterization of immortalized human islet stromal cells reveals a MSC-like profile with pancreatic features.

BACKGROUND: Mesenchymal stromal cells (MSCs) represent an interesting tool to improve pancreatic islet transplantation. They have immunomodulatory properties and secrete supportive proteins. However, the functional properties of MSCs vary according to many factors such as donor characteristics, tissue origin, or isolation methods. To counteract this heterogeneity, we aimed to immortalize and characterize adherent cells derived from human pancreatic islets (hISCs), using phenotypic, transcriptomic, and functional analysis. METHODS: Adherent cells derived from human islets in culture were infected with a hTERT retrovirus vector and then characterized by microarray hybridization, flow cytometry analysis, and immunofluorescence assays. Osteogenic, adipogenic, and chondrogenic differentiation as well as PBMC proliferation suppression assays were used to compare the functional abilities of hISCs and MSCs. Extracellular matrix (ECM) gene expression profile analysis was performed using the SAM (Significance Analysis of Microarrays) software, and protein expression was confirmed by western blotting. RESULTS: hISCs kept an unlimited proliferative potential. They exhibited several properties of MSCs such as CD73, CD90, and CD105 expression and differentiation capacity. From a functional point of view, hISCs inhibited the proliferation of activated peripheral blood mononuclear cells. The transcriptomic profile of hISCs highly clusterized with bone marrow (BM)-MSCs and revealed a differential enrichment of genes involved in the organization of the ECM. Indeed, the expression and secretion profiles of ECM proteins including collagens I, IV, and VI, fibronectin, and laminins, known to be expressed in abundance around and within the islets, were different between hISCs and BM-MSCs. CONCLUSION: We generated a new human cell line from pancreatic islets, with MSCs properties and retaining some pancreatic specificities related to the production of ECM proteins. hISCs appear as a very promising tool in islet transplantation by their availability (as a source of inexhaustible source of cells) and ability to secrete a supportive "pancreatic" microenvironment.

DNMTi/HDACi combined epigenetic targeted treatment induces reprogramming of myeloma cells in the direction of normal plasma cells.

BACKGROUND: Multiple myeloma (MM) is the second most common hematologic malignancy. Aberrant epigenetic modifications have been reported in MM and could be promising therapeutic targets. As response rates are overall limited but deep responses occur, it is important to identify those patients who could indeed benefit from epigenetic-targeted therapy. METHODS: Since HDACi and DNMTi combination have potential therapeutic value in MM, we aimed to build a GEP-based score that could be useful to design future epigenetic-targeted combination trials. In addition, we investigated the changes in GEP upon HDACi/DNMTi treatment. RESULTS: We report a new gene expression-based score to predict MM cell sensitivity to the combination of DNMTi/HDACi. A high Combo score in MM patients identified a group with a worse overall survival but a higher sensitivity of their MM cells to DNMTi/HDACi therapy compared to a low Combo score. In addition, treatment with DNMTi/HDACi downregulated IRF4 and MYC expression and appeared to induce a mature BMPC plasma cell gene expression profile in myeloma cell lines. CONCLUSION: In conclusion, we developed a score for the prediction of primary MM cell sensitivity to DNMTi/HDACi and found that this combination could be beneficial in high-risk patients by targeting proliferation and inducing maturation.

A new digital denture procedure: a first practitioners appraisal.

BACKGROUND: Historically, the complete removable denture is the last prosthetic procedure to switch to digital techniques whose advantages are mainly observed in the laboratory stages; however, it is not possible to measure the depressibility of the oral mucosa using optical cameras, thus conventional impression techniques are still necessary. This article describes the clinical and laboratory procedure and practitioners appraisal of the first fifteen digitally designed complete removable dental prostheses. METHODS: Several systems are now available including the Wieland® Digital Denture® which offers a complete procedure. This system is composed of a five axis-milling machine combined with a laboratory scanner and a design software application. Fifteen rehabilitations were carried out using the Wieland® system. RESULTS: The practitioner's role is simplified by intraoral recording with a central point and a reduced number of sessions. The prosthesis laboratory requires considerable investment in learning and equipment, making it possible to obtain ideal mounting assemblies in accordance with the occluso-prosthetic concept of bilateral balanced occlusion. The absence of polymerization and therefore of base deformation risks reduce the equilibration step. Finally, the creation of templates as an alternative to the assembly of teeth on wax makes it possible to functionally validate (masticatory and phonatory) the future dentures. However, this procedure still presented some limitations in terms of scanning and software scope of applications. CONCLUSION: Digital denture design software is relatively efficient and helps to standardize clinical results. However, to this date, improvements of the software are still required for a routine use.

Predictive Parameters of Oral Health Quality of Life in Complete Mandibular Denture Wearers Stabilized by Mini-Implants: A Two-Year Follow-Up Study.

The frequent instability of mandibular removable complete dentures affects patient Oral Health Related Quality of Life (OHRQoL). An innovative therapeutic strategy used to improve stability involves placing four symphyseal mini-implants. This study was aimed at assessing OHRQoL over time in subjects in which mini-implants were placed and exploring if certain parameters could predict the evolution of their OHRQoL. The OHRQoL of subjects with dentures was assessed using the Geriatric Oral Health Assessment Index (GOHAI) before (T0), 2-6 months (T1), twelve months (T2) and twenty-four or more months (T3) after mini-implant setting. Age, gender and chewing ability were tested as explanatory variables for the change in OHRQoL with time. Thirteen women and six men were included (mean age: 69 ± 10 years). After treatment, mean GOHAI scores at T1, T2 and T3 increased significantly (p < 0.001). The GOHAI-Add mean score was not affected by age or gender. Baseline chewing ability impacted the "functional" and "pain and discomfort" fields of the mean GOHAI scores (p < 0.05). The OHRQoL quickly improved after mini-implant placement in complete denture wearers and then stabilized over time. Baseline chewing ability can be used as a predictive parameter of OHRQoL.

Influence of the renewal of removable dentures on oral health related quality of life.

BACKGROUND: The renewal of removable dentures is often suggested to denture wearers subject to discomfort. However, the impact of this rehabilitation on patients' oral health related quality of life and their removable dentures related satisfaction is still unknown. This study was aimed at assessing these patient-centered outcomes and the potential impact of different factors. METHODS: A cohort of 116 patients in need of removable dental prostheses rehabilitation was recruited at a dental hospital over a period of 1 year. The subjects were separated into two groups according to their prosthesis experience (group in need of removable dentures renewal/group needing an removable dentures for the first time). Subjects were asked to answer the "Geriatric Oral Health Assessment Index" (GOHAI) and the "McGill Denture Satisfaction Instrument" before and after a prosthesis integration period (9-12 weeks). RESULTS: GOHAI scores were slightly higher for patients with removable dentures renewal (from 40.6 ± 10.3 to 47.1 ± 10.0, p < 0.001), independently of the type of prosthetic rehabilitation. However, the scores of the GOHAI functional field did not change. Subjects with no removable dentures experience presented an increase in their functional GOHAI score (p < 0.001). Regarding patient removable dentures related satisfaction, only the "Esthetic" (p < 0.001), "Chewing efficiency" (p < 0.001) and "Oral condition" (p < 0.01) items increased after prosthesis renewal. CONCLUSIONS: This study showed that renewing removable dentures only moderately improved the oral health related quality of life and removable dentures related satisfaction of patients, regardless of age, gender or type of rehabilitation. Other tasks are necessary such as the analysis of physiological parameters and qualitative research on patient's expectations.

Ceramo-Metal Crown or Cad-Cam Rehabilitation: Patient and Practitioner Appraisal.

Crowns produced using CAD-CAM technology must be evaluated so they can be integrated in the dentist's therapeutic arsenal. To this end, an evaluation tool for the fixed element units was developed and tested in a randomized cross-over pilot study. At a hospital centre, 10 single crowns from the same dental preparation and produced using CEREC technology were compared to Ceramo-Metal Crowns produced using a conventional procedure. Practitioners generally evaluated CEREC crowns more positively, corroborating the subjects' preference for these crowns. The CEREC technology used in a hospital setting meets the requirements of both patients and practitioners.

Impact of removable partial denture prosthesis on chewing efficiency.

UNLABELLED: Removable partial denture prostheses are still being used for anatomic, medical and economic reasons. However, the impact on chewing parameters is poorly described. OBJECTIVES: The objective of this study was to estimate the impact of removable partial denture prosthesis on masticatory parameters. MATERIAL AND METHODS: Nineteen removable partial denture prosthesis (RPDP) wearers participated in the study. Among them, 10 subjects were Kennedy Class III partially edentulous and 9 with posterior edentulism (Class I). All presented a complete and full dentate opposing arch. The subjects chewed samples of carrots and peanuts with and without their prosthesis. The granulometry of the expectorated boluses from carrot and peanuts was characterized by median particle size (D50), determined at the natural point of swallowing. Number of chewing cycles (CC), chewing time (CT) and chewing frequency (CF=CC/CT) were video recorded. RESULTS: With RPDP, the mean D50 values for carrot and peanuts were lower [Repeated Model Procedures (RMP), F=15, p<0.001] regardless of the type of Kennedy Class. For each food, mean CC, CT and CF values recorded decreased (RMP, F=18, F=9, and F=20 respectively, p<0.01). With or without RPD, the boluses' granulometry values were above the masticatory normative index (MNI) determined as 4,000 µm. CONCLUSION: RPDP rehabilitation improves the ability to reduce the bolus particle size, but does not reestablish fully the masticatory function. CLINICAL RELEVANCE: This study encourages the clinical improvement of oral rehabilitation procedure.