Maternal and infant oral health benefits from mothers receiving prenatal total oral rehabilitation: a pilot prospective birth cohort study.

Aim: This study aimed to evaluate the maternal and infant oral health benefits from mothers receiving prenatal total oral rehabilitation (PTOR) before childbirth. Methods: Building upon our previous investigation, in which 15 expectant mothers received PTOR before their third trimester, achieving a state of oral health free from disease prior to delivery, we conducted a follow-up study to monitor these mothers and their newborns until they reached 2 years of age. We assessed the impact of PTOR on maternal and infant oral health, the utilization of dental care during the postpartum/early-life period, and the carriage of oral cariogenic microorganisms among mothers and their infants. Control groups consisting of 11 children and 17 mothers who did not undergo PTOR were included for comparative analysis. Results: PTOR demonstrated a sustained improvement in maternal oral health outcomes by the end of 2 years postpartum, evidenced by a reduction in the Plaque Index and decayed surfaces compared with the control group (p < 0.05). PTOR was also associated with increased perinatal oral health literacy compared with the baseline of the mothers themselves (p < 0.05). In addition, PTOR led to a notable increase in maternal dental care utilization, rising from 26.7% before PTOR to 80% at 1 year postpartum and 70% at 2 years postpartum. Intriguingly, 40% of infants in the PTOR group had their first dental visit before reaching 1 year of age, in contrast to national data from the USA indicating a rate of less than 1%. Furthermore, a decrease in plaque Streptococcus mutans was observed in PTOR mothers 2 years postpartum, compared with both their baseline carriage and that of the control group (p < 0.05). Infants in the PTOR group also had a lower incidence of early childhood caries, with 18% in the PTOR group vs. 27% in the control group, although this difference was not statistically significant due to the small sample size. Conclusions: PTOR is associated with sustained oral health benefits and improves dental care utilization by mothers and their infants. Large-scale clinical trials are warranted to validate these study findings.

Association between Salivary Hormones, Dental Caries, and Cariogenic Microorganisms during Pregnancy.

Objective: This study aimed to identify the salivary levels of six hormones (progesterone, estradiol, testosterone, cortisol, thyroxine T3, and triiodothyronine T4) in pregnant women, and to assess the association between salivary hormones, dental caries, and cariogenic microorganisms. Methods: This cross-sectional study included 181 low-income US pregnant women who were in their third trimester. Demographic details, oral hygiene practices, and medical backgrounds were obtained via questionnaires and medical records. Calibrated dentists obtained data on plaque index and caries status through comprehensive oral examinations. Unstimulated saliva was collected 2 h before eating and brushing. Salivary hormones were measured with a multiplex assay. Oral Streptococcus mutans (S. mutans) and Candida albicans (C. albicans) were quantified via colony-forming unit (CFU) counts. A latent model was used to generate clusters of pregnant women based on salivary hormone levels, followed by post-clustering analysis. Factors associated with salivary cariogenic microorganisms were further evaluated via multiple regression analyses. Results: Estradiol, progesterone, testosterone, cortisol, T3, and T4 in saliva were detectable at rates of 92%, 97%, 77%, 99%, 71%, and 50%, respectively. Three distinct participant clusters (high, intermediate, and low) were identified based on salivary hormone levels. Intermediate-level and high-level clusters had increased numbers of decayed teeth, decayed surfaces, ICDAS scores, and salivary S. mutans and C. albicans, compared to the low-level cluster (p < 0.05). Covariate analysis demonstrated that the high-level cluster was positively associated with salivary carriage of S. mutans (CFU/mL) (p < 0.05). Participants with higher levels of progesterone, estradiol, testosterone, and cortisol were associated with a high carriage status of S. mutans in saliva (>105 CFU/mL) (p < 0.05). Conclusions: This study demonstrated the feasibility of detecting salivary hormones during pregnancy and revealed the positive association between salivary steroid hormones and cariogenic pathogens.

Mechanism insights into photo-assisted peroxymonosulfate activation on oxygen vacancy-enriched nolanites via an electron transfer regime.

The utilization of photo-assisted persulfate activation for the removal of organic contaminants in water has garnered significant research interest in recent times. However, there remains a lack of clarity regarding specific contributions of light irradiation and catalyst structure in this process. Herein, a photo-assisted peroxymonosulfate (PMS) activation system is designed for the highly efficient degradation of organic contaminants on oxygen vacancy-enriched nolanites (Vo-FVO). Results suggest that the degradation of bisphenol A (BPA) in this system is a nonradical-dominated process via an electron transfer regime, in which VO improves the local electron density and thus facilitates the electron shuttling between BPA and PMS. During BPA degradation, PMS adsorbed at the surface of FVO-180 withdraws electrons near VO and forms FVO-PMS* complexes. Upon light irradiation, photoelectrons effectively restore the electron density around VO, thereby enabling a sustainable electron transfer for the highly efficient degradation of BPA. Overall, this work provides new insights into the mechanism of persulfate activation based on defects engineering in nolanite minerals.

[Application of free anterolateral thigh flap with fascia lata for diabetic foot ulcers with bone exposure].

OBJECTIVE: To investigate the effectiveness of free anterolateral thigh flap (ALTF) with fascia lata in repairing diabetic foot ulcers (DFUs) with bone exposure. METHODS: Between January 2019 and January 2021, 20 patients with DFUs with bone exposure were admitted. There were 17 males and 3 females with a median age of 57.5 years (range, 48-76 years). There were 10 cases of Wagner grade 3 and 10 cases of grade 4. The DFUs formed 1 to 14 months, with a median time of 3 months. The patients underwent CT angiography, which showed extensive atherosclerosis in both lower limbs; 6 of them were severely narrowed or occluded and underwent percutaneous transluminal angioplasty. The size of wound ranged from 7 cm×6 cm to 27 cm×10 cm after applied first-stage debridement combined with vacuum sealing drainage treatment. In the second-stage, free ALTF with fascia lata was used to repair wounds and partial defects of tendons. The size of flap ranged from 8 cm×5 cm to 28 cm×11 cm. The wound of the donor site was sutured directly. The survival of the flap, the healing time of the wound, and the complications were recorded. The laser speckle blood flow imaging system was used to detect the blood perfusion of the flap and the skin around the flap at 2 weeks and 6 months after operation. The foot function was evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) score at 6 months after operation. RESULTS: After operation, effusion under the flap happened in 6 cases, which cured after symptomatic treatment. Flaps survived completely in 14 cases. The tissue necrosis at the edges of the flaps occurred in 3 cases and healed after dressing changes. Venous crisis of flaps occurred in 3 cases, of which 1 case was completely necrotic after exploration, and the other 2 cases were partially alive. The wounds of 3 cases were repaired with skin grafts after debridement and dressing. The flap survival rate was 95.0%, and the limb salvage rate was 100%. The wound healing time after flap transplantation was 14-30 days, with an average of 19.1 days. Two patients had recurrence of peripheral skin ulcers of the flaps within 1 month after healing, which healed after conservative dressing changes. Eighteen cases of incisions at donor site healed by first intention, 2 cases had local skin necrosis and healed by debridement and suture. All patients were followed up 6-30 months, with a median time of 11 months. The texture, appearance, and elasticity of the flaps were good. All patients could walk alone without pain. At 6 months after operation, the AOFAS score was 75.9±11.9, which was significantly different from that (44.7±18.4) before operation ( t=-7.025, P=0.000). The blood perfusion value increased from (38.1±7.8) PU at 2 weeks to (42.7±10.3) PU, and the difference was significant ( t=-4.680, P=0.001). CONCLUSION: Free ALTF with fascia lata has a rich blood supply and a high survival rate. It can be used to repair DFUs with bone exposure. After the free skin flap healed, it can promote revascularization of the affected foot, reduce the probability of ulcer recurrence, and avoid amputation.

Prediction on the number of confirmed Covid-19 with the FUDAN-CCDC mathematical model and its epidemiology, clinical manifestations, and prevention and treatment effects.

This study was to explore the development trend and clinical manifestations of COVID-19 better. The number of confirmed novel coronavirus pneumonia (COVID-19) was predicted based on the FUDAN-CCDC mathematical model (which was a new model namely based on the novel time delay dynamic model and the statistical data from Chinese Center for Disease Control (CCDC)). The epidemiology and clinical manifestations of COVID-19 were studied based on its clinical classification, and the prevention and treatment effects of antibacterial drugs on the COVID-19 were explored. Firstly, a FUDAN-CCDC mathematical model was established to predict the number of confirmed COVID-19 patients. Secondly, 500 COVID-19 patients with clear epidemiological history and confirmed by nucleic acid testing who were admitted to our Hospital from February 1, 2020 to May 1, 2020 were taken as research objects in this study. They were divided into 4 categories: mild cases, moderate cases, severe cases, and critical cases based on the standards given by the World Health Organization (WHO). The general data characteristics, epidemiological characteristics, clinical manifestations characteristics, laboratory indicator characteristics, and prevention and treatment effects of patients with COVID-19 were analyzed. The FUDAN-CCDC model predicted that the peak time of cumulative confirmed cases in Wuhan was from February 1 to February 5, the peak of cumulative confirmed cases was around 60,000, and the peak time of newly confirmed cases was from February 8 to February 11. Most of the patients with COVID-19 in critical cases were older, with an average age of 65.31 ±â€¯8.26 years old; it was mainly imported case (94 cases, 18.8%) at the beginning, and was mainly local cases (406 cases, 81.2%) later. The initial symptoms were fever (447 cases, 89.4%) and cough (304 cases, 60.8%), and the patients in severe and critical cases were often accompanied by respiratory failure and other late symptoms. There were differences in laboratory tests, patients in critical cases had increased procalcitonin (PCT) and less lymphocytes (LYM). The treatment of COVID-19 was mainly moxifloxacin tablets or injections and cefoperazone sodium sulbactam sodium for injection, with significant efficacy, but the cure rate of patients in severe and critical cases was low, which was 83.1% and 68.4% respectively. FUDAN-CCDC could be applied for prediction of the COVID-19 trend. COVID-19 patients with different clinical classifications were different in clinical symptoms, laboratory tests and treatment options, and the cure rate of patients in severe and critical cases was low. This article was conductive to improving the prevention and treatment of COVID-19, so as to provide a theoretical reference.

Enhanced wound healing and osteogenic potential of photodynamic therapy on human gingival fibroblasts.

BACKGROUND: Photodynamic therapy (PDT) has shown ideal antibacterial effects in clinical treatment of periodontal diseases. However, little is known about the specific potential of PDT on human gingival fibroblasts (HGFs) especially cells in the inflamed state, which may contribute to the repairi of periodontal tissue. METHODS: The effect of PDT with different concentrations of methylene blue (5 µM, 10 µM, 20 µM) on cell vitality of healthy and inflamed human gingival fibroblasts was evaluated by CCK-8, and cell migration was assessed by cell scratching assay. The gene expression of interleukin-6 (IL-6), interleukin-8 (IL-8), type I collagen (Col I), fibronectin (FN) and basic fibroblast growth factor (bFGF) were measured with real-time fluorescent quantitative polymerase chain reaction. The alkaline phosphatase (ALP) production and alizarin red staining of mineralized nodules in healthy and inflamed human gingival fibroblasts was evaluated to explore the effect on osteogenic differentiation. RESULTS: PDT with relatively low concentration of methylene blue (5 µM) inhibited the cell vitality of inflamed human gingival fibroblasts (I-HGFs) slightly (P < 0.05), but had no adverse effect on healthy human gingival fibroblasts (H-HGFs) (P > 0.05). As the concentration increased, PDT with 20 µM methylene blue had significantly negative effect on both healthy and inflamed cells. Further, PDT with 5 µM methylene blue was observed to be able to promote the migration of HGFs especially the healthy state, and increases the expression of wound healing related genes including IL-6, COL1, FN, bFGF in healthy and inflamed HGFs (P < 0.05). PDT with 5 µM methylene blue was also capable of increasing the production of ALP and mineralized nodules (P < 0.05), although the better effect was observed in the laser treatment group. CONCLUSIONS: The relatively low concentration of methylene blue mediated PDT is conducive to the growth of H-HGFs while inhibiting the I-HGFs, and it also has the potential to promote the wound healing and osteogenic related functions of both healthy and inflamed HGFs.

Enhanced effects of electrospun collagen-chitosan nanofiber membranes on guided bone regeneration.

It was aim to study the physicochemical features and biocompatibility of electrospun collagen-chitosan membranes, and its potential in guided bone regeneration. Electrospinning technology was applied in the fabrication of electrospun collagen membranes and electrospun collagen-chitosan membranes following observation of scanning electron microscope. Physicochemical properties including tensile strength, elongation rate, porosity, degradation rate, and biocompatibility of membranes were measured then. In vivo, calvarial bone defects created on rats were covered with two kinds of membranes respectively. In the 4th and 8th week, enzyme-linked immunosorbent assay testing bone alkaline phosphatase and osteocalcin, Micro CT analyzing bone volume, bone volume/total volume, trabecular number and trabecular spacing values, and histological staining were carried out for evaluating the potentials of the membranes on bone regeneration. We found that regular and highly-porous structure favoring the adhesion and proliferation of periodontal ligament cells was observed in all electrospinning groups. Compared with electrospun collagen membranes, electrospun collagen-chitosan membranes performed better physiochemical features including higher tensile strength and more stable degradation rate. In the animal model, compared with the other groups, higher levels of bone alkaline phosphatase in the 4th week and osteocalcin in the 8th week were observed in the electrospun collagen-chitosan membrane. Meanwhile, both of the radiographical and histological results further confirmed that the new bone formation (with higher bone volume, bone volume/total volume, Trabecular number, and lower Trabecular spacing) were more active in the electrospun collagen-chitosan membrane. In conclusion, Electrospun collagen-chitosan membranes perform excellent physicochemical properties, biocompatibility, and great effects on guided bone regeneration, which as the membrane has good application prospect in tissue regeneration.

[Clinical application of laser in crown lengthening].

Crown lengthening is one of the most common surgeries in clinical practice. Under the premise of ensuring the biologic width, the adequate crown is exposed by resecting the periodontal soft tissue and (or) hard tissue to meet the prosthodontic and (or) aesthetic requirements. Considering the various advantages of oral laser, such as safe, precise, minimally invasive and comfort, laser has become a promising technology which can be used to improve the traditional crown lengthening. In this review, the principles and characteristics of laser application in crown lengthening, especially in the minimally invasive or flapless crown lengthening will be reviewed. Its pros and cons will also be discussed.

[Effect and mechanism of astragaloside â £ on Toll-like receptor pathway in fibrotic mice after renal ischemia-reperfusion].

The aim of this paper is to study the effect of astragaloside Ⅳ on renal fibrosis mice with ischemia-reperfusion injury (IRI) and discuss the mechanism. Male C57BL/6 50 mice were randomly divided into four groups, namely Sham-operated group, model group, AS-Ⅳ prevention group and AS-Ⅳ treatment group. Since the day of surgery, the mice in astragaloside Ⅳ prevention group were treated with astragaloside Ⅳ by gavage for 30 days at the dose of 30 mg·kg⁻¹·d⁻¹. At the 60th day after surgery, the mice in astragaloside Ⅳ treatment group were treated with astragaloside Ⅳ 100 by gavage for 30 days at the dose of 30 mg·kg⁻¹·d⁻¹. The mice in Sham-operated group and model group were treated with double distilled water containing 0.1% ethanol instead of astragaloside Ⅳ. Serum creatinine and blood urea nitrogen were detected by chemical methods. Histopathological changes and collagen deposition of affected kidneys were observed under optical microscope by HE and Masson staining. The expression levels of Toll like receptor pathway related molecules (TLR4,MyD88,TRAF6,TRAM,TRIF,NF-κB,TNF-α,IL-6, IFN-γ) in affected kidneys were observed by immunohistochemistry, Western blot methods and reverse transcription-PCR atprotein and mRNA levels in each group. The results showed that the degrees of fibrosis and histopathological damage of affected kidneys of mice in model group were the most obvious. And the expression levels of TLR4/MyD88 dependent signaling pathway-related molecules (TLR4 and MyD88, TRAF6 and NF-κB) in affected kidneys of mice in model group were the highest. At the same time, there was no difference in the expression levels of TLR4/MyD88 independent signaling pathway-related molecules（TRAM, TRIF）among sham-operated group, model group, astragaloside IV prevention group and astragaloside Ⅳ treatment group. In astragaloside Ⅳ prevention group and astragaloside Ⅳ treatment group, the injury of affected kidney was obviously reduced, and the protein expression levels of TLR4/MyD88 dependent signaling pathway-related molecules were also correspondingly reduced; at the same time, the expressions of terminal inflammatory cytokines (TNF-α,IL-6, IFN-γ) were suppressed. Therefore, astragaloside Ⅳ may improve renal interstitial fibrosis in mice after IRI by inhibiting the expression of TLR4/MyD88 dependent signaling pathway and the release of inflammatory cytokines (TNF-α,IL-6, IFN-γ), while the TLR4/MyD88 independent signaling pathway may not be involved in the process of renal fibrosis after ischemia-reperfusion injury.

SMART Design of a Bulk-Capped Supramolecular Segment for the Assembly into Organic Interdigital Lipid Bilayer-Like (ILB) Nanosheets.

Rational molecular design for the organic nanocrystal morphology still remains a challenge due to the structural diversity and complicated weak intermolecular interactions. In this work, a typical attractor-repulsor molecule N,N-diphenyl-4-(9-phenyl-fluoren-9-yl) phenylamine (TPA-PF) is designed to explore a general assembly strategy for 2D nanocrystals. Via an interdigital lipid bilayer-like (ILB) molecular packing mode, large-sized lamellar 2D nanosheets are obtained with a length:width:thickness ratio as ≈2500:1000:1. The d-spacing of the largest (001) plane is 1.32 nm, which equals to the thickness of a single interdigital stacking layer. The synergetic effect of the attractive supramolecular segment (TPA) and the repulsive bulky group (PF) is supposed to be the critical factor for the ILB packing that leads to the 2D structures. The attractor-repulsor molecule design is expected to be an effective strategy for the growth of 2D nanocrystals based on small organic molecules.