Clinical outcomes of rigid and non-rigid telescopic double-crown-retained removable dental prostheses: An analytical review.

PURPOSE: The objective of this literature review was to analyze the cumulative survival rates (CSRs) of rigid and non-rigid double-crown-retained removable dental prostheses. MATERIALS AND METHODS: Screening of the literature published from January 1995 to December 2019 was performed by using electronic data base (Pubmed) and manual search. The CSRs of rigid and non-rigid double crown removable dental prostheses were investigated. RESULTS: A total of 403 articles were reviewed and 56 relevant articles of them were selected. Subsequently, 25 articles were included for data extraction. These articles were classified according to rigid and non-rigid type double crowns and further subdivided into teeth, implants, and teeth-implant combination types. The CSRs of rigid type double crown ranged from 68.9% to 95.1% of 5 to 10 years in tooth abutments, 94.02% to 100% over a 3-year mean observation periods in implant abutments, and 81.8% to 97.6% in tooth-implant combination. Non-rigid type double crowns had various CSR ranges from 34% to 94% maximum during 10 years observation in teeth abutment. The CSRs of non-rigid type had over 98% in implant abutments, and ranged from 85% to 100% in tooth-implant combination. CONCLUSION: The CSRs of double crowns varies according to types. With accurate evaluation of the remaining teeth and plan of the strategic implant placement, it could be successful treatment alternatives for partially or completely edentulous patients.

The effect of periodontal and prosthodontic therapy on glycemic control in patients with diabetes.

PURPOSE: To evaluate the effect of periodontal and prosthodontic therapy on glycated hemoglobin A(HbA1c) level in patients with diabetes. MATERIALS AND METHODS: This is a retrospective study of 70 patients suffering from diabetes who visited the Kyungpook National University Hospital between January 2016 and May 2018. Patients underwent medical evaluation for their routine check-up, which includes laboratory test for HbA1c levels. Among the 70 patients, 35 patients also visited Kyungpook National University Dental Hospital during the same period to receive periodontal and prosthodontic therapy, while the other 35 patients did not receive such therapy. The HbA1c levels were compared before and after periodontal and prosthodontic therapy. Comparisons between groups and within groups were performed using independent t-test. RESULTS: The HbA1c levels in the group who have received periodontal and prosthodontic therapy decreased from 7.2 to 6.7 (P=.001). The HbA1c levels in the control group decreased from 7.2 to 7.1 (P=.580). The difference in changes between the two patient groups was statistically significant (P=.011). CONCLUSION: Periodontal and prosthodontic therapy can be effective on glycemic control in patients with diabetes.

Precision of the milled full-arch framework fabricated using pre-sintered soft alloy: A pilot study.

PURPOSE: This study aimed to evaluate the marginal discrepancy of full-arch frameworks in implant-supported prostheses fabricated using pre-sintered soft alloy (PSA). MATERIALS AND METHODS: Full-arch metal frameworks were fabricated on the edentulous implant model using casting alloy (CA), fully-sintered hard alloy (FHA), and PSA (n = 4 in each group). To evaluate the misfit of the framework to the abutments, the absolute marginal discrepancy (AMD) values of the frameworks were measured in cross-sectional images that had been drawn as part of the triple-scan protocol. The AMD values were compared among the tested alloy groups using the Kruskal-Wallis test, with a post hoc Mann-Whitney U test (α=.05). RESULTS: The FHA and PSA groups showed lower marginal discrepancies than the CA group (P<.001). However, the FHA group did not differ significantly from the PSA group. CONCLUSION: Soft alloy milling is comparable to hard alloy milling, and it is more precise than casting in terms of the marginal fit of implant-supported, full-arch prostheses.

Tiny RNAs and their voyage via extracellular vesicles: Secretion of bacterial small RNA and eukaryotic microRNA.

MicroRNAs are small non-coding RNAs that bind to the 3'-untranslated region of target mRNAs and have transcriptional or translational inhibitory function in eukaryotes. Before microRNAs were widely known, bacterial non-coding small RNAs around 50-200 nt in length were discovered whose mechanism of action resembled that of microRNAs. Recently, RNAs that are of similar size to or smaller than microRNAs have been discovered in bacteria and indeed, this class of small RNAs have been found throughout all domains of life. Moreover, recent findings suggest that these tiny RNAs can be released via extracellular vesicles (such as exosomes in eukaryotes and outer membrane vesicles in bacteria), which in turn heralds a new field of research, interkingdom communication. This review discusses two similar classes of small RNAs in evolutionarily distinct eukaryotes and bacteria. In addition to their biogenesis and regulation, we discuss small RNA vehicles and their secretion. Impact statement The possible endogenous functions of small RNAs such as regulatory small RNAs in bacteria and microRNAs in eukaryotes have been extensively studied since they were first discovered. However, their powerful functions should not be seen as limited to their cells of origin. Recently, several papers have demonstrated that small RNAs function as signaling molecules between cells. This is possible because small RNAs can be shuttled around after being incorporated into environmentally protective extracellular vesicles. It is now clearly plausible that secreted small RNAs can regulate other types of cells through biofluids. Given their "common molecule" status, the role of small RNAs in mediating bacteria-human crosstalk is an emerging and competitive area of genetic research. This review provides insight into the function of small RNAs in intercellular and even interkingdom communication.

Long-term evaluations of teeth and dental implants during dental maintenance period.

PURPOSE: This study was designed to evaluate the teeth and dental implants during dental maintenance therapy over 3 years in different conditions after periodontal and dental prosthetic treatment. MATERIALS AND METHODS: 166 patients received maintenance therapy. 59 patients were treated with 2% minocycline-HCl ointment as local drug delivery (LDD) (L group) and 107 patients were treated without LDD (NL group). Clinical data was collected in maintenance period for evaluation. Patients were classified into groups depending on the application of LDD with maintenance therapy, the type of dental treatment before maintenance period (Pre-Tx), the frequency (F-MT), and regularity (R-MT) of maintenance therapy. RESULTS: The numbers of lost teeth (N-teeth, P=.003) and newly placed dental implants (N-implants, P=.022) are significantly different according to Pre-Tx. F-MT among patients who received surgical dental treatment before maintenance period showed statistical differences in N-teeth (P=.041), but not in N-implants (P=.564). All of the patients in L group showed high F-MT (F-MT1). In NL group, there were no statistical differences in N-teeth or N-implants according to F-MT or R-MT. In F-MT1 group, application of LDD made N-teeth significantly different from both Pre-Tx groups while no significant difference could be found in N-implant. Independent t-test and one-way ANOVA were selected for statistical analysis. CONCLUSION: The regular maintenance therapy and LDD can be effective for teeth during maintenance period. It is not only pharmacological efficacy in decreasing bacterial species that makes LDD a useful adjunct. Application of LDD also motivates patients to take adequate check-ups in the aspects of both frequency and regularity.

Comparison of the fit accuracy of zirconia-based prostheses generated by two CAD/CAM systems.

PURPOSE: The purposes of this study are to evaluate the internal and marginal adaptation of two widely used CAD/CAM systems and to study the effect of porcelain press veneering process on the prosthesis adaptation. MATERIALS AND METHODS: Molar of a lower jaw typodont resin model was prepared by adjusting a 1.0 mm circumferential chamfer, an occlusal reduction of 2.0 mm, and a 5° convergence angle and was duplicated as an abrasion-resistant master die. The monolithic crowns and copings were fabricated with two different CAD/CAM system-Ceramil and Zirkonzahn systems. Two kinds of non-destructive analysis methods are used in this study. First, weight technique was used to determine the overall fitting accuracy. And, to evaluate internal and marginal fit of specific part, replica technique procedures were performed. RESULTS: The silicone weight for the cement space of monolithic crowns and copings manufactured with Ceramil system was significantly higher than that from Zirkonzahn system. This gap might cause the differences in the silicone weight because the prostheses were manufactured according to the recommendation of each system. Marginal discrepancies of copings made with Ceramil system were between 106 and 117 µm and those from Zirkonzahn system were between 111 and 115 µm. Marginal discrepancies of copings made with Ceramil system were between 101 and 131 µm and those from Zirkonzahn system were between 116 and 131 µm. CONCLUSION: Marginal discrepancy was relatively lower in Ceramil system and internal gap was smaller in Zirkonzahn system. There were significant differences in the internal gap of monolithic crown and coping among the 2 CAD/CAM systems. Marginal discrepancy produced from the 2 CAD/CAM systems were within a reported clinically acceptable range of marginal discrepancy.

Long-term evaluation of teeth and implants during the periodic maintenance in patients with viral liver disease.

PURPOSE: This study was designed to investigate the maintenance of teeth and implants in patients with viral liver disease. MATERIALS AND METHODS: 316 patients without any significant systemic disease were selected as a control group. Liver disease group was consisted of 230 patients. Necessary data were collected using clinical records and panoramic radiographs. Then, the patients were subdivided into 2 groups based on the type of active dental therapy received before maintenance period (Pre-Tx). Analysis for finding statistically significant difference was performed based on the need for re-treatment of active dental therapy (Re-Tx) and change in the number of teeth (N-teeth) and implants (N-implants). RESULTS: Comparing to control group, the patients with liver disease showed higher value on N-teeth, N-implants, and Re-Tx. Statistically significant differences were found on N-teeth (P=.000) and Re-Tx (P=.000) in patients with non-surgical Pre-Tx. Analysis based on severity of liver disease showed that N-teeth and Re-Tx were directly related to severity of liver disease regardless of received type of Pre-Tx. Significant differences were found on N-teeth (P=.003) and Re-Tx (P=.044) in patients with non-surgical Pre-Tx. CONCLUSION: In this study, it was concluded that liver disease might influence the loss of teeth and cause the relapse of dental disease during maintenance period in patients. A significant positive relationship between tooth and implant loss and severity of liver disease seems to exist.

MCT4 as a potential therapeutic target for metastatic gastric cancer with peritoneal carcinomatosis.

Monocarboxylate transporters (MCTs) play a major role in up-regulation of glycolysis and adaptation to acidosis. However, the role of MCTs in gastric cancer (GC) is not fully understood. We investigated the potential utilization of a new cancer therapy for GC. We characterized the expression patterns of the MCT isoforms 1, 2, and 4 and investigated the role of MCT in GC through in vitro and in vivo tests using siRNA targeting MCTs. In GC cell lines, MCT1, 2, and 4 were up-regulated with different expression levels; MCT1 and MCT4 were more widely expressed in GC cell lines compared with MCT2. Inhibition of MCTs by siRNA or AR-C155858 reduced cell viability and lactate uptake in GC cell lines. The effect of inhibition of MCTs on tumor growth was also confirmed in xenograft models. Furthermore, MCT inhibition in GC cells increased the sensitivity of cells to radiotherapy or chemotherapy. Compared with normal gastric tissue, no significant alterations of expression levels in tumors were identified for MCT1 and MCT2, whereas a significant increase in MCT4 expression was observed. Most importantly, MCT4 was highly overexpressed in malignant cells of acsites and its silencing resulted in reduced tumor cell proliferation and lactate uptake in malignant ascites. Our study suggests that MCT4 is a clinically relevant target in GC with peritoneal carcinomatosis.

The Use of Telescopic Crowns in Removable Partial Denture Treatment for Patients with Severe Periodontal Disease: Two Patient Case History Reports.

Two patient case histories are described as examples of treatment of severe periodontitis in severely compromised partial dentitions. Management consisted of periodontal treatment and telescopic crown support for removable partial dentures with friction pin retention.

A simplified pocket reduction procedure around a stud attachment without suturing.

Plaque accumulation on the implant titanium surface plays a critical role in the initiation and progression of periimplant disease. Removing plaque and calculus deposits, and reducing the periimplant probing depth, therefore, are important. The reduction of the periimplant probing depth in periimplant disease by using a cord and a surgical dressing pack has not been previously reported. This procedure is useful for periimplant mucositis and mild periimplantitis before a surgical intervention and can maintain a narrow keratinized mucosa with less pain than surgical intervention.

Implant overdenture impressions using a dynamic impression concept.

A dynamic impression is a functional impression that records the functional movement of the patient's own muscle and muscle attachment. This process reduces the number of random factors. This article describes a method for making a special tray using a dynamic impression concept that was made from provisional dentures used for implant healing. The individual tray is used to make a wash-impression to record the features of the mucosa in detail. The main advantage of this technique is that it provides a functional relationship of the implant components to the supporting tissues without overextension because provisional denture had been used for 2 months and the border length of individual tray was nearly the same as that of provisional denture. The delivery of the prosthesis constructed using this impression technique is time-saving because there is no need for border molding and there are fewer post-insertion appliance adjustments.

The influence of systemically administered oxytocin on the implant-bone interface area: an experimental study in the rabbit.

PURPOSE: The purpose of this study was to assess the effect of systemically administered oxytocin (OT) on the implant-bone interface by using histomorphometric analysis and the removal torque test. MATERIALS AND METHODS: A total of 10 adult, New Zealand white, female rabbits were used in this experiment. We placed 2 implants (CSM; CSM Implant, Daegu, South Korea) in each distal femoral metaphysis on both the right and left sides; the implants on both sides were placed 10 mm apart. In each rabbit, 1 implant was prepared for histomorphometric analysis and the other 3 were prepared for the removal torque test (RT). The animals received intramuscular injections of either saline (control group; 0.15 M NaCl) or OT (experimental group; 200 µg/rabbit). The injections were initiated on Day 3 following the implant surgery and were continued for 4 subsequent weeks; the injections were administered twice per day (at a 12-h interval), for 2 days per week. RESULTS: While no statistically significant difference was observed between the two groups (P=.787), the control group had stronger removal torque values. The serum OT concentration (ELISA value) was higher in the OT-treated group, although no statistically significant difference was found. Further, the histomorphometric parameter (bone-toimplant contact [BIC], inter-thread bone, and peri-implant bone) values were higher in the experimental group, but the differences were not significant. CONCLUSION: We postulate that OT supplementation via intramuscular injection weakly contributes to the bone response at the implant-bone interface in rabbits. Therefore, higher concentrations or more frequent administration of OT may be required for a greater bone response to the implant. Further studies analyzing these aspects are needed.

Comparison of osseointegration between laser-etched and magnesium-incorporated oxidized implants in the rabbit femur.

PURPOSE: To compare the osseointegration of a laser-etched (LE) implant with a magnesium-incorporated oxidized (MgO) implant, evaluating their ability to enhance the bond strength between a titanium substrate and rabbit femur. MATERIALS AND METHODS: Two type of dental implants, LE (test, commercially pure [CP] titanium grade 4) and MgO (control, CP titanium grade 4) (length, 8 mm; diameter, 3.3 mm), were evaluated for the surface characteristics using a field emission scanning electron microscope (FE-SEM), an energy dispersive spectrometer (EDS), and an optical three-dimensional profiling system. After that, two types of dental implants were implanted at the right and left distal femoral metaphysis of 10 adult rabbits weighing approximately 3.0 kg. After 6 weeks, histomorphometric analysis, removal torque tests, and surface analysis of the torque-tested implants were performed. RESULTS: After surgery, the LE group showed thick bonelike materials within the pores observed using FE-SEM (magnifications ×500 and ×900). The mean removal torque was 40.72 ± 13.3 Ncm for the test (LE) implant and 22.26 ± 6.4 Ncm for the control (MgO) implant, respectively (P = .041). The mean bone-implant contact in the three best consecutive threads in the cortical region was 63.35% ± 16.44% in the LE group and 51.63% ± 5.09% in the MgO. CONCLUSIONS: In the beginning stage of cancellous bone healing, biomechanical properties of the LE implant could influence a more favorable bone response than that of MgO.

A case report of paraneoplastic pemphigus associated with esophageal squamous cell carcinoma.

Paraneoplastic pemphigus is an autoimmune blistering and erosive mucocutaneous syndrome associated with underlying neoplasm. It is primarily associated with lymphoproliferative disorders, and uncommonly with malignancies of epithelial origin. We report on a case of a 68-year-old male who presented with whole body bullous and erosive skin lesions. Findings on upper gastrointestinal endoscopy and skin biopsy revealed esophageal squamous cell carcinoma and paraneoplastic pemphigus. Palliative chemotherapy and systemic glucocorticoid were started, however, the patient died of overwhelming sepsis on the ninth day of chemotherapy. This case demonstrates that paraneoplastic pemphigus can occur in esophageal squamous cell carcinoma and could be a cause of morbidity.

Relationship of tooth mortality and implant treatment in Type 2 diabetes mellitus patients in Korean adults.

PURPOSE: The purpose of this study was to to analyze the effect of Type 2 diabetes on tooth mortality, implant treatment and prosthetic status. MATERIALS AND METHODS: 275 Type 2 diabetics and 300 non-diabetics, aged 40-80 years were selected for analysis. The assessment of number of teeth, missing teeth, fixed prostheses (bridge pontics), implants using panoramic radiographs and dental records were carried out. RESULTS: Diabetes mellitus (DM) patients had a higher number of missing teeth (P<.05) and placed implants (P=.074), age (P<.05), male gender percentage (P=.042), smoker percentage (P<.05) than non-DM patients. In univariate analysis, the patients in older group showed significantly higher number of tooth loss rate at the first dental examination than the patients in younger group. Tooth loss rate of smokers did not show higher value than that of non-smokers. When multiple variables including DM, age, smoking, gender were considered together, diabetics and older group patients showed significantly higher tooth loss rate at the first dental examination than non-diabetics and younger group patients, respectively. Smokers and male group did not show a significant difference than non-smokers and female group, respectively. CONCLUSION: Tooth mortality and implant treatment rate were significantly higher in the DM group as indicated by univariate and multivariate logistic regression analysis. Old age groups showed significantly higher odds ratios and tooth loss rate. As diabetics showed the higher tooth loss rate than non-diabetics, diabetics also had more implant restorations than non-diabetics.

Expression of transient receptor potential ankyrin 1 in human dental pulp.

INTRODUCTION: Transient receptor potential ankyrin 1 (TRPA1) is activated by noxious cold (<17°C) and contributes to cold and mechanical hypersensitivity after inflammation and nerve injury. METHODS: To investigate whether TRPA1 is involved in the mediation of nociception, including noxious cold and cold hypersensitivity in teeth, we examined the expression of TRPA1 and sodium channel Nav1.8 in human dental pulp using fluorescent and electron microscopic immunocytochemistry. RESULTS: TRPA1 was expressed in a large number of axons branching extensively in the peripheral pulp and in a few axons within the nerve bundles in the core of the coronal pulp and in the radicular pulp. Under electron microscopy, TRPA1 immunoreactivity was typically localized near the plasma membrane of unmyelinated axons in the peripheral pulp, suggesting that in these axons it may act as a functional receptor. The proportion of axons expressing TRPA1 in neurofilament 200-positive axons significantly increased in the painful pulp compared with the normal pulp. TRPA1 was also densely expressed in the processes and the cell body of odontoblasts. A large number of axons coexpressed TRPA1 and Nav1.8. CONCLUSIONS: These findings support the notion that TRPA1 is involved in the perception of noxious cold and cold hypersensitivity in human dental pulp and that TRPA1-mediated nociception is primarily mediated by axons and odontoblasts in the peripheral pulp.

Prognostic relevance of pretreatment quality of life in diffuse large B-cell lymphoma patients treated with rituximab-CHOP: results from a prospective cohort study.

The self-reported quality of life (QoL) has been used as an index of general health status. Thus, we evaluated the significance of pretreatment QoL in predicting survival outcome of patients with diffuse large B cell lymphoma (DLBCL). Two hundred sixty-three patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) were enrolled to this prospective cohort study, and their QoL was evaluated. The pretreatment QoL was significantly associated with increased serum lactate dehydrogenase, extranodal involvement, and stage III/IV. Patients scoring poorly on the global health and function scale and high on the symptom/sign scale completed treatment at a significantly lower rate than patients with good scale. The treatment-related mortality was also more frequent in patients with poor QoL. The univariate analysis showed a prognostic relevance of pretreatment QoL, so the poor QoL group showed a worse survival outcome than the good QoL group. This pretreatment QoL also independently predicted overall survival in the multivariate analysis. Thus, the pretreatment assessment of QoL may be a valid prognostic marker for DLBCL patients treated with R-CHOP.

A case of swallow syncope associated with cold beverage ingestion.

Swallow syncope (also known as deglutition syncope) is a relatively rare type of syncope that is treatable if diagnosed correctly. We report a case of a 39-year-old man with recurrent swallow syncope. The patient did not have structural heart disease. He developed a complete atrioventricular block upon drinking a cold beverage (Chilsung cider) while undergoing a repeated head-up tilt test. The patient was advised to avoid cold beverages and has been symptom free for 5 months.

Nilotinib in patients with metastatic melanoma harboring KIT gene aberration.

PURPOSE: Patients with metastatic melanoma have a poor prognosis and few treatment options are available. We evaluated the anti-tumor activity and safety of nilotinib, a KIT inhibitor, in patients with metastatic melanoma harboring KIT alterations, either mutations or amplifications. PATIENTS AND METHODS: This study was open-label, single center, prospective phase II clinical trial. Between October 2009 and April 2011, 11 patients with metastatic melanoma harboring KIT gene mutations or KIT gene amplifications were enrolled in the first stage of phase II study and nilotinib was administered orally at a dose of 400 mg twice a day until disease progression or intolerable toxicities. The primary endpoint was response rate and secondary endpoints were safety, progression-free survival (PFS) and overall survival (OS). RESULTS: Of 11 patients, 9 patients were evaluable for treatment response. Of 9 patients, three patients had KIT mutations in exon 11, Leu576Pro, Val559Ala and Lys558Arg; and 6 patients had KIT amplifications > 50 copies compared to control DNA. Two patients achieved partial response (22.2%) and 5 patients achieved stable disease (55.6%). In two patients who responded to nilotinib, both had KIT mutations and showed durable response for 8.4 months and 10.0+ months. Of note, one patient with KIT amplification had stable disease with response for 6 months. A decrease in tumor size from baseline was observed in four patients (44.4%). Nilotinib 800 mg/d was very well tolerated with grade 1 nausea and grade 1 dry-eye being the most common adverse events. CONCLUSIONS: We have decided to publish the preliminary results because anti-tumor activity of nilotinib was promising in KIT mutated patients. Although our results are preliminary, nilotinib had very favorable toxicity profile with durable response in metastatic melanoma patients with KIT mutations. The anti-tumor activity of nilotinib in melanoma patients with KIT amplification is yet to be determined in future studies. Currently, phase II nilotinib trial is ongoing in Korea as multi-center study.