Impaired Tertiary Dentin Secretion after Shallow Injury in Tgfbr2-Deficient Dental Pulp Cells Is Rescued by Extended CGRP Signaling.

The transforming growth factor ß (TGFß) superfamily is a master regulator of development, adult homeostasis, and wound repair. Dysregulated TGFß signaling can lead to cancer, fibrosis, and musculoskeletal malformations. We previously demonstrated that TGFß receptor 2 (Tgfbr2) signaling regulates odontoblast differentiation, dentin mineralization, root elongation, and sensory innervation during tooth development. Sensory innervation also modulates the homeostasis and repair response in adult teeth. We hypothesized that Tgfbr2 regulates the neuro-pulpal responses to dentin injury. To test this, we performed a shallow dentin injury with a timed deletion of Tgfbr2 in the dental pulp mesenchyme of mice and analyzed the levels of tertiary dentin and calcitonin gene-related peptide (CGRP) axon sprouting. Microcomputed tomography imaging and histology indicated lower dentin volume in Tgfbr2cko M1s compared to WT M1s 21 days post-injury, but the volume was comparable by day 56. Immunofluorescent imaging of peptidergic afferents demonstrated that the duration of axon sprouting was longer in injured Tgfbr2cko compared to WT M1s. Thus, CGRP+ sensory afferents may provide Tgfbr2-deficient odontoblasts with compensatory signals for healing. Harnessing these neuro-pulpal signals has the potential to guide the development of treatments for enhanced dental healing and to help patients with TGFß-related diseases.

Effects of extraoral storage time on autologous gingival graft early healing: A split-mouth randomized study.

AIMS: Despite the established use of palatal tissue grafts for mucogingival procedures, there are no studies on the effect of extraoral storage time on graft outcomes. This prospective split-mouth randomized experimental clinical trial aimed to assess whether gingival graft extraoral storage time affects graft healing. METHODS: Standardized grafts were harvested from the palate and stored extraorally for 2 (Control) or 40 (Test) minutes before being placed at recipient beds. Intraoral scans, clinical photographs, and tissue blood perfusion were obtained preoperatively, postoperatively, and at follow-up visits (Days 2 (PO2), 3 (PO3), 7 (PO7), and 14 (PO14)). Healing Score Index (HSI) and wound fluid (WF) biomarkers (angiogenin, IL-6, IL-8 (CXCL8), IL-33, VEGF-A, and ENA-78 (CXCL5)) were also assessed. RESULTS: Twenty-three participants completed all study visits. Extraoral storage time was 2.3 ± 1.1 min and 42.8 ± 3.4 min for C and T grafts, respectively (p < .0001). Recipient beds remained open for 21.4 ± 1.7 min. No graft underwent necrosis or failed to heal by PO14. Minimal volumetric changes were observed, without significant intergroup differences (p ≥ .11). Graft perfusion initially decreased post-harvesting before peaking on PO7 for both C and T grafts, with no significant intergroup differences (p ≥ .14). HSI values progressively increased, with no significant intergroup differences (p ≥ .22). WF analysis revealed detectable levels for all biomarkers tested, without significant intergroup differences (p ≥ .23). CONCLUSION: Extraoral storage time of 40 min has neither statistically significant nor clinically discernible effects on autologous graft revascularization, early healing, or survival, as determined by physiological, wound healing, and molecular parameters.

The Impact of Technology Teaching in the Dental Predoctoral Curriculum on Students' Perception of Digital Dentistry.

The goal was to assess dental students' perception of digital technologies after participating in a CAD/CAM exercise for scanning, designing, and manufacturing computer-aided provisional fixed dental restorations. A survey was conducted among second- (pre-D2 and post-D2), first- (D1, negative control), third-, and fourth-year dental students (D3 and D4, positive controls). Only OSU College of Dentistry students who completed the activity and completed the surveys were included. Seven questions were rated, which evaluated changes in knowledge, skill, interest, the importance of technology availability in an office, patients' perception of technology, the importance of having the technology, and the expected frequency of clinics utilizing the technology. Statistical analysis was performed with a significance level of 0.05. A total of 74 pre-D2 and 77 post-D2 questionnaires were completed. Additionally, 63 D1, 43 D3, and 39 D4 participants responded to the survey. Significant differences were found for "knowledge" and "skill" between the pre-D2 and post-D2 and pre-D2 and control groups (p < 0.001). There was a significant difference between the post-D2 participants and all the controls in terms of "interest" (p = 0.0127) and preference for in-practice technology availability (p < 0.05). There were significant results between the post-D2 participants and all the controls regarding the importance of technology availability in an office (p < 0.001) and the expected frequency of clinics utilizing the technology (p = 0.01). No significance was found for "value of technology to patients" and "the importance of having the technology". The presence of technology in practice and in educational academic environments significantly improved students' interest and perception of their knowledge and skill.

Effect of scan powder and scanning technology on measured deviations of complete-arch implant supported frameworks digitized with industrial and intraoral scanners.

OBJECTIVES: To evaluate the suitability of intraoral scanners (IOSs) to analyze the fabrication trueness of titanium complete-arch implant-supported frameworks by comparing with an industrial-grade scanner and investigate how anti-reflective scan powder affects measured deviations. METHODS: Ten titanium complete-arch implant-supported frameworks were milled from a reference standard tessellation language (STL) file. An industrial-grade blue light scanner (ATOS Core 80 (AT)) and three IOSs (Primescan (PS), TRIOS T3 (T3), and TRIOS T4 (T4)) with (PS-P, T3-P, and T4-P) or without (PS, T3, and T4) anti-reflective scan powder application were used to generate test STL (TSTL) files of the frameworks. Reference STL and TSTLs were imported into a metrology-grade analysis software (Geomagic Control X) and whole surface root mean square (RMS) values were calculated. Another software (Medit Link v 2.4.4) was used to virtually isolate marginal surfaces of all STL files and marginal RMS values were calculated by using the same metrology-grade analysis software. A linear mixed effects model was used to compare the transformed deviations of the scans performed by using each IOS (with or without powder) with the deviations of those performed by using the reference AT scanner within each surface, where a Box-Cox type transformation was used for variance stability. Bonferroni corrected post-hoc tests were used to compare conditions within each IOS (α=0.05). RESULTS: All IOSs had significantly higher whole surface and marginal RMS values than AT, regardless of the condition (P≤.002). However, scan powder application did not affect the whole surface and marginal RMS values in scans of tested IOSs (P≥.054). CONCLUSION: Measured whole surface and marginal deviations in all IOS scans performed with or without the use of scan powder were higher than those in AT scans. The application of anti-reflective scan powder did not affect the deviations in scans of tested IOSs. CLINICAL SIGNIFICANCE: Even though deviations measured in the scans of tested scanners were significantly different than those in the reference scanner, the maximum raw mean difference was 37.33 µm and the maximum raw confidence interval value of estimated differences was 47.88 µm, which can be considered clinically small taking into account the size of the frameworks tested. Therefore, tested intraoral scanners may be feasible to scan prostheses similar to or smaller than tested frameworks for fabrication trueness analysis, which may facilitate potential clinical adjustments.

Comparison of intraoral and laboratory scanners to an industrial-grade scanner while analyzing the fabrication trueness of polymer and titanium complete-arch implant-supported frameworks.

OBJECTIVES: To compare the scans of different intraoral scanners (IOSs) and laboratory scanners (LBSs) to those of an industrial-grade optical scanner by measuring deviations of complete-arch implant-supported frameworks from their virtual design file. MATERIAL AND METHODS: Ten polyetheretherketone (PEEK) and 10 titanium (Ti) complete-arch implant-supported frameworks were milled from a master standard tessellation language (STL) file. An industrial-grade blue light scanner (AT), 2 LBSs (MT and E4), and 3 IOSs (PS, T3, and T4) were used to generate STL files of these frameworks. All STLs were imported into an analysis software (Geomagic Control X) and overall root mean square (RMS) values were calculated. Marginal surfaces of all STL files were then virtually isolated (Medit Link v 2.4.4) and marginal RMS values were calculated. Deviations in scans of tested scanners were compared with those in scans of AT by using a linear mixed effects model (α = 0.05). RESULTS: When the scans of PEEK frameworks were considered, PS and T3 had similar overall RMS to those of AT (p ≥ .076). However, E4 and T4 had higher and MT had lower overall RMS than AT (p ≤ .002) with a maximum estimated mean difference of 13.41 µm. When the scans of Ti frameworks were considered, AT had significantly lower overall RMS than tested scanners (p ≤ .010) with a maximum estimated mean difference of 31.35 µm. Scans of tested scanners led to significantly higher marginal RMS than scans of AT (p ≤ .006) with a maximum estimated mean difference of 53.90 µm for PEEK and 40.50 µm for Ti frameworks. CONCLUSION: Only the PEEK framework scans of PS and T3 led to similar overall deviations to those of AT. However, scans of all tested scanners resulted in higher marginal deviations than those of AT scans. CLINICAL SIGNIFICANCE: Scans performed by using PS and T3 may be alternatives to those of tested reference industrial scanner AT, for the overall fabrication trueness analysis of complete-arch implant-supported PEEK frameworks.

Scale mixture of skew-normal linear mixed models with within-subject serial dependence.

In longitudinal studies, repeated measures are collected over time and hence they tend to be serially correlated. These studies are commonly analyzed using linear mixed models (LMMs), and in this article we consider an extension of the skew-normal/independent LMM, where the error term has a dependence structure, such as damped exponential correlation or autoregressive correlation of order p. The proposed model provides flexibility in capturing the effects of skewness and heavy tails simultaneously when continuous repeated measures are serially correlated. For this robust model, we present an efficient EM-type algorithm for parameters estimation via maximum likelihood and the observed information matrix is derived analytically to account for standard errors. The methodology is illustrated through an application to schizophrenia data and some simulation studies. The proposed algorithm and methods are implemented in the new R package skewlmm.