Endoscope-assisted maxillary sinus floor augmentation with a mini-lateral window: A retrospective study.

OBJECTIVES: The aim of this study was to evaluate the efficacy of endoscope-controlled sinus floor augmentation through a mini-lateral window, compared with traditional lateral window approach. MATERIALS AND METHODS: This retrospective research included 19 patients and 20 augmented sinuses using lateral window approach with simultaneous implant placement (test group: a 3-4 mm round osteotomy; control group: a 10 × 8 mm rectangular osteotomy). Preoperatively (T0), immediately after surgery (T1), and 6 months postoperatively (T2), cone-beam computed tomography (CBCT) scans were obtained. Residual bone height (RBH), lateral window dimension (LWD), endo-sinus bone gain (ESBG), apical bone height (ABH), and bone density were measured. Intraoperative and postoperative complications were recorded. Patients' evaluation of pain first day after surgery and a week later was assessed by visual analog scale (VAS). RESULTS: No significant difference was found in ESBG, ABH between the two groups at T1, T2 or their changes from T1 to T2. However, the increase of bone density value in the test group was significantly higher than control group (356.28 ± 149.59 vs. 242.99 ± 129.54; p < 0.05). The sinus perforation rate of test and control group was 10% and 20%, respectively. The VAS score of the test group at the first day after surgery was significantly lower than control group (4.20 ± 1.03 vs. 5.60 ± 1.71; p < 0.05). CONCLUSIONS: Endoscope-controlled maxillary sinus floor augmentation through a mini-lateral window yield similar result with traditional approach in terms of bone height gain. The modified approach could facilitate new bone formation, reducing sinus perforation rate and postoperative pain.

EFFECTIVENESS OF INTRA-ARTICULAR INJECTIONS OF SODIUM HYALURONATE, CORTICOSTEROIDS, PLATELET-RICH PLASMA ON TEMPOROMANDIBULAR JOINT OSTEOARTHRITIS: A SYSTEMATIC REVIEW AND NETWORK META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS.

OBJECTIVE: To compare the efficacy of Intra-articular injections of corticosteroids (CCS), hyaluronic acid (HA), and platelet-rich plasma (PRP) on temporomandibular joint osteoarthritis. METHODS: Studies were identified from PubMed, Embase and Cochrane Central Register of Controlled Trials, ClinicalTrials.gov with date up to January 15, 2022. Randomized controlled trials included were the studies of patients with temporomandibular joint osteoarthritis who had intra-articular treatment with CCS, HA, PRP, placebo and follow-up assessing temporomandibular joint function in target outcome variables. The primary outcome was temporomandibular joint pain. The secondary outcomes were maximal mouth opening (mm), and lateral movement to the affected side (mm). This study is registered with PROSPERO, number CRD42021270914. RESULTS: Nine randomized controlled trials involving 316 patients were included. For primary pain outcome, no significance was detected when CCS, HA and PRP were compared with placebo by both short- (3-6 months) and long-term (>12 months) follow-up. Relatively, the top ranking of which was PRP in the long-term (Mean Difference, -0.23 [95% CI, -2.49 to 2.04]). In addition, these injectables did not significantly outperform placebo by evaluating secondary functional outcomes (maximal mouth opening and lateral movement) with the same follow-up. Subgroup analyses showed that the effect of CCS on subgroups with more than 70% women was statistically less effective compared with placebo (Mean Difference, 1.73 [95% CI, 0.37-3.09]). CONCLUSION: Evidence suggested that intra-articular pharmacological injections of CCS, HA, and PRP had no effect on improving temporomandibular joint pain and functional outcomes compared with placebo injection.

Pathogenic variant of DYNC2H1 associated with lingual hamartoma in a Chinese pedigree.

BACKGROUND: Molecular etiology of lingual hamartoma is poorly understood. This study aims to identify potentially deleterious mutations for lingual hamartoma and analyze its molecular profile by a combination of whole-exome sequencing and RNA-sequencing. METHODS: Whole-exome sequencing was conducted on the proband presenting lingual hamartoma and patient's unaffected family members. Potentially pathogenic mutations were identified after filtration. The pathogenicity of the identified variants was predicted by in silico algorithms and conservative analysis. RNA-sequencing was performed to further explore the molecular profile of lingual hamartoma. RESULTS: Whole-exome sequencing of the proband and patients' unaffected brother and parents identified a de novo mutation c.931C>T_p.Pro311Ser in the DYNC2H1 gene (NM_001080463.2). The DYNC2H1 mutation was predicted to be disease-causing for affecting highly conserved amino acid by PolyPhen2 and Mutation Taster. RNA-sequencing analysis showed that the DYNC2H1 gene was significantly down-regulated in lingual hamartoma. Gene set enrichment analysis revealed cilium assembly and Hedgehog signaling pathway were significantly affected. CONCLUSION: The study expanded our knowledge on the clinical and genetic spectrum of lingual hamartoma by identifying causal variants in a Chinese pedigree. DYNC2H1 is likely to participate in tongue development and its pathologic mutation may underlie the etiology of lingual hamartoma.

Association of high-density lipoprotein cholesterol and periodontitis severity in Chinese elderly: a cross-sectional study.

OBJECTIVES: Periodontitis is a local inflammatory disease of high prevalence worldwide. Increasing evidence has shown its association with cardiovascular diseases. While high-density lipoprotein is an important protective factor in preventing cardiovascular diseases, this study aims to examine whether high-density lipoprotein cholesterol (HDL-C) level is associated with different status of periodontitis. MATERIALS AND METHODS: A total of 874 Chinese retirees (≥ 60 years of age) with different statuses of periodontitis were enrolled. Periodontal clinical data were collected to define periodontal disease severity (no, mild-moderate, severe). Peripheral blood was collected for serum lipid profile analysis. Linear and logistic regression analysis with adjustment for potential confounders (gender, age, BMI, alcohol intake, exercise frequency, smoking habits) were used to determine the association of periodontitis with HDL-C. RESULTS: After adjustments for confounders, linear regression analyses revealed a significant relationship between the decreased HDL-C and periodontitis severity (p < 0.05). Although the multivariable-adjusted ORs of decreased HDL-C were not statistically significant, logistic regression analyses showed Chinese elderly with severe periodontitis had higher odds of exhibiting clinically abnormal HDL-C levels than those without periodontitis. CONCLUSIONS: The elderly population with periodontitis showed HDL-C levels significantly lower than those without periodontitis. The severity of periodontitis was positively correlated with serum HDL-C levels. CLINICAL RELEVANCE: Periodontitis reduces HDL-C level in the elderly population, indicating that oral health should be paid attention to in the prevention and treatment of dyslipidemia.

CariesNet: a deep learning approach for segmentation of multi-stage caries lesion from oral panoramic X-ray image.

Dental caries has been a common health issue throughout the world, which can even lead to dental pulp and root apical inflammation eventually. Timely and effective treatment of dental caries is vital for patients to reduce pain. Traditional caries disease diagnosis methods like naked-eye detection and panoramic radiograph examinations rely on experienced doctors, which may cause misdiagnosis and high time-consuming. To this end, we propose a novel deep learning architecture called CariesNet to delineate different caries degrees from panoramic radiographs. We firstly collect a high-quality panoramic radiograph dataset with 3127 well-delineated caries lesions, including shallow caries, moderate caries, and deep caries. Then we construct CariesNet as a U-shape network with the additional full-scale axial attention module to segment these three caries types from the oral panoramic images. Moreover, we test the segmentation performance between CariesNet and other baseline methods. Experiments show that our method can achieve a mean 93.64% Dice coefficient and 93.61% accuracy in the segmentation of three different levels of caries.

Palliative care medical student education: a cross-sectional medical school survey in mainland China.

OBJECTIVE: According to the 2015 Quality of Death Index, China ranks 71st in terms of quality of palliative care out of 80 countries. Lack of palliative care education for health professionals is regarded as largely responsible. The study aims to evaluate the status of palliative care education for medical students in mainland China. METHODS: A list of all medical schools was obtained from the Ministry of Education. A telephone survey of associate deans responsible for medical education at all 282 medical schools in mainland China was conducted in May 2019, following a standardised protocol. Telephone interviews focused on attitudes to palliative care teaching and the extent and manner in which palliative care is incorporated into the curriculum. RESULTS: Associate deans from 173 (61.2%) of the 282 medical schools responded. A total of 120 schools (42.5%) completed the interview, while 53 (18.7%) evaded direct questions related to palliative care. Of the responding deans, 92 (76.7%) regarded palliative care education as very important. However, only 11 (9.2%) provided specific teaching on palliative care. A few schools (n=18) integrated palliative care education within required curricula, such as medical ethics and nursing science. The main reason reported for not providing palliative care education was that the medical curriculum dictated by the Ministry of Education does not require it. CONCLUSION: A very small minority of medical schools in mainland China have any formal teaching about palliative care. Clearly, national standards for didactic and clinical teaching in palliative care for medical students and other health professionals are needed.

Periosteal Tissue Engineering: Current Developments and Perspectives.

Periosteum, a highly vascularized bilayer connective tissue membrane plays an indispensable role in the repair and regeneration of bone defects. It is involved in blood supply and delivery of progenitor cells and bioactive molecules in the defect area. However, sources of natural periosteum are limited, therefore, there is a need to develop tissue-engineered periosteum (TEP) mimicking the composition, structure, and function of natural periosteum. This review explores TEP construction strategies from the following perspectives: i) different materials for constructing TEP scaffolds; ii) mechanical properties and surface topography in TEP; iii) cell-based strategies for TEP construction; and iv) TEP combined with growth factors. In addition, current challenges and future perspectives for development of TEP are discussed.

Identification of a Novel Mutation in the Runt-Related Transcription Factor 2 Gene in a Chinese Family With Cleidocranial Dysplasia.

ABSTRACT: Cleidocranial dysplasia (CCD) is an uncommon autosomal dominant disease, characterized by hypoplasia of clavicles, delayed fontanelle closure, dental anomalies, and short stature. It has been reported in the literature that the pathogenic variants of Runt-related transcription factor 2 (RUNX2) gene are correlated with CCD patients.Here, we report a consanguineous Chinese family with 2 patients suffering from CCD, presenting similar skeleton and dentition malformation. Upon whole-exome sequencing, 52863 variants were detected in the propositus. Based on the genotype phenotype correlation, a frameshift deletion c.1554delG p.(Trp518Cysfs∗61), located in exon 8 of RUNX2, remained after filtration. For Sanger sequencing, all exons of the RUNX2 gene in members of this Chinese family were amplified by polymerase chain reaction. Mutation mentioned above was confirmed in the propositus and his mother, which has not been reported previously and cannot be found in the publicly available databases. The present study expands the pathogenic variant spectrum of RUNX2 gene and contributes to molecular diagnosis.

Magnetic-Field-Assisted Cellular Osteogenic Differentiation on Magnetic Zinc Ferrite Coatings via MEK/ERK Signaling Pathways.

Combining an external stimulus and stimuli-responsive biomaterials can regulate cellular behaviors. In this paper, a magneto-responsive zinc ferrite (ZnFe2O4) coating was designed to gain insight into the preosteoblasts behaviors and osteogenic differentiation mechanism under a static magnetic field (SMF). ZnFe2O4 coatings with distinct magnetization (low, medium, and high magnetizations) were prepared by being annealed at different temperatures. Cellular biology experiments indicated that all ZnFe2O4 coatings with the assistance of SMF could promote the early proliferation (3 days) and osteogenic differentiation of MC3T3-E1 cells. Among different ZnFe2O4 samples, low and medium magnetization of ZnFe2O4 showed a higher osteogenesis-related gene expression (Runx2, Col-I, OCN) than that of high magnetization ZnFe2O4 under SMF, while cellular adhesion and proliferation cultured on different ZnFe2O4 samples presented insignificant differences. Molecular biology tests showed that the combination of ferromagnetic ZnFe2O4 and SMF could significantly improve the expression level of α2ß1 integrin and p-ERK. However, the addition of the inhibitor U0126 sharply reduced the expression level of p-ERK, which indicated that α2ß1 integrin-mediated MEK/ERK signaling pathways play a key role in SMF-assisted cellular osteogenic differentiation over ZnFe2O4 coatings. This work provides an attractive strategy to enhance cellular osteogenic differentiation in a remote-control way, which exhibited enormous potential in the field of bone tissue repair and regeneration.

Ultraviolet Radiant Energy-Dependent Functionalization Regulates Cellular Behavior on Titanium Dioxide Nanodots.

Titanium dioxide (TiO2) photofunctionalization has been demonstrated as an effective surface modification method for the osseointegration of implants. However, the insufficient understanding of the mechanism underlying photofunctionalization limits its clinical applications. Here, we report an ultraviolet (UV) radiant energy-dependent functionalization on TiO2 nanodots (TN) surfaces. We found the cell adhesion, proliferation, and osteogenic differentiation gradually increased with the accumulation of UV radiant energy (URE). The optimal functionalizing treatment energy was found to be 2000 mJ/cm2, which could regulate cell-specific behaviors on TN surfaces. The enhanced cell behaviors were regulated by the adsorption and functional site exposure of the extracellular matrix (ECM) proteins, which were the result of the surface physicochemical changes induced by the URE. The correlation between the URE and the reconstruction of surface hydroxyl groups was considered as an alternative mechanism of this energy-dependent functionalization. We also demonstrated the synergistic effects of FAK-RHOA and ERK1/2 signaling pathways on mediating the URE-dependent cell behaviors. Overall, this study provides a novel insight into the mechanisms of photofunctionalization, guiding the design of implants and the clinical practice of photofunctionalization.