A Multivariate Logistic Regression Analysis of Risk Factors for Peri-implant Bone Loss.

OBJECTIVE: To evaluate multiple risk factors of peri-implant bone loss. MATERIALS AND METHODS: A case-control study was conducted on patients who had received dental implants treatment from January 2018 to December 2021. Implants with bone loss were included in the case group, and implants with no bone loss were included in the control group. Risk factors including history of periodontitis, abutment connection type, implant surface, diameter, location, three-dimensional position, opposing dentition, adjacent teeth, prosthetic type, retention type and custom abutment were evaluated. A multivariate logistic regression model was used to evaluate these risk factors, providing corresponding odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: A total of 776 implants in 479 patients were included in the analysis. The number of implants in the case group and the control group were 84 and 692, respectively. Cement-retained prostheses (OR=2.439, 95%CI=1.241-4.795) and nonplatform switch design (OR=2.055, 95%CI=1.167-3.619) were identified as weak risk factors. Horizontal deviation (OR=4.177, 95%CI=2.265-7.703) was a moderate risk factor. Vertical deviation (OR=10.107, 95%CI=5.280-19.347) and implants located in the mandibular molar region (OR=10.427, 95%CI=1.176-92.461) were considered high risk factors. CONCLUSION: Implants in the molar region, cement retained, non-platform switch design, and poor three-dimensional implant positioning are identified as significant risk factors for peri-implant bone loss.

Immediate versus Non-immediate Loading Protocols for Reduced-diameter Implants Supporting Overdentures: A Systematic Review and Meta-analysis.

OBJECTIVE: This systematic review aimed to compare the influence of immediate and non-immediate loading protocols on overdentures retained by reduced-diameter implants(≦3.5mm). METHODS: Electronic databases, including MEDLINE (via PubMed), Embase and the Cochrane Central Register of Controlled Trials were searched for randomized controlled trials (RCTs) comparing clinical outcomes of immediately and nonimmediately loaded reduced-diameter implants supported overdentures. The risk of bias within and across the studies and the certainty of evidence were assessed by RoB 2.0 and GRADE, respectively. Sensitivity analysis was performed by eliminating studies at high risk of bias, and repeating the data synthesis employing the randomeffect model. Subgroup analyses were conducted based on the implant diameter and the length of follow-up. RESULTS: Six RCTs with 255 patients were included in this systematic review. The meta-analyses found similar implant survival rates between immediate and nonimmediate loaded implants in mini implant (RR=0.98; 95% CI=0.95, 1.01; p=0.12) and narrow implant subgroups (RR=0.99, 95% CI=0.94, 1.03, p =0.56), as well as in short-term (RR=0.98, 95% CI=0.97, 1.00, p =0.11) and long-term (RR=0.97, 95% CI=0.93, 1.01, p =0.09) follow-up subgroups. Additionally, marginal bone loss (MBL) showed no statistically significant difference between the loading protocols in the subgroup of long-term follow-up (MD=0.03; 95%CI=-0.16, 0.23; p=0.74). Three RCTs investigating peri-implant parameters found relatively higher modified plaque index and probing depth in reduced-diameter implant under immediate loading. CONCLUSION: Compared with non-immediate loading, the immediately loading protocol can achieve comparable survival rates and MBL in reduced-diameter implant retained overdentures.

Sulforaphene Inhibits Periodontitis through Regulating Macrophage Polarization via Upregulating Dendritic Cell Immunoreceptor.

Periodontitis is one of the most prevalent chronic inflammatory diseases that may eventually lead to the loss of teeth. Macrophage polarization plays an important role in the development of periodontitis, and several naturally occurring food compounds have recently been reported to regulate macrophage polarization. In this study, we aimed to investigate the therapeutic potential of sulforaphene (SFE) in macrophage polarization and its impact on periodontitis. Through in vitro and in vivo experiments, our study demonstrated that SFE effectively inhibits M1 polarization while promoting M2 polarization, ultimately leading to the suppression of periodontitis. Transcriptome sequencing showed that SFE significantly upregulated the expression of dendritic cell immunoreceptor (DCIR, also known as CLEC4A2). We further validated the crucial role of DCIR in macrophage polarization through knockdown and overexpression experiments and demonstrated that SFE regulates macrophage polarization by upregulating DCIR expression. In summary, the results of this study suggest that SFE can regulate macrophage polarization and inhibit periodontitis. Moreover, this research identified DCIR (dendritic cell immunoreceptor) as a potential novel target for regulating macrophage polarization. These findings provide new insights into the treatment of periodontitis and other immune-related diseases.

Sulforaphene suppresses RANKL-induced osteoclastogenesis and LPS-induced bone erosion by activating Nrf2 signaling pathway.

BACKGROUND AND PURPOSE: Inflammatory disorders have been found to induce bone loss through sustained and persistent activation of osteoclast differentiation, leading to heightened bone resorption. The current pharmacological interventions for combating bone loss to harbor adverse effects or contraindications. There is a pressing need to identify drugs with fewer side effects. EXPERIMENTAL APPROACH: The effect and underlying mechanism of sulforaphene (LFS) on osteoclast differentiation were illustrated in vitro and in vivo with RANKL-induced Raw264.7 cell line osteoclastogenesis and lipopolysaccharide (LPS)-induced bone erosion model. KEY RESULTS: In this study, LFS has been shown to effectively impede the formation of mature osteoclasts induced from both Raw264.7 cell line and bone marrow macrophages (BMMs), mainly at the early stage. Further mechanistic investigations uncovered that LFS suppressed AKT phosphorylation. SC-79, a potent AKT activator, was found to reverse the inhibitory impact of LFS on osteoclast differentiation. Moreover, transcriptome sequencing analysis revealed that treatment with LFS led to a significant upregulation in the expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and antioxidant-related genes. Then it's validated that LFS could promote NRF2 expression and nuclear translocation, as well as effectively resist oxidative stress. NRF2 knockdown reversed the suppression effect of LFS on osteoclast differentiation. In vivo experiments provide convincing evidence that LFS is protective against LPS-induced inflammatory osteolysis. CONCLUSION AND IMPLICATIONS: These well-grounded and promising findings suggest LFS as a promising agent to addressing oxidative-stress related diseases and bone loss disorders.

Clinical and Radiographic Evaluation of Short Locking-Taper Implants Supporting Single Crowns in the Posterior Region: A 12-Year Retrospective Study.

Few studies have reported the outcomes of short implants with a follow-up time > 10 years. This retrospective study aimed to evaluate the long-term outcomes of short locking-taper implants supporting single crowns in the posterior region. Patients who received these supporting implants (≤ 8 mm) in the posterior region from 2008 to 2010 were included. The clinical and radiographic outcomes and patient satisfaction were recorded. A total of 18 patients with 34 implants were included. The cumulative survival rate was 91.4% and 83.3% at implant and patient levels, respectively. Tooth brushing habit and history of periodontitis were significantly associated with implant failure (P < .05). The median marginal bone loss (MBL) was 0.24 mm (IQR: 0.01 to 0.98 mm). Biologic and technical complications occurred in 14.7% and 17.8% of implants, respectively. The mean modified Sulcus Bleeding Index was 0.52 ± 0.63, and the mean peri-implant probing depth was 2.38 ± 0.79 mm. All patients were at least quite satisfied, with the majority of patients (88.9%) being fully satisfied with the treatment. Within the limitations of this study, the short locking-taper implants supporting single crowns in the posterior region achieved promising outcomes in the long-term follow-up.

Effect of the number and distribution of fiducial markers on the accuracy of robot-guided implant surgery in edentulous mandibular arches: An in vitro study.

OBJECTIVES: Robot-guided implant placement based on the screw marker-assisted registration technique has been applied in dentistry. This study aimed to identify the optimal number and distribution of fiducial markers for robot-guided implant placement in edentulous mandibular phantoms. METHODS: Four implants were digitally planned and placed in edentulous mandibular phantoms under robotic guidance. Different numbers of fiducial markers (3, 4, 5, or 6) and distribution patterns (dispersed or localized) were used to register the robotic system. Platform, apex, and angular deviations were measured between the planned and actual implant positions using different numbers and distributions of fiducial markers. RESULTS: Inserting six fiducial markers resulted in optimal implant position accuracy at the platform (0.53 ± 0.19 mm) and apex (0.59 ± 0.2 mm) deviations. However, the angular deviation did not differ significantly between different numbers of fiducial markers. Furthermore, the implant position accuracy did not differ significantly between the dispersed and localized distributions of fiducial markers. CONCLUSION: In robot-guided implant placement for edentulous mandibular arches, the insertion of six fiducial markers significantly increases the implant placement accuracy. CLINICAL SIGNIFICANCE: The findings of this in vitro study may serve as a reference for clinicians to determine the optimal placement of fiducial markers and to facilitate the clinical application of robot-guided systems for implant placement in edentulous patients. Further clinical studies are necessary to confirm these findings.

Efficient sonodynamic ablation of deep-seated tumors via cancer-cell-membrane camouflaged biocompatible nanosonosensitizers.

Ultrasound (US)-triggered therapies are promising in cancer treatments, and their effectiveness can be enhanced through the proper camouflage of sonosensitizers. Herein, we have constructed cancer cell membrane (CCM)-camouflaged sonosensitizers for homotypic tumor-targeted sonodynamic therapy (SDT). The camouflaged sonosensitizers have been prepared by encapsulating hemoporfin molecules in poly(lactic acid) polymers (H@PLA) and extruding with CCM from Colon Tumor 26 (CT26) cells, forming the H@PLA@CCM. Under excitation with US, the hemoporfin encapsulated in H@PLA@CCM can convert O2 into cytotoxic 1O2, which exerts an efficient sonodynamic effect. The H@PLA@CCM nanoparticles show enhanced cellular internalization to CT26 cells compared to H@PLA, and they also can be more efficiently engulfed by CT26 cells than by mouse breast cancer cells, due to the homologous targeting ability of CT26 CCM. After the intravenous injection, the blood circulation half-life of H@PLA@CCM is determined to be 3.23 h which is 4.3-time that of H@PLA. With high biosafety, homogeneous targeting ability, and sonodynamic effect, the combination of H@PLA@CCM and US irradiation has induced significant apoptosis and necrosis of tumor cells through the efficient SDT, achieving the strongest inhibition rate of tumors among other groups. This study provides insights into designing efficient and targeted cancer therapies using CCM-camouflaged sonosensitizers.

Characteristics, level of evidence, and impact of clinical studies on peri-implantitis: 2017 to 2021.

BACKGROUND: The level of evidence (LOE) is an important tool in current evidence-based practice and clinical research. However, in clinical studies on peri-implantitis, the present status of the LOE and its association with research impact remains to be determined. The present study aimed to gather the characteristics and LOE of clinical studies on peri-implantitis conducted from 2017 to 2021 and assess the association of the LOE with social and scientific impact. METHODS: The PubMed database was searched to retrieve clinical studies that evaluated peri-implantitis-related healthcare interventions and were published between 2017 and 2021. A 4-level modified Oxford 2011 LOE tool was used to determine the LOE of these studies. Citation count and Altmetric Attention Scores (AAS) were derived from the Web of Science and Altmetric Explorer, respectively. Multivariate generalized estimation equation (GEE) analysis was conducted to explore relationships between the LOE and citation count, and between the LOE and AAS; the publication year was considered the grouping factor for adjusting for potential clustering effects. RESULTS: Two hundred and thirty-five studies were considered eligible. The percentages by level from Level-1 to Level-4 were 9.8%, 35.7%, 28.9%, and 25.5%. Multivariable GEE analyses revealed that studies with higher LOE ratings had significantly greater citation counts (p = 0.008). However, no significant association (p = 0.872) was observed between the LOE and AAS. CONCLUSIONS: From 2017 to 2021, more than 40% of studies published on peri-implantitis each year had high-LOE ratings. High-LOE studies showed a tendency to have greater scientific impact.

Design and synthesis of cancer-cell-membrane-camouflaged hemoporfin-Cu9S8 nanoagents for homotypic tumor-targeted photothermal-sonodynamic therapy.

Multimodal therapies have aroused great interest in tumor therapy due to their highly effective antitumor effect. However, immune clearance limits the practical application of nanoagents-based multimodal therapies. To solve this problem, we have designed hemoporfin-Cu9S8 hollow nanospheres camouflaged with the CT26 cell membrane (CCM) as a model of multifunctional agents, achieving homologous-targeted synergistic photothermal therapy (PTT) and sonodynamic therapy (SDT). Hollow Cu9S8 as photothermal agents and carriers have been obtained through sulfurizing cuprous oxide (Cu2O) nanoparticles through "Kirkendall effect", and they exhibit hollow nanospheres structure with a size of ∼200 nm. Then, Cu9S8 nanospheres could be used to load with hemoporfin sonosensitizers, and then hemoporfin-Cu9S8 nanospheres (abbreviated as H-Cu9S8) can be further surface-camouflaged with CCM. H-Cu9S8@CCM nanospheres exhibit a broad photoabsorption in the range of 700-1100 nm and high photothermal conversion efficiency of 39.8% under 1064 nm laser irradiation for subsequent PTT. In addition, under the excitation of ultrasound, the loaded hemoporfin could generate 1O2 for subsequent SDT. Especially, H-Cu9S8@CCM NPs are featured with biocompatibility and homologous targeting capacity. When intravenously (i.v.) injected into mice, H-Cu9S8@CCM NPs display a higher blood circulation half-life (3.17 h, 6.47 times) and tumor accumulation amount (18.75% ID/g, 1.94 times), compared to H-Cu9S8 NPs (0.49 h, 9.68% ID/g) without CCM. In addition, upon 1064 nm laser and ultrasound irradiation, H-Cu9S8@CCM NPs can inhibit tumor growth more efficiently due to high accumulation efficiency and synergistic PTT-SDT functions. Therefore, the present study provides some insight into the design of multifunctional efficient agents for homotypic tumor-targeted therapy.

The benefit of antimicrobial photodynamic therapy to mechanical debridement in the treatment of smokers with peri-implant diseases: a systematic review and meta-analysis.

Antimicrobial photodynamic therapy (aPDT) has been proposed as an adjunctive treatment strategy for peri-implant diseases. This systematic review aimed to determine whether aPDT as an adjunct to mechanical debridement has an additional benefit for smokers with peri-implant diseases. Randomized controlled trials (RCTs), which evaluated the clinical outcomes of mechanical debridement alone versus mechanical debridement + aPDT among smokers, were considered eligible to be included. The primary outcome was bleeding on probing (BOP) and secondary outcomes included probing depth (PD), plaque index (PI), and crestal bone loss (CBL). Meta-analyses using a random-effects model were conducted to calculate the mean difference (MD) with a 95% confidence interval (CI). The quality of evidence was assessed according to Grading of Recommendations Assessment, Development and Evaluation (GRADE). A total of four RCTs (188 participants) were included. The aPDT group showed significantly improved PD (MD = - 1.26, 95% CI = - 2.19 to - 0.32, p = 0.008) and PI (MD = - 10.6%, 95% CI = - 14.46 to - 6.74%, p = 0.0001) compared with mechanical debridement group at 3-month follow-up. No significant difference in bleeding on probing (BOP) was observed at 3-month follow-up (MD = - 0.60%, 95% CI = - 2.36 to 1.16%, p = 0.50). The subgroup analyses on photosensitizers demonstrated significant differences between the two groups on PD (MD = - 1.23, 95% CI = - 2.41 to - 0.05, p = 0.04) and PI (MD = - 12.33, 95% CI = - 14.74 to - 9.92, p < 0.00001) by the use of methylene blue (MB). Within the limitation of this study, compared with mechanical debridement alone, combined use of aPDT was more effective in reducing PD and PI in smokers at 3-month follow-up. MB was a predictable photosensitizer for aPDT. However, the findings should be interpreted with caution due to the limited number of included studies, methodological deficiencies, and heterogeneity between studies.