The repeatability of periodontal imaging with intraoral ultrasound scanning.

OBJECTIVE: Ultrasound is a non-invasive and low-cost diagnostic tool widely used in medicine. Recent studies have demonstrated that ultrasound imaging might have the potential to be used intraorally to assess the periodontium by comparing it to current imaging methods. This study aims to characterize the repeatability of intraoral periodontal ultrasound imaging. MATERIALS AND METHODS: Two hundred and twenty-three teeth were scanned from fourteen volunteers participating in this study. One operator conducted all the scans in each tooth thrice with a 20 MHz intraoral ultrasound. The repeatability of three measurements, alveolar bone crest to the cementoenamel junction (ABC-CEJ), gingival thickness (GT), and alveolar bone thickness (ABT), was calculated with intercorrelation coefficient (ICC). Measurements were also compared with mean absolute deviation (MAD), repeatability coefficient (RC), and descriptive statistics. RESULTS: ICC scores for intra-rater repeatability were 0.917(0.897,0.933), 0.849(0.816,0.878), and 0.790(0.746,0.898), MAD results were 0.610 mm (± 0.508), 0.224 (± 0.200), and 0.067 (± 0.060), and RC results were 0.648, 0.327, and 0.121 for ABC-CEJ, GT, and ABT measurements, respectively. CONCLUSION: Results of the present study pointed towards good or excellent repeatability of ultrasound as a measurement tool for periodontal structures. CLINICAL RELEVANCE: Clinicians could benefit from the introduction of a novel chairside diagnostic tool. Ultrasound is a non-invasive imaging assessment tool for the periodontium with promising results in the literature. Further validation, establishment of scanning protocols, and commercialization are still needed before ultrasound imaging is available for clinicians.

Use of ultrasound imaging for assessment of the periodontium: A systematic review.

The objective of this study was to systematically review the literature regarding diagnostic applications of ultrasound imaging for evaluation of the periodontium in humans. The search was conducted on Medline, EMBASE, Web of Science, Scopus, Cochrane, and PubMed up to April 3, 2023. The studies included were exclusively human studies that assessed the periodontium with ultrasound (US) imaging (b-mode). Outcomes measured included alveolar bone level, alveolar bone thickness, gingival thickness, and blood flow quantification. References were imported to Covidence. Two reviewers conducted phases 1 and 2. The JBI risk assessment tool for cross-sectional studies was used. Extracted data included the transducer and measurements used and the study's outcomes. The search yielded 4892 studies after removing duplicates. From these, 25 studies were included and selected for extraction. Included studies retrieved outcomes from US examinations of the periodontal tissues. From the selected studies, 15 used US on natural teeth, 4 used US on implants, 2 used US on edentulous ridges, and 4 used color flow/power in US to evaluate the blood flow. The results of the present systematic review suggest that US might be a feasible and valuable diagnostic tool for the periodontium, with the potential to complement shortfalls of current radiographic technologies.

A Novel Apparatus to Standardise the Polishing Protocol to Achieve Different Roughness of Titanium and Zirconia Disc Surfaces.

PURPOSE: This study aimed to propose and evaluate standardised polishing protocols for in vitro experiment using a custom-made apparatus under controlled force to create consistent surface roughness on titanium and zirconia disks. METHODS: A total of 160 discs were manufactured with a diameter of 10mm, 80 titanium (Ti), and 80 zirconium oxide (Zr). Specimens were categorised into 2 groups: controlled force (CF) and without controlled force (WCF). Specimens in the CF group were polished with a custom apparatus incorporating a tension gauge on the Ti and Zr disc surfaces to achieve consistent roughness. The WCF was polished without the use of a tension gauge. Each group had 4 subgroups (10 disks in each): control/machined (C) with no polishing, rough (R), smooth (S) and very smooth (VS). The subgroups were processed using a sequence of diamond-impregnated polishing burs and polishing paste. RESULTS: CF group showed consistent surface roughness and a gradual decrease in surface roughness. Control (Ra=6.5±0.03µm) in Ti and (Ra=5.4±0.04µm) in Zr; R (Ra=3.5± 0.06µm) in Ti and (Ra=3.2± 0.07 µm) in Zr; S (Ra=1.5±0.04µm) in Ti and (Ra=1.1±006µm) in Zr; VS (Ra=0.05± 0.002µm) in Ti and (Ra=0.02±0.005µm) in Zr. There were significant differences for R, S, and SV under CF and WCF in Ti and Zr surfaces. CONCLUSION: The specimens polished under control force produced significantly more uniform surface roughness than those polished without controlled force and were produced with a higher degree of consistency.

The international platform of registered systematic review and meta-analysis protocols (INPLASY) at 3 years: an analysis of 4,658 registered protocols on inplasy.com, platform features, and website statistics.

Background: INPLASY® is an international platform for registering systematic reviews and meta-analysis protocols that was launched in March 2020. INPLASY® provides an online database in which the protocols are maintained as permanent public records and can be accessed on its website (www.inplasy.com). Methods: We described the database features and registered information of all records published since the launch of the registry on March 31, 2023. Additionally, we analyzed the website statistics dataset to explore user experience and promote data transparency. Results: Four thousand six hundred fifty-eight records were registered in INPLASY®, and more than 94% of the protocols were published within 24 h. Most of the submissions were from China, followed by Portugal, Taiwan, Malaysia, and Brazil. The INPLASY® website received 386,395 page views from 64,568 visitors during the first three years. The accesses were obtained from 170 countries. Most of the accesses were from China, followed by the US, the UK, and Portugal. The review status "completed and published" was observed in 898 protocols, and these studies were published in 372 different scientific peer-reviewed journals. The features of INPLASY® include the following: (i) INPLASY® identifier, a unique protocol number; (ii) the digital object identifier (DOI) number, the URL of the protocol linked to a specific DOI; (iii) ORCID update, INPLASY® automatically updates authors' ORCID page, including their protocol; and (iv) search tools, the protocols are freely accessible on www.inplasy.com. Conclusions: INPLASY® has several practical and useful features that should be considered when planning the registration of a systematic review protocol. Furthermore, the sharp increase in the number of protocols registered in INPLASY® in the first three years and the database statistics demonstrate that INPLASY® has become an important source of systematic review protocols. Therefore, authors should access INPLASY® before planning a future review study to avoid unintended duplication of efforts and to obtain timely registration.

The Effect of Non-Surgical Periodontal Treatment on Patients with Combined Refractory Arterial Hypertension and Stage III, Grade B Periodontitis: A Preliminary Prospective Clinical Study.

We sought to evaluate the effects of non-surgical periodontal treatment (NSPT) on periodontal clinical parameters, systemic blood pressure (BP), and plasma levels of systemic inflammation markers in patients with combined refractory arterial hypertension (RAH) and stage III grade B periodontitis. Twenty-seven participants with RAH and periodontitis received NSPT. The analyzed clinical parameters were probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and plaque index (PI). An assessment was performed for systemic BP, complete blood count, coagulogram, creatinine measurement, C-reactive protein (CRP), glycated hemoglobin, cholesterol, glutamic oxaloacetic transaminase, glutamate pyruvic transaminase, waist-hip ratio, and body mass index. In the follow-up period, twenty-two patients were evaluated at baseline and after 90 and 180 days. The data were submitted for statistical analysis (α = 0.05%). As expected, the clinical results showed a significant improvement in the percentages of PI, BOP, PD, and CAL, which were statistically significant at 90 and 180 days (p < 0.0001). Importantly, NSPT significantly reduced the blood level of CRP (p < 0.02). However, no significant reduction in BP parameters was noted in the evaluated follow-up periods. NSPT, despite the benefits in periodontal clinical parameters, reduced the plasma level of CRP but not the BP in patients with combined RAH and periodontitis.

The Resolution of Periodontal Inflammation Promotes Changes in Cytokine Expression in the Intestine and Gingival Tissues of Aged Rats with DSS-Induced Colitis.

Our research aimed to explore how resolving periodontal inflammation impacts cytokine expression in the colons of aged Wistar rats. Research studies involving animals have been conducted to investigate the two-way relationship between periodontitis and inflammatory bowel disease (IBD), where chronic inflammation in either the mouth or intestines can negatively affect the other. We allocated seventeen male Wistar rats aged between 8 and 11 months to one of four groups: (1) ligature-induced periodontitis (LIP) without the resolution of periodontal inflammation (RPI) (LIP; n = 4), (2) LIP + RPI (n = 4), (3) LIP + dextran-sulphate-sodium-induced colitis (DIC) without RPI (n = 4), and LIP + DIC + RPI (n = 5). We performed histopathological and immunological analyses on periodontal and intestinal tissues and analysed cytokine expressions using a Rat Cytokine 23-Plex Immunoassay. Our findings showed that animals with and without DIC who underwent RPI showed significantly lower levels of IL-2, IL-4, IL-5, IL-10, IL-13, IL-17, IL-18, and TNF-α in the intestine compared to those without treatment. The RPI effectively reduced the number of inflammatory cells in the lamina propria and restored the epithelial barrier in the intestine in animals with DIC. The resolution of periodontal inflammation significantly reduced the levels of pro-inflammatory cytokines and chemokines in the intestines of aged rats with and without DSS-induced colitis.

A Novel Irrigation System to Reduce Heat Generation during Guided Implantology: An In Vitro Study.

The purpose of this in vitro study is to evaluate the effectiveness of incorporating a new irrigation system into a surgical guide and monitor its effect on heat generation during implant bed preparation. A total of 48 surgically guided osteotomies were performed on 12 bovine ribs divided into 4 groups, using different irrigation techniques: Group A (test) had entry and exit channels incorporated into the guide; Group B had a similar design with an entry channel only; Group C had conventional external irrigation; and Group D (control) had no irrigation. Heat generation during the osteotomies was measured using thermocouples placed at a depth of 2 mm and 6 mm. The lowest mean temperature was observed in Group A (22.1 °C at 2 mm and 21.4 °C at 6 mm), which was statistically significant when compared with Groups C and D (p < 0.001). Group A showed a lower mean temperature compared with Group B as well; however, it was statistically significant only at 6 mm depth (p < 0.05). In conclusion, the proposed surgical guide has significantly reduced heat generation during implant osteotomy compared to conventional external irrigation. The integration of an exit cooling channel can resolve limitations found in previously designed surgical guides such as debris blockage and can be easily incorporated into computer designing and 3D printing software.

Higher expression of Th1/Th2-related cytokines in the intestine of Wistar rats with ligature-induced periodontitis.

OBJECTIVE: This study aimed to investigate the impact of ligature-induced periodontitis (LIP) on histopathological and immunological outcomes in the colon of Wistar rats. BACKGROUND: It has been repeatedly shown that inflammatory bowel disease (IBD) patients are at higher risk of developing periodontitis and presenting worse oral health than non-IBD patients. However, whether the chronic inflammatory process around teeth contributes to the pathophysiology of IBD needs to be further explored. MATERIALS AND METHODS: Thirteen Wistar rats were allocated into LIP (n = 7) and controls (n = 6). Half of the colon was processed for histopathological analyses and immunohistochemical (CD45); the other half was homogenized for immunological analyses. Periodontal destruction was confirmed by measuring the distance from the cementum-enamel junction to the mandible's apical position of the mesial interproximal bone. The immunological analyses were performed with the Bio-Plex Th1/Th2 assay. RESULTS: There was a significantly higher interproximal bone loss in LIP compared to controls. The LIP group showed a moderate infiltrate of inflammatory cells, predominantly mononucleated cells in the intestinal tissues. There was significantly higher expression of GM-CSF, IFN-γ, IL-1α, IL-1ß, IL-2, IL-4, IL-5, IL-10, IL-12 (p70), IL-13, and TNF-α in the intestinal tissues of LIP group compared to controls. CONCLUSION: Ligature-induced periodontitis was associated with an overexpression of Th1/Th2-related cytokines in the colon of Wistar rats.

Ultrasound Imaging of the Periodontium Complex: A Reliability Study.

Background: Ultrasonography is a noninvasive, low-cost diagnostic tool widely used in medicine. Recent studies have demonstrated that ultrasound imaging might have the potential to be used intraorally to assess periodontal biomarkers. Objectives: To evaluate the reliability of interlandmark distance measurements on intraoral ultrasound images of the periodontal tissues. Materials and Methods: Sixty-four patients from the graduate periodontics (n = 33) and orthodontics (n = 31) clinics were recruited. A 20 MHz handheld intraoral ultrasound transducer was used to scan maxillary and mandibular incisors, canines, and premolars. Distances between the alveolar bone crest and cementoenamel junction (ABC-CEJ), gingival thickness (GT), and alveolar bone thickness (ABT) were measured by 3 raters. The intercorrelation coefficient (ICC) and mean absolute deviation (MAD) were calculated among and between the raters. Raters also scored images according to quality. Results: The ICC scores for intrarater reliability were 0.940 (0.932-0.947), 0.953 (0.945-0.961), and 0.859 (0.841-0.876) for ABC-CEJ, GT, and ABT, respectively. The intrarater MAD values were 0.023 (±0.019) mm, 0.014 (±0.005) mm, and 0.005 (±0.003) mm, respectively. The ICC scores for interrater reliability were 0.872 (95% CI: 0.836-0.901), 0.958 (95% CI: 0.946-0.968), and 0.836 (95% CI: 0.789-0.873) for ABC-CEJ, GT, and ABT, respectively. The interrater MAD values were 0.063 (±0.029) mm, 0.023 (±0.018) mm, and 0.027 (±0.012) mm, respectively. Conclusions: The present study showed the high reliability of ultrasound in both intrarater and interrater assessments. Results suggest there might be a potential use of intraoral ultrasound to assess periodontium.

Factors Impacting Survival in Those Transplanted for NASH Cirrhosis: Data From the NailNASH Consortium.

BACKGROUND & AIMS: Nonalcoholic steatohepatitis (NASH) is the leading indication for liver transplant (LT) in women and the elderly. Granular details into factors impacting survival in this population are needed to optimize management and improve outcomes. METHODS: Patients receiving LT for NASH cirrhosis from 1997 to 2017 across 7 transplant centers (NailNASH consortium) were analyzed. The primary outcome was all-cause mortality, and causes of death were enumerated. All outcomes were cross referenced with United Network for Organ Sharing and adjudicated at each individual center. Cox regression models were constructed to elucidate clinical factors impacting mortality. RESULTS: Nine hundred thirty-eight patients with a median follow-up of 3.8 years (interquartile range, 1.60-7.05 years) were included. The 1-, 3-, 5-, 10-, and 15-year survival of the cohort was 93%, 88%, 83%, 69%, and 46%, respectively. Of 195 deaths in the cohort, the most common causes were infection (19%), cardiovascular disease (18%), cancer (17%), and liver-related (11%). Inferior survival was noted in patients >65 years. On multivariable analysis, age >65 (hazard ratio [HR], 1.70; 95% confidence interval [CI], 1.04-2.77; P = .04), end-stage renal disease (HR, 1.55; 95% CI, 1.04-2.31; P = .03), black race (HR, 5.25; 95% CI, 2.12-12.96; P = .0003), and non-calcineurin inhibitors-based regimens (HR, 2.05; 95% CI, 1.19-3.51; P = .009) were associated with increased mortality. Statin use after LT favorably impacted survival (HR, 0.38; 95% CI, 0.19-0.75; P = .005). CONCLUSIONS: Despite excellent long-term survival, patients transplanted for NASH at >65 years or with type 2 diabetes mellitus at transplant had higher mortality. Statin use after transplant attenuated risk and was associated with improved survival across all subgroups, suggesting that careful patient selection and implementation of protocol-based management of metabolic comorbidities may further improve clinical outcomes.

The impact of smartphone applications on bowel preparation, compliance with appointments, cost-effectiveness, and patients' quality of life for the colonoscopy process: A scoping review.

The aim of this scoping review is to evaluate the impact of smartphone application (SPA) technology in patients undergoing elective colonoscopy to measure compliance with appointments, cost-effectiveness, bowel preparation, and quality of life. The scoping review was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Ovid Medline, Web of Science, Science Direct, Scopus, Cochrane Library, and PubMed were screened up to Oct 14, 2020, and bibliographies of the retrieved articles were included. Based on pre-specified inclusion and exclusion criteria, 8 primary studies were included in the final analysis from a total of 3,979 non-duplicate articles. Seven out of eight studies measured the bowel preparation quality. In six of these studies, patients in the smartphone group had a successful bowel preparation when compared with the control arm; on the other hand, one study did not find any differences between groups. Adherence to colonoscopy screening was assessed by one study. Patients in the digital intervention arm were significantly more likely to complete a screening test. Patient satisfaction during the periprocedural period of colonoscopy was assessed by five studies which reported significantly higher patient satisfaction in the intervention arm compared to the control arm. None of the studies measured cost-effectiveness. We came to the conclusion that a well-designed, user-friendly SPA can help and guide patients undergoing colonoscopy through the process of following up on their appointments, adhering to bowel preparation, and better understanding their disease condition. Future trials investigating SPAs should include cost-effectiveness and adherence to appointments as an endpoint.

Salivary metabolomic profile in adolescents with juvenile systemic lupus erythematosus.

The aim of this study was to characterize the salivary metabolomic profile in adolescents with juvenile systemic lupus erythematosus (jSLE). A total of 24 adolescents with jSLE (15.92 ± 2.06 years) and 12 systemically healthy controls (15.25 ± 2.7 years) were included in the study. Participants underwent rheumatologic testing and periodontal examination, with the recording of plaque index (PI), probing depth (PD), clinical attachment level (CAL), and bleeding on probing index (BPI). Unstimulated whole saliva was collected from both groups and stored at -80 ºC. The salivary proton nuclear magnetic resonance (1H-NMR) spectra were acquired in a spectrometer operating at 500 MHz. Partial least squared discriminant analysis (PLS-DA) and orthogonal PLS-DA (O-PLS-DA) were used for statistical analysis. Mean CAL and PI were significantly increased in the group with jSLE (p < 0.01). Patients with jSLE presented a significantly different salivary metabolic profile (accuracy = 0.54; R2 = 0.86; Q2 = -0.293), significantly higher salivary levels of N-acetyl sugars, and significantly reduced levels of phenylalanine, glycine, taurine, hydroxybutyrate, and valerate compared with healthy controls (p < 0.05). It is suggested that the salivary metabolomic profile analyzed by 1H NMR in patients with jSLE presents a different fingerprint that the systemically healthy subjects. Integrating the variation of metabolites with the identification of the metabolic pathways involved seems to provide a better understanding of the influence of systemic disease on salivary metabolites.

Colitis induced by dextran sulphate sodium causes histopathological and immunological changes in the periodontal tissues of Wistar rats.

OBJECTIVE: This study investigated the impact of colitis induced by dextran sulphate sodium (DSS)-induced colitis (DIC) on histopathological and immunological outcomes in the periodontal tissues of Wistar rats. BACKGROUND: Inflammatory bowel diseases (IBD) and periodontitis have been reported to present a bidirectional relationship. However, the inflammatory pathway that connects both diseases needs further investigation. MATERIAL AND METHODS: Twenty-five male Wistar rats were allocated in four groups: unilateral ligature-induced periodontitis for 14 days: LIP (n = 7); dextran sulphate sodium-induced colitis only: DIC (n = 6); DIC + LIP (n = 6) and controls (n = 6). Digital images were obtained from the histological sections. In order to assess the attachment loss (AL), the linear distance between the cementoenamel junction (CEJ) and the alveolar bone crest was measured on the mesial root using histological photomicrography's ImageJ software. Immunological analyses of gingival tissues and plasma were performed by Bio-Plex Th1/Th2 Assay. RESULTS: The DIC group showed inflammatory cells extending to the periodontal connective tissues, which contained significantly elevated expressions of IL-1α, IL-1ß, IL-2, IL-6, IL-12, IL-13, GM-CSF, IFN-γ and TNF-α compared to controls. There was no significant difference in bone loss between controls and DIC. There were no significant histopathological differences between DIC + LIP and LIP. However, DIC + LIP presented a significantly lower IL-2 and IL-5 than the LIP group. There was no bone loss difference between LIP+DIC and LIP groups. DIC + LIP group presented significantly higher levels of GM-CSF in plasma. CONCLUSION: DSS-induced colitis was associated with an overexpression of Th1/Th2- related cytokines in the gingival tissue.

Increased Levels of C5a in Gingival Crevicular Fluid and Saliva of Patients with Periodontal Disease.

C5a is a powerful complement effector molecule that is considered to be an important proinflammatory mediator in several systemic chronic inflammatory diseases. However, its levels in periodontal diseases are yet to be assessed. We aimed to analyse the secretion of C5a in gingival crevicular fluid (GCF) and saliva of patients with periodontal disease. Twenty-eight patients diagnosed with stage 3-4 periodontitis and 16 periodontally healthy subjects participated in this study. GCF was collected from sites with the deepest probing depth of each patient, and volume was measured using a Periotron 8000®. One mL of unstimulated saliva was also collected. Samples were analysed using a commercially available ELISA kit. The data were analysed using the Mann-Whitney U test, Pearson's bivariate testing, and receiver operating characteristic curve. C5a was present in GCF from patients with periodontitis (1.06 ± 0.25 ng/mL) whilst it was undetected in controls. Saliva concentration was also significantly higher in periodontitis (1.82 ± 2.31 ng/mL) than controls (0.60 ± 0.72 ng/mL, p = 0.006). C5a levels were more pronounced in periodontitis in both oral fluids assessed by the present pilot study. These results suggest that the more pronounced levels of C5a in oral fluids from periodontitis patients indicate a potential role of this molecule in this disease pathogenesis, deserving to be better explored in subsequent studies.

The role of Dentin Sialophosphoprotein (DSPP) in craniofacial development.

DSPP is known to be important in the formation of dentin. In DSPP's absence, a severely hypomineralized dentin is formed, in a condition known as dentinogenesis imperfecta (DGI). DSPP has recently been found in several different tissues, including the mandibular condylar cartilage and craniofacial skeleton. However, there is limited literature on the role of DSPP in these tissues. Therefore, the objective of the present study was to investigate the role of DSPP in craniofacial development. Two mice strains, DSPP knockout and C57BL/6J wild type, were compared at 1, 3, and 6-months of age. Skulls and condyles were investigated through morphological and histological analyses. Cell culture was also conducted to investigate the potential effects of DSPP absence in osteoblasts from the calvaria. Mineralization defects were noticed in the structures of skulls and MCC, with the most significant impact at 1 month of age. Therefore, DSPP is an essential protein for the normal mineralization of craniofacial tissues.

Characterization of SIBLING Proteins in the Mineralized Tissues.

The SIBLING proteins are a family of non-collagenous proteins (NCPs) previously thought to be expressed only in dentin but have been demonstrated in other mineralized and non-mineralized tissues. They are believed to play vital roles in both osteogenesis and dentinogenesis. Since they are tightly regulated lifelong processes and involve a peak of mineralization, three different age groups were investigated. Fifteen wild-type (WT) mice were euthanized at ages 1, 3, and 6 months. Hematoxylin and eosin staining (H&E) was performed to localize various microscopic structures in the mice mandibles and tibias. The immunostaining pattern was compared using antibodies for dentin sialoprotein (DSP), dentin matrix protein 1 (DMP1), bone sialoprotein (BSP), and osteopontin (OPN). Immunostaining of DSP in tibia showed its most noticeable staining in the 3-month age group. DSP was expressed in alveolar bone, cellular cementum, and PDL. A similar expression of DMP1 was seen in the tibia and dentin. BSP was most noticeably detected in the tibia and acellular cementum. OPN was mainly expressed in the bone. A lower level of OPN was observed at all age groups in the teeth. The immunostaining intensity was the least detected for all proteins in the 6-month tibia sample. The expression patterns of the four SIBLING proteins showed variations in their staining intensity and temporospatial patterning concordant with skeletal and dental maturity. These findings suggest some role in this tightly regulated mineralization process.

A systematic review on neutrophils interactions with titanium and zirconia surfaces: Evidence from in vitro studies.

OBJECTIVES: This systematic review aimed to assess in vitro studies that evaluated neutrophil interactions with different roughness levels in titanium and zirconia implant surfaces. MATERIAL AND METHODS: An electronic search for literature was conducted on PubMed, Embase, Scopus, and Web of Science and a total of 14 studies were included. Neutrophil responses were assessed based on adhesion, cell number, surface coverage, cell structure, cytokine secretion, reactive oxygen species (ROS) production, neutrophil activation, receptor expression, and neutrophil extracellular traps (NETs) release. The method of assessing the risk of bias was done using the toxicological data reliability assessment tool (TOXRTOOL). RESULTS: Ten studies have identified a significant increase in neutrophil functions, such as surface coverage, cell adhesion, ROS production, and NETs released when interacting with rough titanium surfaces. Moreover, neutrophil interaction with rough-hydrophilic surfaces seems to produce less proinflammatory cytokines and ROS when compared to naive smooth and rough titanium surfaces. Regarding membrane receptor expression, two studies have reported that the FcγIII receptor (CD16) is responsible for initial neutrophil adhesion to hydrophilic titanium surfaces. Only one study compared neutrophil interaction with titanium alloy and zirconia toughened alumina surfaces and reported no significant differences in neutrophil cell count, activation, receptor expression, and death. CONCLUSIONS: There are not enough studies to conclude neutrophil interactions with titanium and zirconia surfaces. However, different topographic modifications such as roughness and hydrophilicity might influence neutrophil interactions with titanium implant surfaces.

Peri-Implant Surgical Treatment Downregulates the Expression of sTREM-1 and MMP-8 in Patients with Peri-Implantitis: A Prospective Study.

sTREM-1 and its ligand PGLYRP1 play an essential role in the inflammatory process around teeth and implants. In this study, we aimed to evaluate the impact of peri-implant treatment on the salivary levels of the sTREM-1/PGLYRP-1/MMP-8 axis after 3 months. A total of 42 participants (with a mean age of 61 years old ± 7.3) were enrolled in this longitudinal study, 24 having peri-implant mucositis (MU) and 18 having peri-implantitis (PI). Clinical peri-implant parameters, such as probing pocket depth (PPD), % of plaque, and bleeding on probing (BOP), and the whole unstimulated saliva samples were evaluated at baseline and 3 months after treatment. The MU group received nonsurgical peri-implant treatment, while the PI group received open-flap procedures. The levels of sTREM-1, PGLYRP-1, MMP-8, and TIMP-1 were analyzed using enzyme-linked immunosorbent assays. BOP, plaque levels, and PPD significantly reduced after treatment in both groups. A significant decrease in the salivary levels of sTREM-1, MMP-8, and TIMP-1 in the PI group and PGLYRP1 and TIMP-1 in the MU group were observed. Salivary levels of sTREM-1 were significantly reduced in patients with PI but not with MU. Additionally, peri-implant treatment had a significantly higher impact on MMP-8 reduction in patients with PI than in those with MU.

Gingival recession treatment with enamel matrix derivative associated with coronally advanced flap and subepithelial connective tissue graft: a split-mouth randomized controlled clinical trial with molecular evaluation.

OBJECTIVES: The goal of this study was to evaluate the impact of enamel matrix derivative (EMD) on periodontal healing after root coverage (RC) surgery, involving CAF in combination with SCTG, and to assess the molecular profile, verifying the inflammation level in early stage (1 and 2 weeks). MATERIALS AND METHODS: Thirty-two recessions (RT1) were submitted to periodontal surgery with (test) or without (control) EMD. The clinical parameters analyzed on the day of surgery and 6 months after the surgical procedure were as follows: recession height and width, keratinized tissue height, percentual root coverage, and the gingival thickness of keratinized tissue. Moreover, the main inflammatory biomarkers and growth factors (IL-1ß, IL-6, IL-8, FGF, MIP-1α and ß, PDGF, TNF-α, and VEGF) were evaluated at baseline, 7, and 14 days after procedures. RESULTS: The average root coverage was significantly higher in the test group as compared to the control group (86% vs. 66%, p = 0.008). The test side had significantly lesser final RH compared to the control side (p = 0.01). Also, there was a significant reduction of RW in both groups, with more significant results in the test group. KTH and GT were not significantly different at any time and group. After 14 days, the immunological analysis showed an increase of VEGF (p = 0.03) on the test group compared to the control side. CONCLUSION: The use of EMD in RC surgeries resulted in a significantly higher RC, as well as a significant increase in VEGF expression, suggesting that EMD may contribute to the angiogenic and healing process. CLINICAL RELEVANCE: EMD provided better results in root coverage treatment when associated with CAF and SCTG, beyond a greater releasing of angiogenic growth factor (VEGF), which enhanced the result.

Salivary metabolomic profile in adolescents with juvenile systemic lupus erythematosus

Abstract The aim of this study was to characterize the salivary metabolomic profile in adolescents with juvenile systemic lupus erythematosus (jSLE). A total of 24 adolescents with jSLE (15.92 ± 2.06 years) and 12 systemically healthy controls (15.25 ± 2.7 years) were included in the study. Participants underwent rheumatologic testing and periodontal examination, with the recording of plaque index (PI), probing depth (PD), clinical attachment level (CAL), and bleeding on probing index (BPI). Unstimulated whole saliva was collected from both groups and stored at -80 ºC. The salivary proton nuclear magnetic resonance (1H-NMR) spectra were acquired in a spectrometer operating at 500 MHz. Partial least squared discriminant analysis (PLS-DA) and orthogonal PLS-DA (O-PLS-DA) were used for statistical analysis. Mean CAL and PI were significantly increased in the group with jSLE (p < 0.01). Patients with jSLE presented a significantly different salivary metabolic profile (accuracy = 0.54; R2 = 0.86; Q2 = -0.293), significantly higher salivary levels of N-acetyl sugars, and significantly reduced levels of phenylalanine, glycine, taurine, hydroxybutyrate, and valerate compared with healthy controls (p < 0.05). It is suggested that the salivary metabolomic profile analyzed by 1H NMR in patients with jSLE presents a different fingerprint that the systemically healthy subjects. Integrating the variation of metabolites with the identification of the metabolic pathways involved seems to provide a better understanding of the influence of systemic disease on salivary metabolites.