Five-step unilateral biportal endoscopic surgery for central lumbar canal stenosis: "Z" technique nuance.

The treatment for lumbar spinal stenosis has advanced through the use of minimally invasive surgery techniques. Endoscopic methods go even further, with studies showing that both uniportal and biportal endoscopic techniques have outcomes comparable to traditional approaches. However, there is limited knowledge of the step-by-step decompression process when using the unilateral biportal endoscopic (UBE). To address this, the authors introduce the five steps in the "Z" sequence, which aims to reduce surgical time and complications. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23182.

Impulsive and compulsive reading comprehension in the prison population.

BACKGROUND: Developmental dyslexia is characterized by reading and writing deficits that persist into adulthood. Dyslexia is strongly associated with academic underachievement, as well as impulsive, compulsive, and criminal behaviors. The aims of this study were to investigate impulsive or compulsive reading comprehension, analyzing the differences in reading errors between two distinct groups -one with Antisocial Personality Disorder (ASPD) and another with Obsessive-Compulsive Personality Disorder (OCPD) and examine their correlation with criminal behavior within a prison population. METHODS: We gathered data from 194 participants: 81 with ASPD and 113 with OCPD from a prison center. Participants took part in interviews to gather data on demographic, criminal, and behavioral data. Additionally, the participants underwent various assessments, including the International Examination for Personality Disorders; Symptom Inventory, and Battery for the Assessment of Reading Processes in Secondary and High School - Revised. RESULTS: Our analysis revealed differences in reading skills between the ASPD and OCPD groups. Specifically, the OCPD group showed poorer performance on lexical selection, semantic categorization, grammar structures, grammatical judgements, and expository comprehension when compared with the ASPD group. Conversely, the OCPD group obtained higher scores on narrative comprehension relative to the ASPD group. CONCLUSIONS: The OCPD group showed slow lexical-phonological coding and phonological activation.

Comprehensive treatment protocol for peri-implantitis: an up-to date narrative review of the literature.

This narrative review describes up-to-date treatment options for peri-implantitis and proposes a treatment protocol and flowchart based on the current scientific evidence. Peri-implantitis treatment should be based on the phased treatment protocol for periodontitis, which is a continuous flow of decisions for extraction, nonsurgical and surgical treatments with step-by-step re-evaluation. The protocol's goals are to fulfill the success criteria for peri-implantitis treatment (probing depth of ≤5 mm, and absence of bleeding on probing, suppuration, and progressive bone loss) and to halt disease progression. Fixtures with peri-implantitis can initially be classified as failed or failing. A failed implant needs to be removed. In contrast, nonsurgical and surgical treatments can be applied to a failing implant. Nonsurgical treatment should be the initial treatment for failing implants; however, sole nonsurgical treatment was regarded as inefficient for peri-implantitis. Recent studies have found that the adjunctive use of antibiotics to nonsurgical debridement increased the success of nonsurgical treatment for peri-implantitis. Surgical treatments can be classified into resective, access, and reconstructive surgeries. The technique should be selected according to the patient's bone defect configuration, which relate to regenerative potential. Various combinations of decontamination methods (e.g., mechanical, chemical, and pharmacological approaches) are required to achieve absolute surface decontamination. Clinicians should select an appropriate surface decontamination strategy according to the purpose of surgery. After signs of disease disappear and its progression is halted through active peri-implantitis treatment, it is necessary to enroll patients into maintenance programs. Compliance of patients with the maintenance program reduces the recurrence of peri-implantitis and sustains clinical success after treatment. Maintenance visits should include professional plaque control and hygiene care reinforcement for patients, and their interval should be set according to individual peri-implantitis risk. Clinicians should remind that peri-implantitis treatment is not a single procedure, but rather a continuing cycle of treatment and re-evaluation.

Efficacy of a collagen matrix for soft tissue augmentation after implant placement compared to connective tissue grafts: A multicenter, noninferiority, randomized controlled trial.

OBJECTIVES: To test whether soft tissue volume augmentation using a collagen matrix (VCMX) leads to noninferior results in terms of gain of mucosal thickness at single implant sites, compared to connective tissue grafts (SCTG). METHODS: The study was designed as a multi-center randomized controlled clinical trial. Subjects in need of soft tissue volume augmentation at single tooth implant sites were consecutively recruited at nine centers. The deficient mucosal thickness at the implant sites (one per patient) was augmented by applying either a VCMX or a SCTG. Patients were examined at 120 days (abutment connection = primary endpoint), 180 days (final restoration), and 360 days (1-year after insertion of the final restoration). Outcome measures included: transmucosal probing of the mucosal thickness (crestal = primary outcome), profilometric measurements of the tissue volume, and patient-reported outcome measures (PROMs). RESULTS: Out of the 88 patients, 79 attended the one-year follow-up. The median increase of the crestal mucosal thickness between pre-augmentation and 120 days was 0.3 ± 2.1 mm in the VCMX group and 0.8 ± 1.6 mm in the SCTG group (p = .455). Non-inferiority of the VCMX compared to the SCTG was not observed. The respective numbers at the buccal aspect amounted to 0.9 ± 2.0 mm (VCMX) and 1.1 ± 1.4 mm (SCTG; p = .431). PROMs including pain perception favored the VCMX group. CONCLUSION: It remains inconclusive whether soft tissue augmentation using a VCMX is noninferior to SCTG in terms of crestal mucosal thickening at single implant sites. However, the use of collagen matrices favors PROMs especially pain perception, while achieving similar buccal volume gains along with comparable clinical and aesthetic parameters to SCTG.

Low IL-13Rα1 expression on mast cells tunes them unresponsive to IL-13.

Cytokine-mediated mast cell regulation enables precise optimization of their own proinflammatory cytokine production. During allergic inflammation, interleukin (IL)-4 regulates mast cell functions, tissue homing, and proliferation, but the direct role of closely related IL-13 for mast cell activation remains unclear. Previous work has shown that mast cells are potent IL-13 producers, but here we show that mouse mast cells do not directly respond to IL-13 by Stat6 activation, as they do not express measurable amount of IL-13 receptor α1 (IL-4Rα1) messenger RNA. Consequently, IL-4 responses are mediated via type I IL-4R (IL-4/IL4Rα/γC), and IL-4-induced Stat6 activation is abolished in γC-deficient mast cells. Type II IL-4R deficiency (IL-13Rα1 knockout) has no effect on IL-4-induced Stat6 activation. In basophils, both IL-4 and IL-13 induce Stat6 activation in wild-type and γC-deficient cells, while in type II IL-4R-deficient basophils, IL-4 signaling is impaired at low ligand concentration. Thus, mast cell and basophil sensitivity to IL-4/IL-13 is different, and in mast cells, lack of IL-13Rα1 expression likely explains their unresponsiveness to IL-13.

Efficacy of the application of leukocyte and platelet-rich fibrin (L-PRF) on alveolar ridge preservation. A randomized controlled clinical trial.

INTRODUCTION: Alveolar ridge preservation (ARP) is a well-defined treatment performed to reduce bone dimensional changes occurring during the healing of post-extraction sockets to allow for adequate implant placement. Leukocyte and platelet-rich fibrin (L-PRF) has been showing to potentially promote bone and tissue regeneration during wound healing. Therefore, the aim of this study is to evaluate its efficacy for ARP when applied to fresh extraction sockets, in comparison with spontaneous healing. MATERIALS AND METHODS: Twenty-seven patients with hopeless non-molar teeth were treated. After randomization, fresh extraction sockets were either filled with L-PRF or allowed to heal spontaneously. CBCTs and intraoral scans were obtained immediately after extraction and at 4 months. Through superimposition of the obtained images, changes in the horizontal ridge width, height, buccal volume, and ridge contour changes were measured, as well as patient-reported outcome measures (PROM's). RESULTS: The ridge dimensions changed similarly in both groups. Although less reduction occurred in the test group at 1 mm from the bone crest, differences were not statistically significant (p > 0.05). Application of L-PRF did not prevent reductions of ridge contours, neither in the linear vertical aspect nor in volumetric changes. There were no differences between groups in the need for bone regeneration when placing implants. Patients in both groups reported similar outcomes in terms of bleeding, pain, inflammation, and function at 1 and 4 weeks postoperatively. CONCLUSION: Alveolar preservation with L-PRF neither minimized bone resorption occurring after tooth extraction in non-molar sites nor reduced the need for bone regeneration when placing implants. Furthermore, its use did not improve PROM's.

The Rootstock Genotypes Determine Drought Tolerance by Regulating Aquaporin Expression at the Transcript Level and Phytohormone Balance.

Grapevine rootstocks may supply water to the scion according to the transpiration demand, thus modulating plant responses to water deficit, but the scion variety can alter these responses, as well. The rootstock genotypes' effect on the scion physiological response, aquaporin expression, and hormone concentrations in the xylem and the leaf was assessed under well watered (WW) and water stress (WS) conditions. Under WW, vines grafted onto 1103P and R110 rootstocks (the more vigorous and drought-tolerant) showed higher photosynthesis (AN), stomatal conductance (gs), and hydraulic conductance (Khplant) compared with the less vigorous and drought-sensitive rootstock (161-49C), while under WS, there were hardly any differences between vines depending on the rootstock grafted. Besides, stomatal traits were affected by drought, which was related to gs, but not by the rootstock. Under WS conditions, all VvPIP and VvTIP aquaporins were up-regulated in the vines grafted onto 1103P and down-regulated in the ones grafted onto 161-49C. The 1103P capability to tolerate drought was enhanced by the up-regulation of all VvPIP and VvTIP aquaporins, lower ABA synthesis, and higher ACC/ABA ratios in leaves during WS compared with 161-49C. It was concluded that, under WW conditions, transpiration and stomatal control were rootstock-dependent. However, under WS conditions, alterations in the molecular components of water transport and hormone concentration of the scion resulted in similar gas exchange values in the studied scions grafted onto different rootstocks.

PUVA therapy in persistent cutaneous histiocytosis: Case report and literature review.

BACKGROUND: Cutaneous and mucocutaneous histiocytosis (group C) comprise a wide variety of entities affecting skin and/or mucosae. Although they are considered as reactive proliferations, their exact pathophysiology remains unknown and, therefore, they lack a specific treatment. AIMS: The aim of this study is to review the evidence on cases of histiocytosis treated with UVB and/or UVA and to report a new case of relapsing group C histiocytosis that has been successfully treated with PUVA therapy. MATERIALS & METHODS: We have conducted a review of the literature published over the last 40 years on the treatment of histiocytosis with phototherapy in the online PubMed database. We also describe a new case of successful treatment of histiocytosis with PUVA therapy. RESULTS: Our patient was a 27-year-old man with persistent outbreaks of cutaneous histiocytosis over the previous 8 years. He responded successfully to PUVA therapy, and no relapse has been detected after one year of follow-up. DISCUSSION: Self-involution is usual in group C histiocytosis, so conservative management is usually the first approach. Relapsing cases pose a therapeutic challenge. Reported treatment options for these patients include isotretinoin, cryotherapy, immunosuppressants, low-dose chemotherapy, CO2 laser, radiotherapy, and surgery. Phototherapy and photochemotherapy have been used in a small number of patients with considerable success. The main limitation to provide firm recommendations on histiocytosis therapy is the absence of solid evidence, as the articles published are mainly case reports with a short follow-up. In our patient, despite the short follow-up we have considered photochemotherapy to be effective since no spontaneous remission had been achieved in the previous 8 years. CONCLUSION: PUVA therapy could be a safe and effective option to treat persistent cutaneous manifestations in patients with histiocytosis, although more evidence is required to support this statement.

Formación en reanimación cardiopulmonar pediátrica en los grados de Medicina y Enfermería en las universidades españolas / Training in pediatric cardiopulmonary resuscitation in the Medicine and Nursing degrees in Spanish universities

Objetivos: Conocer la docencia en reanimación cardiopulmonar (RCP) pediátrica en las universidades españolas.Material y métodos.Se envió una encuesta a los responsables de pediatría de las universidades españolas.Resultados.Se recibieron 35 respuestas de Medicina y 18 de Enfermería. Existió una gran diversidad en la docencia de la RCP y su duración. En muchos casos, la duración de la formación en RCP es insuficiente.Conclusiones.Es necesario establecer unos requisitos de formación obligatoria en RCP pediátrica para los grados de Medicina y Enfermería. (AU)

Aims: To analyse the education in pediatric cardiopulmonary resuscitation (CPR) in the universities in Spain.Material and methods.A survey was sent to those responsible for Pediatrics at the Spanish universities.Results.35 responses from Medicine and 18 from Nursing were received). There was a great diversity in CPR teaching and duration. In many cases, the duration of the training is insufficient.Conclusions.It is necessary to establish mandatory training requirements in pediatric CPR for Medicine and Nursing degrees. (AU)

Strategies for implant surface decontamination in peri-implantitis therapy.

Peri-implantitis is an infectious disease that leads to progressive bone loss. Surgical therapy has been advocated as a way of halting its progression and re-establishing peri-implant health. One of the most challenging but crucial tasks in the management of peri-implantitis is biofilm removal to achieve reosseointegration and promote the reduction of peri-implant pockets. A wide variety of strategies have been used for implant surface decontamination. Mechanical means have been demonstrated to be effective in eliminating calculus deposits and residual debris; however, the presence of undercuts and the grooves and porosities along the roughened implant surface make it difficult to achieve an aseptic surface. In conjunction with mechanical measures, use of chemical adjuncts has been advocated to dilute bacterial concentrations, destroy the bacteria's organic components and eliminate endotoxins. Pharmacological adjuncts have also been recommended to diminish the bacterial load. Other strategies, such as use of lasers, implantoplasty and electrolysis, have been suggested for implant surface decontamination to promote predictable clinical and radiographic outcomes.

In vitro effect of different implant decontamination methods in three intraosseous defect configurations.

OBJECTIVES: This in vitro investigation was aimed to evaluate the cleaning ability of four mechanical devices designed for decontaminating implant surfaces. MATERIAL AND METHODS: Ninety-six implants were coated with permanent ink and inserted into 3D-printed resin blocks simulating three different intraosseous defect configurations (types Ib, Ic, and Ie). The four tested mechanical decontamination devices (air-polishing with glycine powder, rotating titanium brush, polyetheretherketone [PEEK]-coated ultrasonic tip, and stainless steel ultrasonic tip) were randomly applied onto the 5 mm exposed implant surface. Standardized photographs were taken from a frontal perspective and with a 30° angle coronally and apically to the implant axis. The area with remnant ink on the implant surface was calculated. RESULTS: Although none of the groups achieved complete ink removal, air-polishing with glycine and titanium brushes demonstrated a higher cleaning ability when compared with ultrasonic devices either with standard or PEEK tips for all three defect configurations. For the three tested models, the best cleaning ability in all groups was shown on implant surfaces without facing an intraosseous wall. Titanium brush was the most effective when the intraosseous walls existed. Cleaning effectiveness diminished in the threads located in the apical third, especially when using air-polishing and ultrasonic devices. CONCLUSIONS: Titanium brushes and air-polishing devices were more effective in removing artificial biofilm using this in vitro model, although their effectiveness was influenced by the presence of the intrabony component.

Selective modulation of placental and fetal MDR transporters by chronic in utero exposure to NRTIs in Sprague-Dawley rats: Importance for fetoprotection.

Multidrug resistance (MDR) transporters present in placenta and fetal tissues reduce intracellular accumulation of their substrates. Consequently, induction of protein expression may further reduce toxic effects of specific xenobiotics. This work aimed to study whether sustained drug treatments in utero could modulate MDR transporters P-gp, BCRP, and MRP2 and thus impact their fetoprotective action. Pregnant Sprague-Dawley rats were daily treated by gavage with zidovudine (AZT, 60 mg/kg) or lamivudine (3TC, 30 mg/kg) from gestation day (GD) 11 to 20. On GD 21, DNA damage and MDR protein abundance were assessed by comet assay and western blotting, respectively. Moreover, a single IV dose of AZT or 3TC was administered on GD 21 and drug concentrations were measured in maternal blood and fetal liver by HPLC-UV. Chronic exposure to 3TC caused significantly higher DNA damage than AZT in fetal liver cells, whereas no differences were observed in maternal blood cells. Increased levels of BCRP protein were found in the placenta and fetal liver after AZT, but not 3TC, chronic in utero exposure. Contrarily, no modifications in the protein abundance of P-gp or MRP2 were found after sustained exposure to these drugs. The area under the curve of AZT in fetal liver was significantly lower in the AZT-pretreated rats than in the VEH or 3TC groups. Moreover, pre-administration of the BCRP inhibitor gefitinib (20 mg/kg, IP) increased AZT levels to the values observed in the VEH-treated group in this tissue. On the other hand, the disposition of 3TC in maternal blood or fetal liver was not modified after chronic treatment in either group. In conclusion, chronic exposure to AZT selectively induces BCRP expression in the placenta and fetal liver decreasing its own accumulation which may account for the lower DNA damage observed for AZT compared to 3TC in fetal liver cells.

Surfing the tide: Homeward migration of sea trout (Salmo trutta) in a Patagonian river.

This study evaluates the influence of marine and freshwater conditions on the timing of river entry and upstream migration of sea trout (Salmo trutta) in the Grande River of Tierra del Fuego, Patagonia. We analysed the in-river catch-and-release records from a group of fishing lodges that dominate the Grande River fishery during January-April 2008 (n = 5029 fish) as a function of environmental variables: tidal amplitude, stage in the lunar cycle, river discharge, and river water temperature along the homeward migration season. We discuss the value of the daily catch rate as an abundance index in the Grande river, then analyse the temporal structure of the tidal cycle in the Grande River estuary, a macro-tidal environment with a mean tidal amplitude of 5.7 m, and analyse the fit of a generalized additive model to trout catches on a daily basis in four sections along the river to identify the environmental variables that may affect trout abundance throughout the homeward migration. Fish catches in each section of the river were differentially affected by specific environmental variables: tidal amplitude had a positive and significant effect on catches in the lower river sections, whereas water temperature and river discharge significantly affected catches in upper sections (positive effect of temperature; negative effect of discharge). Catches in the lower section clearly reflect the river entry stage of the homeward migration, with a bi-modal shape significantly correlated with the tidal cycle. The first peak was composed mainly of larger multi-sea-winter trout that move upstream, whereas the second one had a wider range of fish lengths, including a large proportion of small and maybe nonreproductive trout that overwinter in the lower river. Based on our results, we conclude that the large tides in the Grande River estuary strongly affect the river entry timing of sea trout. The underlying mechanisms of this effect may be a combination of increased olfactory recognition and increased tidal transport modulated by the seasonal tidal cycle, which operates on trout during coastal migration to produce the pulses observed in the Grande River sea trout run. In the middle and upper sections of the river, where the tidal effect at river entry was dissipated as upstream migration progressed, trout catches increased with water temperature and decreased with river discharge, which may operate through their influence on in-river migration rate and abundance, but also through changes in catchability.

Peripheral Neural Sheath Breast Sarcoma: Case Report and Literature Review.

Primary sarcomas of the breast are heterogeneous neoplasms derived from the non-epithelial elements of the mammary gland. Malignant peripheral nerve sheath tumors comprise 5-10% of all malignant soft tissue sarcomas. Its heterogeneity and low incidence (1 in 100,000) limit the performance of prospective studies. Therefore, most published articles include individual reports and case series with a small number of patients, making it impossible to determine clear treatment standards in this scenario. A 36-year-old young woman with no personal history consulted the National Cancer Institute of Colombia with a 1-year progression of a rapidly growing mass in her left breast until reaching an approximate tumor size of 20 × 20 cm. Histopathological analysis with a tru-cut biopsy taken from the lesion revealed the presence of a breast sarcoma with positive staining for SOX-10 and S-100. A radical mastectomy as her first treatment included the resection of a costal arch and, therefore, the reconstruction of the chest wall with coverage of the defect with an extended latissimus dorsi flap followed by consolidation therapy with adjuvant radiotherapy (RT) and chemotherapy. Evidence regarding malignant peripheral nerve sheath sarcoma of the breast treatment corresponds to retrospective analyses and case reports with high heterogeneity and variability about strategies in surgical procedures and adjunctive therapy such as complementary chemotherapy and RT; therapeutic approach should always include a multidisciplinary team.

Occurrence, associated factors and soft tissue reconstructive therapy for buccal soft tissue dehiscence at dental implants: Consensus report of group 3 of the DGI/SEPA/Osteology Workshop.

OBJECTIVES: To systematically assess the literature and report on (1) the frequency of occurrence of buccal soft tissue dehiscence (BSTD) at implants, (2) factors associated with the occurrence of BSTD and (3) treatment outcomes of reconstructive therapy for the coverage of BSTD. MATERIALS AND METHODS: Two systematic reviews addressing focused questions related to implant BSTD occurrence, associated factors and the treatment outcomes of BSTD coverage served as the basis for group discussions and the consensus statements. The main findings of the systematic reviews, consensus statements and implications for clinical practice and for future research were formulated within group 3 and were further discussed and reached final approval within the plenary session. RESULTS: Buccally positioned implants were the factor most strongly associated with the risk of occurrence of BSTD, followed by thin tissue phenotype. At immediate implants, it was identified that the use of a connective tissue graft (CTG) may act as a protective factor for BSTD. Coverage of BSTD may be achieved with a combination of a coronally advanced flap (CAF) and a connective tissue graft, with or without prosthesis modification/removal, although feasibility of the procedure depends upon multiple local and patient-related factors. Soft tissue substitutes showed limited BSTD coverage. CONCLUSION: Correct three-dimensional (3D) positioning of the implant is of utmost relevance to prevent the occurrence of BSTD. If present, BSTD may be covered by CAF +CTG, however the evidence comes from a low number of observational studies. Therefore, future research is needed for the development of further evidence-based clinical recommendations.

Buccal soft tissue dehiscence defects at dental implants-associated factors and frequency of occurrence: A systematic review and meta-analysis.

AIM: To identify the factors associated with buccal peri-implant soft tissue dehiscences (BSTDs) and their frequency of occurrence. MATERIALS AND METHODS: Randomized controlled trials, controlled clinical trials, cohort studies, and case series assessing the frequency of occurrence of BSTD were included. BSTD was defined as an apical migration of the peri-implant soft tissues of ≥1 mm from the baseline examination (final restoration) or in comparison with the adjacent or contralateral natural tooth. Frequency distributions of BSTD related to the presence or absence of any surgical, prosthetic, or anatomic factor that may have contributed to the development of BSTD were recorded. Random-effects meta-analyses using odds ratios (OR) were performed to investigate the association of certain factors with the development of BSTD. RESULTS: Twenty-four articles were finally included belonging to 22 clinical investigations. Patients at higher risk of developing BSTD were associated with thin biotype (OR = 2.85 [1.40, 5.8], n = 5, p = .003) and with buccally placed implants (OR = 14.37 [4.58, 45.14], n = 3, p ≤ .001). Patients without connective tissue grafting (CTG) had greater odds of developing BSTD (OR = 9.00 [3.11, 26.02], n = 5, p ≤ .001), while buccal bone plate thickness of <1 mm and immediately placed implants were not associated with greater BSTD (OR = 1.29 [0.35, 4.77], n = 2, p = .704 and OR = 1.56 [0.46, 5.26], n = 4, p = .477, respectively). The frequency of occurrence of BSTD varied across the included studies with a range from 0% to 61%. CONCLUSIONS: Thin tissue biotype and buccally placed implants were associated with BSTD, whereas CTG seemed to have a protective effect. Thin buccal plates and immediately placed implants did not demonstrate a higher risk of BSTD.

Expanding the measurement of culture with a sample of two billion humans.

Culture has played a pivotal role in human evolution. Yet, the ability of social scientists to study culture is limited by the currently available measurement instruments. Scholars of culture must regularly choose between scalable but sparse survey-based methods or restricted but rich ethnographic methods. Here, we demonstrate that massive online social networks can advance the study of human culture by providing quantitative, scalable and high-resolution measurement of behaviourally revealed cultural values and preferences. We employ data across nearly 60 000 topic dimensions drawn from two billion Facebook users across 225 countries and territories. We first validate that cultural distances calculated from this measurement instrument correspond to traditional survey-based and objective measures of cross-national cultural differences. We then demonstrate that this expanded measure enables rich insight into the cultural landscape globally at previously impossible resolution. We analyse the importance of national borders in shaping culture and compare subnational divisiveness with gender divisiveness across countries. Our measure enables detailed investigation into the geopolitical stability of countries, social cleavages within small- and large-scale human groups, the integration of migrant populations and the disaffection of certain population groups from the political process, among myriad other potential future applications.

Cell Therapy Based on Gingiva-Derived Mesenchymal Stem Cells Seeded in a Xenogeneic Collagen Matrix for Root Coverage of RT1 Gingival Lesions: An In Vivo Experimental Study.

(1) Background: To investigate the effect of a xenogeneic collagen matrix (CMX) seeded with autologous gingiva-derived mesenchymal cells (GMSCs) when combined with a coronally advanced flap (CAF) in the treatment of localized gingival recession type 1 (RT1). (2) Methods: Dehiscence-type defects were created in seven dogs. GMSCs were isolated, transfected with a vector carrying green fluorescent protein (GFP) and expanded. Once chronified, the defects were randomly treated with (1) CAF plus the combination of CMX and GFP+ GMSCs, (2) CAF plus CMX with autologous fibroblasts, (3) CAF plus CMX and (4) CAF alone. Histological and clinical outcomes at 2- and 6-week healing periods were analyzed and compared among groups. (3) Results: Histologically, the addition of autologous cells to the CMX resulted in reduced inflammation and a variable degree of new cementum/bone formation. CMX plus GMSCs resulted in greater mean recession reduction (1.42; SD = 1.88 mm) and percentage of teeth with recession reduction of ≥2 mm (57%) when compared to the other groups, although these differences were not statistically significant. (4) Conclusions: The histometric and clinical results indicated a positive trend favouring the combination of CMX and GMSCs with the CAF when compared to the groups without cells, although these differences were not statistically significant.

Complications in sinus lifting procedures: Classification and management.

Open and closed sinus lifting procedures are predictable methods to augment the bone needed for appropriate implant placement in the posterior maxilla in cases where available bone is limited. However, these techniques may give rise to complications and associated comorbidities. In the case of open sinus lifting, perforation of the Schneiderian membrane during osteotomy is the most common complication, with an incidence rate of around 20%-25%. Apart from those complications associated with oral surgery in general (such as swelling or hematoma), there are specific complications of open sinus lifting procedures that may arise less frequently (chronic rhinosinusitis, hemorrhage, or ostium blockage by overfilling) but which may nevertheless compromise the viability of the graft and/or the implants and cause substantial discomfort to the patient. Closed sinus lifting is a less invasive approach that allows transcrestal placement of the implants in cases where there is sufficient residual bone height. However, it may also be associated with specific complications, including membrane perforation, benign paroxysmal positional vertigo, and implant displacement to the sinus cavity. New technologies have been proposed to reduce these complications and comorbidities associated with conventional sinus lifting procedures, such as the use of piezoelectric devices and hydraulic sinus lift or reamer burs. The evidence supporting their effectiveness and safety, however, is still lacking. A detailed medical history together with a thorough radiographic and clinical examination are essential prior to any kind of bone regenerative augmentation involving the maxillary sinus. Moreover, it is recommended to employ the most appropriate surgical technique for the specific characteristics of the case and, at the same time, accommodating the experience and skills of the surgeon.