Differences in platelet-rich plasma composition influence bone healing.

AIM: Platelet-rich plasma (PRP) is an autologous blood-derived material that has been used to enhance bone regeneration. Clinical studies, however, reported inconsistent outcomes. This study aimed to assess the effect of changes in leucocyte and PRP (L-PRP) composition on bone defect healing. MATERIALS AND METHODS: L-PRPs were prepared using different centrifugation methods and their regenerative potential was assessed in an in-vivo rat model. Bilateral critical-size tibial bone defects were created and filled with single-spin L-PRP, double-spin L-PRP, or filtered L-PRP. Empty defects and defects treated with collagen scaffolds served as controls. Rats were euthanized after 2 weeks, and their tibias were collected and analysed using micro-CT and histology. RESULTS: Double-spin L-PRP contained higher concentrations of platelets than single-spin L-PRP and filtered L-PRP. Filtration of single-spin L-PRP resulted in lower concentrations of minerals and metabolites. In vivo, double-spin L-PRP improved bone healing by significantly reducing the size of bone defects (1.08 ± 0.2 mm3 ) compared to single-spin L-PRP (1.42 ± 0.27 mm3 ) or filtered L-PRP (1.38 ± 0.28 mm3 ). There were fewer mast cells, lymphocytes, and macrophages in defects treated with double-spin L-PRP than in those treated with single-spin or filtered L-PRP. CONCLUSION: The preparation method of L-PRP affects their composition and potential to regenerate bone.

The effect of aging on the bone healing properties of blood plasma.

OBJECTIVES: Age-related changes in blood composition have been found to affect overall health. Thus, this study aimed to understand the effect of these changes on bone healing by assessing how plasma derived from young and old rats affect bone healing using a rat model. METHODS: . Blood plasma was collected from 6-month and 24-month old rats. Differences in elemental composition and metabolome were assessed using optical emission spectrometry and liquid mass spectrometry, respectively. Bilateral tibial bone defects were created in eight rats. Young plasma was randomly applied to one defect, while aged plasma was applied to the contralateral one. Rats were euthanized after two weeks, and their tibiae were analyzed using micro-CT and histology. The proteome of bone marrow was analyzed in an additional group of three rats. RESULTS: Bone-defects treated with aged-plasma were significantly bigger in size and presented lower bone volume/tissue volume compared to defects treated with young-plasma. Histomorphometric analysis showed fewer mast cells, macrophages, and lymphocytes in defects treated with old versus young plasma. The proteome analysis showed that young plasma upregulated pathways required for bone healing (e.g. RUNX2, platelet signaling, and crosslinking of collagen fibrils) whereas old plasma upregulated pathways, involved in disease and inflammation (e.g. IL-7, IL-15, IL-20, and GM-CSF signaling). Plasma derived from old rats presented higher concentrations of iron, phosphorous, and nucleotide metabolites as well as lower concentrations of platelets, citric acid cycle, and pentose phosphate pathway metabolites compared to plasma derived from young rats. CONCLUSION: bone defects treated with plasma-derived from young rats showed better healing compared to defects treated with plasma-derived from old rats. The application of young and old plasmas has different effects on the proteome of bone defects.

Osseointegration Pharmacology: A Systematic Mapping Using Artificial Intelligence.

Clinical performance of osseointegrated implants could be compromised by the medications taken by patients. The effect of a specific medication on osseointegration can be easily investigated using traditional systematic reviews. However, assessment of all known medications requires the use of evidence mapping methods. These methods allow assessment of complex questions, but they are very resource intensive when done manually. The objective of this study was to develop a machine learning algorithm to automatically map the literature assessing the effect of medications on osseointegration. Datasets of articles classified manually were used to train a machine-learning algorithm based on Support Vector Machines. The algorithm was then validated and used to screen 599,604 articles identified with an extremely sensitive search strategy. The algorithm included 281 relevant articles that described the effect of 31 different drugs on osseointegration. This approach achieved an accuracy of 95%, and compared to manual screening, it reduced the workload by 93%. The systematic mapping revealed that the treatment outcomes of osseointegrated medical devices could be influenced by drugs affecting homeostasis, inflammation, cell proliferation and bone remodeling. The effect of all known medications on the performance of osseointegrated medical devices can be assessed using evidence mappings executed with highly accurate machine learning algorithms.

Patient-Reported Outcomes of Metal and Acrylic Resin Removable Partial Dentures: A Systematic Review and Meta-Analysis.

PURPOSE: Metal removable partial dentures (RPDs) are often considered long-term treatment options for partially edentulous patients, while acrylic resin RPDs are considered interim treatments. The aim of this review was to compare metal and acrylic resin RPDs regarding patient-reported outcomes for partially edentulous individuals. MATERIALS AND METHODS: Four databases (MEDLINE, EMBASE, CENTRAL, and Web of Science) were systematically searched for observational studies and randomized controlled trials comparing patient-reported outcomes between metal and acrylic resin RPDs. The primary outcome was patient satisfaction. Included studies were assessed for risk of bias using the Cochrane risk of bias in nonrandomized studies of interventions tool (ROBINS-I) and the Cochrane Collaboration Risk of Bias Tool for Randomized Controlled Trials. The level of evidence was evaluated using Oxford Center for Evidence-based Medicine tool. A random-effects model was used to analyze the data. RESULTS: A total of 15 studies were included in the systematic review; 10 in the meta-analysis. The pooled effect size for patient satisfaction and oral health-related quality of life showed no statistical significant difference between metal and acrylic resin dentures (0.22, 95% confidence interval -0.01, 0.45, p = 0.06; 1.45, 95% confidence interval -2.43, 5.33, p = 0.46, respectively). Compliance with using RPDs was significantly higher in patients with metal compared to patients with acrylic resin dentures (pooled odds ratio = 0.57, 95% confidence interval 0.45, 0.73, p < 0.001). Most studies had critical to serious risk of bias and low level of evidence. CONCLUSIONS: The reviewed studies showed that there was no significant difference between metal and acrylic resin RPDs in patient satisfaction and oral health-related quality of life. Metal dentures were associated with higher patient compliance rates and were preferred more by patients compared to acrylic resin dentures. However, the reviewed studies had low levels of evidence and therefore, high-quality randomized controlled trials are needed to conclusively address the question of this review.

Prevalence and severity of gingivitis in school students aged 6-11 years in Tafelah Governorate, South Jordan: results of the survey executed by National Woman's Health Care Center.

BACKGROUND: A cross-sectional census was conducted on 994 public school students aged 6-11 years living in 3 different parts of Tafeleh Governorate-South of Jordan, to determine the prevalence, and severity of gingivitis and to evaluate the oral hygiene habits among them as a part a survey executed by National Woman's Health Care Center. All students were examined for gingival index (GI) and plaque index (PI), information about oral hygiene habits was recorded. RESULTS: Only 29.8 % had healthy gingiva, 38.5 % had mild gingivitis, 31.4 % had moderate gingivitis, and 0.3 % had severe gingivitis. The difference between both genders was not statistically significant P > 0.05. 36.8 % of the examined students never brushed their teeth. Average gingival index (GI) and average plaque index (PI) were 0.77 and 0.61 respectively. CONCLUSIONS: Fair oral hygiene with mild to moderate gingivitis is highly prevalent among Tafelah school children. This study indicated that oral health status among schoolchildren in Tafelah is poor and needs to be improved. Long-term school based oral health education programme is highly recommended.

Anatomical landmarks of maxillary bifurcated first premolars and their influence on periodontal diagnosis and treatment.

OBJECTIVE: To assess the anatomical landmarks of the roots of bifurcated maxillary first premolars and study their effect on the diagnosis and management of periodontal disease. METHODS: One hundred sixty-five maxillary first premolars were selected. The frequency of single-, two-rooted, and three-rooted premolars was assessed, but only the dual-rooted were used for the purpose of this study. For each tooth, the following measurements were obtained using a micrometer caliper: buccal and palatal root length, mesial and distal root trunk length, crown length, and width of the furcation entrance. The types of root trunk were classified according to the ratio of root trunk height to root length into types A, B and C. Root trunk types A, B and C are defined as root trunks involving the cervical third or less, up to half of the length of the root, or greater than the apical half of the root, respectively. The presence of any root grooves and concavities, as well as bifurational ridges, was assessed. The crown to root ratio was calculated. RESULTS: Of the 165 maxillary first premolar teeth retrieved, 100 (60.6%) were two-rooted, 62 (37.57%) were single-rooted, and three (1.81%) were triple-rooted. Type A root trunks comprised only 7% of the examined teeth, while types B and C had more or less comparable results (46% and 47% respectively). Type B was more common in distal root trunks while type C was dominant in mesial root trunks. Bifurcation ridges were observed in 37% of the teeth; the mean root trunk length was greater in teeth with bifurcation ridges than in teeth without (7.41 mm vs. 5.96 mm). Root grooves and concavities were found in 96% of the mesial aspects of the root, and in 57% of the palatal aspect of the buccal root. The mean width of the furcation entrance was 0.89 +/- 0.19 mm (range 0.39-1.28). The average crown to root ratio was 0.69:1. CONCLUSION: Awareness of root surface anatomical variations may help the practitioner when assessing the diagnosis, treatment plan and prognosis of periodontally involved two-rooted maxillary premolars.